Quantification of contrast-enhanced digital breast tomosynthesis

Digital breast tomosynthesis (DBT) is a technique in which tomographic images of the breast are reconstructed from X-ray projection images acquired over a limited angular range In contrast-enhanced DBT (CE-DBT) functional information is observed by administration of an X-ray contrast agent. To date, 13 patients have had CE-DBT in an ongoing clinical trial at the University of Pennsylvania. Using a simplified physiological model, a 0.5 cm thick breast lesion is expected to change X-ray transmission by approximately 5% for a 4 cm thick compressed breast. In this paper, we consider the technical requirements necessary to quantitatively analyze CE-DBT exams by investigating the effect of scatter, and patient motion on quantifying iodine uptake. These parameters were evaluated by means of experiments, analysis of clinical images, and theoretical modelling.