Evaluation of a variable dose acquisition technique for microcalcification and mass detection in digital breast tomosynthesis

In this article the authors evaluate a recently proposed variable dose (VD)-digital breast tomosynthesis (DBT) acquisition technique in terms of the detection accuracy for breast masses and microcalcification (MC) clusters. With this technique, approximately half of the total dose is used for one center projection and the remaining dose is split among the other tomosynthesis projection views. This acquisition method would yield both a projection view and a reconstruction view. One of the aims of this study was to evaluate whether the center projection alone of the VD acquisition can provide equal or superior MC detection in comparison to the 3D images from uniform dose (UD)-DBT. Another aim was to compare the mass-detection capabilities of 3D reconstructions from VD-DBT and UD-DBT. In a localization receiver operating characteristic (LROC) observer study of MC detection, the authors compared the center projection of a VD acquisition scheme (at 2 mGy dose) with detector pixel size of 100 mu m with the UD-DBT reconstruction (at 4 mGy dose) obtained with a voxel size of 100 mu m. MCs with sizes of 150 and 180 mu m were used in the study, with each cluster consisting of seven MCs distributed randomly within a small volume. Reconstructed images in UD-DBT were obtained from a projection set that had a total of 4 mGy dose. The current study shows that for MC detection, using the center projection alone of VD acquisition scheme performs worse with area under the LROC curve (A(L)) of 0.76 than when using the 3D reconstructed image using the UD acquisition scheme (A(L)=0.84). A 2D ANOVA found a statistically significant difference (p=0.038) at a significance level of 0.05. In the current study, although a reconstructed image was also available using the VD acquisition scheme, it was not used to assist the MC detection task which was done using the center projection alone. In the case of evaluation of detection accuracy of masses, the reconstruction with VD-DBT (A(L)=0.71) was compared to that obtained from the UD-DBT (A(L)=0.78). The authors found no statistically significant difference between the two (p-value=0.22), although all the observers performed better for UD-DBT.