Reduced anatomical clutter in digital breast tomosynthesis with statistical iterative reconstruction

Purpose Digital breast tomosynthesis (DBT) has been shown to somewhat alleviate the breast tissue overlapping issues of two‐dimensional (2D) mammography. However, the improvement in current DBT systems over mammography is still limited. Statistical image reconstruction (SIR) methods have the potential to reduce through‐plane artifacts in DBT, and thus may be used to further reduce anatomical clutter. The purpose of this work was to study the impact of SIR on anatomical clutter in the reconstructed DBT image volumes. Methods An SIR with a slice‐wise total variation (TV) regularizer was implemented to reconstruct DBT images which were compared with the clinical reconstruction method (filtered backprojection). The artifact spread function (ASF) was measured to quantify the reduction of the through‐plane artifacts level in phantom studies and microcalcifications in clinical cases. The anatomical clutter was quantified by the anatomical noise power spectrum with a power law fitting model: NPS a ( f ) = α f − β . The β values were measured from the reconstructed image slices when the two reconstruction methods were applied to a cohort of clinical breast exams ( N = 101) acquired using Hologic Selenia Dimensions DBT systems. Results The full width half maximum (FWHM) of the measured ASF was reduced from 8.7 ± 0.1 mm for clinical reconstruction to 6.5 ± 0.1 mm for SIR which yields a 25% reduction in FWHM in phantom studies and the same amount of ASF reduction was also found in clinical measurements from microcalcifications. The measured β values for the two reconstruction methods were 3.17 ± 0.36 and 2.14 ± 0.39 for the clinical reconstruction method and the SIR method, respectively. This difference was statistically significant ( P << 0.001). The dependence of β on slice location using either method was negligible. Conclusions Statistical image reconstruction enabled a significant reduction of both the through‐plane artifacts level and anatomical clutter in the DBT reconstructions. The β value was found to be β ≈2.14 with the SIR method. This value stays in the middle between the β ≈1.8 for cone beam CT and β ≈3.2 for mammography. In contrast, the measured β value in the clinical reconstructions ( β ≈3.17) remains close to that of mammography.