digital tomosynthesis

Tomosynthesis, also digital tomosynthesis, is a method for performing high-resolution limited-angle tomography at mammographic dose levels.

Digital tomosynthesis is expected to replace conventional mammography due to the fact that it increases the sensitivity of breast cancer detection, as well as improving the patient procedure.[1] In digital tomosynthesis, unlike conventional mammography, minimal pressure is needed during the acquisition. This makes the experience less painful, and also reduces compression artifacts in the tissue images.[2] A subject of ongoing research, early findings have also shown that the mean glandular dose of digital breast tomosynthesis is comparable to that of full field digital mammography.[3]

The tomosynthesis technique dates back to the 1930s and belongs to the category of geometric or linear tomography.[4]

Because the data acquired are incomplete, tomosynthesis is unable to offer the extremely narrow slice widths that CT offers. However, higher resolution detectors can be used, allowing very high in-plane resolution, even if the Z-axis resolution is poor. The primary interest in tomosynthesis is in breast imaging, as an extension to mammography, where it may offer better detection rates with little extra increase in radiation.[5]

Tomosynthesis is now Food and Drug Administration (FDA) approved for use in breast cancer screening.[6]
Differences with conventional CT

Digital tomosynthesis combines digital image capture and processing with simple tube/detector motion as used in conventional radiographic tomography. Although there are some similarities to CT, it is a separate technique. In CT, the source/detector makes a complete 360-degree rotation about the subject obtaining a complete set of data from which images may be reconstructed. In digital tomosynthesis, only a small rotation angle (e.g., 40 degrees) with a small number of discrete exposures (e.g., 10) are used. This incomplete set of data can be digitally processed to yield images similar to conventional tomography with a limited depth of field. However, because the image processing is digital, a series of slices at different depths and with different thicknesses can be reconstructed from the same acquisition, saving both time and radiation exposure.

Reconstruction algorithms for tomosynthesis are significantly different from those of conventional CT because the conventional filtered back projection algorithm requires a complete set of data. Iterative algorithms based upon expectation maximization are most commonly used, but are extremely computationally intensive. Some manufacturers have produced practical systems using off-the-shelf GPUs to perform the reconstruction.