title: Breast tomosynthesis using the multiple projection algorithm adapted for stationary detectors.
abstract: OBJECTIVE
  The aim of this study is to investigate the validity of using the Multiple Projection Algorithm (MPA) for Breast Tomosynthesis (BT) using real projection images acquired with phantoms at a clinical setting.
  
  
  METHODS
  The CIRS-BR3D phantom with ranging thicknesses between 3 cm and 6 cm was used for all image quality evaluations. Five sets of measurements were acquired, each comprised of a 2D mammographic image followed by a set of 25 projections within an arc length of 50°. A reconstruction algorithm based on the MPA was adapted for partial isocentric rotation using a stationary detector. For reference purposes, a Back Projection (BP) algorithm was also developed for this geometry. The performance of the algorithms was evaluated, in combination with pre-filtering of the projections, in comparative studies that involved also a comparison between tomosynthesis slices and 2D mammograms.
  
  
  RESULTS
  Evaluation of tomosynthesis slices reconstructed with BP and MPA showed close performance for the two algorithms with no considerable differences in feature detection, size and appearance of the background tissue with the MPA running faster the overall process. Pre-filtering of the projections, led to better BT images compared to non-filtering. Increased thickness resulted in limited detection of the features of interest, especially the smaller sized ones. In these cases, the filtered BT slices allowed improved visualization due to removed superimposed tissue compared to the 2D images. The different breast-like slab arrangements in phantoms of the same thickness demonstrated a slight influence on the quality of reconstructed features.
  
  
  CONCLUSIONS
  The MPA which had been applied previously to reconstruct tomograms from projections acquired at synchrotron facilities, is a time efficient algorithm, and is fully compliant with and can be successfully used in BT clinical systems. Compared to 2D mammography, BT shows advantage in visualizing features of small size and for increased phantom thickness or features within a dense background with superimposed structures.
authors.affiliation: Department of Medical Physics, School of Medicine, University of Patras, Patras, Greece.
authors.forename: A
authors.initials: A
authors.lastname: Malliori
authors.affiliation: Department of Medical Electronics, Technical University of Varna, Varna, Bulgaria.
authors.forename: K
authors.initials: K
authors.lastname: Bliznakova
authors.affiliation: Department of Medical Physics, School of Medicine, University of Patras, Patras, Greece.
authors.forename: Z
authors.initials: Z
authors.lastname: Bliznakov
authors.affiliation: Department of Radiology, University Hospitals Leuven, Herestraat, Leuven, Belgium.
authors.forename: L
authors.initials: L
authors.lastname: Cockmartin
authors.affiliation: Department of Radiology, University Hospitals Leuven, Herestraat, Leuven, Belgium.
authors.forename: H
authors.initials: H
authors.lastname: Bosmans
authors.affiliation: Department of Medical Physics, School of Medicine, University of Patras, Patras, Greece.
authors.forename: N
authors.initials: N
authors.lastname: Pallikarakis
mesh_terms: D000465:Algorithms; D001940:Breast / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008327:Mammography / Q000379:methods*; D019047:Phantoms, Imaging
keywords: Breast tomosynthesis; image quality; multiple projection algorithm; reconstruction algorithms; stationary detector