Evaluation of a flat fielding method for simultaneous DBT and MI acquisition

We are developing a prototype system for simultaneous digital breast tomosynthesis (DBT) and mechanical imaging (MI). MI maps the local pressure distribution during clinical exams, to distinguish breast abnormalities from the normal tissue. Both DBT alone, and MI when combined with digital mammography, have demonstrated the ability to reduce false positives; however, the benefit of combining DBT with MI has not been investigated. A practical limitation in simultaneous DBT and MI is the presence of the MI sensor in DBT images. Metallic elements of the sensor generate noticeable artifacts, which may interfere with clinical analysis. Previously, we shown that the sensor artifacts can be reduced by flat fielding, which combines projections of the sensor acquired with and without the breast. In this paper we evaluate the flat fielding by assessing artifact reduction and visibility of breast abnormalities. Images of a physical anthropomorphic breast phantom were acquired using a clinical wide-angle DBT system. Visual evaluation was performed by experienced medical physicists. Image quality descriptors were calculated in images with and without flat fielding. To evaluate the visibility of abnormalities we estimated the full width at half maximum (FWHM) for calcifications modeled in the phantom. Our preliminary results suggest a substantial reduction of artifacts by flat fielding (on average 83%). Few noticeable artifacts remain near the breast edge, in the reconstructed image with the sensor in focus. We observed a 17% reduction in the FWHM. Future work would include a detailed assessment, and method optimization using virtual trials as a design aid.