Impact of angular range of digital breast tomosynthesis on mass detection in dense breasts

The detection of cancerous mass lesions using digital breast tomosynthesis (DBT) has been shown to be limited in patients with dense breasts. Detection may potentially be improved by increasing the DBT angular range (AR), which reduces breast structural noise and increases object contrast in the reconstructed slice. We investigate the impact of DBT AR on the detection of masses in a simulation study using a cascaded linear system model (CLSM) for DBT. We compare the mass conspicuity between wide-and narrow-AR DBT system in a clinical pilot study. The simulation results show reduced in-plane breast structural noise and increased in-plane detectability of masses with increasing AR. The clinical results show that masses are more conspicuous in wide-AR DBT than narrow-AR DBT. Our study indicates that the detection of mass lesions in dense breasts can be improved by increasing DBT AR.