Evaluation of a photon-counting breast tomosynthesis imaging system

Digital breast tomosynthesis promises solutions to many of the problems currently associated with projection mammography, including elimination of artifactual densities due to the superposition of normal tissues and increasing the conspicuity of true lesions that would otherwise be masked by superimposed normal tissue. We have investigated tomosynthesis using 45 photon counting, orientation sensitive, linear detectors which are precisely aligned with the focal spot of the x-ray source. The x-ray source and the digital detectors are scanned in a continuous motion across the object (patient); each linear detector collecting an image at a distinct angle. Simulations of the imaging system were performed to evaluate the effect of. (1) the range of angles over which projection images are acquired; and (2) the number of projection images acquired used in the tomosynthetic reconstruction. Two different simulations were evaluated; the first was a numerical simulation of a tungsten wire; the second consisted of tomosynthetic reconstructions of a cadaveric rabbit, in which the number and/or range of projection angles was varied. We have shown, analytically and through these simulations, that both the use of more projection angles and the use of a larger range of projection angles improve the image quality of tomosynthetic image reconstructions. The use of a photon-counting x-ray detector system allows us to consider image acquisition geometries with a large number of projection angles, as there is no additive detector noise to degrade the projection or reconstructed images. The maximum number of projection angles and the range of projections angles do have upper practical limits; the range of projection angles is determined predominantly by the detector element size.