The advent of anthropomorphic three-dimensional breast phantoms for X-ray imaging.

Anthropomorphic breast phantoms are both, computational and physical, anatomically and radiologically realistic models of the human female breast, and are considered an excellent tool for development, comparing, characterizing and optimizing of novel and existing breast screening and diagnostic modalities. Their role in the objective assessment of diagnostic task performance of breast imaging systems without conducting high cost and time-consuming clinical trials, as well as in developing and optimizing clinical protocols and image reconstruction algorithms is tangible increasing. The aim of this paper is to present a historical journey from the advent of the breast anthropomorphic models used with x-ray modalities, their further development and realistic improvement, to current achievements. Anthropomorphic breast models are both computational and physical. Computational phantoms are mainly based on mathematical formulations and patient medical images. The mathematical breast models consist of mathematical description of the breast structures, while the patient-based are created from segmented clinical datasets acquired by dedicated breast Computed Tomography. The later approach guarantees a very high degree of realism. Molding techniques, 3D printing and low cost paper-based approaches are the main methods for creation of physical breast anthropomorphic models. Among them, 3D printing technologies provide an excellent opportunity to create realistic models of the breast by using a number of printing materials with x-ray characteristics similar to these of breast tissues. The anatomical and radiological realism of the anthropomorphic breast phantoms together with the possibility for unlimited exposure during important diagnostic tasks is transforming them into a key instrument of every Radiology Department.