Computational Breast Anatomy Simulation Using Multi-Scale Perlin Noise

Assessment of Volumetric Dense Tissue Segmentation in Tomosynthesis Using Deep Virtual Clinical Trials

The adoption of artificial intelligence (AI) in medical imaging requires careful evaluation of machine-learning algorithms. We propose the use of a "deep virtual clinical trial" (DeepVCT) method to effectively evaluate the performance of AI algorithms. In this paper, DeepVCTs have been proposed to elucidate limitations of AI applications and predictions of clinical outcomes, avoiding biases in study designs. The DeepVCT method was used to evaluate the performance of nnU-Net models in assessing volumetric breast density (VBD) from digital breast tomosynthesis (DBT) images. In total, 2,010 anatomical breast models were simulated. Projections were simulated using the acquisition geometry of a clinical DBT system. The projections were reconstructed using 0.1, 0.2, and 0.5 mm plane spacing. nnU-Net models were developed using the center-most planes of the reconstructions with the respective ground-truth. The results show that the accuracy of the nnU-Net improves significantly with DBT images reconstructed with 0.1 mm plane spacing (78.4×205.3×40.1 mm3). The segmentations resulted in Dice values up to 0.84 with area under the receiver operating characteristic curve of 0.92. The optimization of plane spacing for VBD assessment was used as an exemplar of a DeepVCT application, allowing us to interpret better the input parameters and outcomes of the nnU-Net. Thus, DeepVCTs can provide a plethora of evidence to predict the efficacy of these algorithms using large-scale simulation-based data.

THUBreast: an open-source breast phantom generation software for x-ray imaging and dosimetry

Objective. Establishing realistic phantoms of human anatomy is a continuing concern within virtual clinical trials of breast x-ray imaging. However, little attention has been paid to glandular distribution within these phantoms. The principal objective of this study was to develop breast phantoms considering the clinical glandular distribution.Approach. This research introduces an innovative method for integrating glandular distribution information into breast phantoms. We have developed an open-source software, THUBreast44http://github.com/true02Hydrogen/THUBreast/, which generates breast phantoms that accurately replicate both the structural texture and glandular distribution, two crucial elements in breast x-ray imaging and dosimetry. To validate the efficacy of THUBreast, we assembled three groups of breast phantoms (THUBreast, patient-based, homogeneous) for irradiation simulation and calculated the power-law exponents (β) and mean glandular dose (Dg), indicators of texture realism and radiation risk, respectively, utilizing MC-GPU.Main results. Upon the computation of theDgfor the THUBreast phantoms, it was found to be in agreement with that absorbed by the phantoms based on patients, with an average deviation of 4%. The estimates of averageDgthus obtained were on average 23% less than those computed for the homogeneous phantoms. It was observed that the homogeneous phantoms did overestimate the averageDgby 30% when compared to the phantoms based on patients. The mean value ofβfor the images of THUBreast phantoms was found to be 2.92 ± 0.08, which shows a commendable agreement with the findings of prior investigations.Significance. It is evidently clear from the results that THUBreast phantoms have a preliminary good performance in both imaging and dosimetry in terms of indicators of texture realism and glandular dose. THUBreast represents a further step towards developing a powerful toolkit for comprehensive evaluation of image quality and radiation risk.

Non-Isocentric Geometry for Next-Generation Tomosynthesis With Super-Resolution

Our lab at the University of Pennsylvania (UPenn) is investigating novel designs for digital breast tomosynthesis. We built a next-generation tomosynthesis system with a non-isocentric geometry (superior-to-inferior detector motion). This paper examines four metrics of image quality affected by this design. First, aliasing was analyzed in reconstructions prepared with smaller pixelation than the detector. Aliasing was assessed with a theoretical model of r -factor, a metric calculating amplitudes of alias signal relative to input signal in the Fourier transform of the reconstruction of a sinusoidal object. Aliasing was also assessed experimentally with a bar pattern (illustrating spatial variations in aliasing) and 360°-star pattern (illustrating directional anisotropies in aliasing). Second, the point spread function (PSF) was modeled in the direction perpendicular to the detector to assess out-of-plane blurring. Third, power spectra were analyzed in an anthropomorphic phantom developed by UPenn and manufactured by Computerized Imaging Reference Systems (CIRS), Inc. (Norfolk, VA). Finally, calcifications were analyzed in the CIRS Model 020 BR3D Breast Imaging Phantom in terms of signal-to-noise ratio (SNR); i.e., mean calcification signal relative to background-tissue noise. Image quality was generally superior in the non-isocentric geometry: Aliasing artifacts were suppressed in both theoretical and experimental reconstructions prepared with smaller pixelation than the detector. PSF width was also reduced at most positions. Anatomic noise was reduced. Finally, SNR in calcification detection was improved. (A potential trade-off of smaller-pixel reconstructions was reduced SNR; however, SNR was still improved by the detector-motion acquisition.) In conclusion, the non-isocentric geometry improved image quality in several ways.

PAAQ: Paired Alternating AcQuisitions for virtual high frame rate multichannel cardiac fluorescence microscopy

In vivo fluorescence microscopy is a powerful tool to image the beating heart in its early development stages. A high acquisition frame rate is necessary to study its fast contractions, but the limited fluorescence intensity requires sensitive cameras that are often too slow. Moreover, the problem is even more complex when imaging distinct tissues in the same sample using different fluorophores. We present Paired Alternating AcQuisitions, a method to image cyclic processes in multiple channels, which requires only a single (possibly slow) camera. We generate variable temporal illumination patterns in each frame, alternating between channel-specific illuminations (fluorescence) in odd frames and a motion-encoding brightfield pattern as a common reference in even frames. Starting from the image pairs, we find the position of each reference frame in the cardiac cycle through a combination of image-based sorting and regularized curve fitting. Thanks to these estimated reference positions, we assemble multichannel videos whose frame rate is virtually increased. We characterize our method on synthetic and experimental images collected in zebrafish embryos, showing quantitative and visual improvements in the reconstructed videos over existing nongated sorting-based alternatives. Using a 15 Hz camera, we showcase a reconstructed video containing two fluorescence channels at 100 fps.

Multiclass Segmentation of Breast Tissue and Suspicious Findings: A Simulation-Based Study for the Development of Self-Steering Tomosynthesis

In breast tomosynthesis, multiple low-dose projections are acquired in a single scanning direction over a limited angular range to produce cross-sectional planes through the breast for three-dimensional imaging interpretation. We built a next-generation tomosynthesis system capable of multidirectional source motion with the intent to customize scanning motions around "suspicious findings". Customized acquisitions can improve the image quality in areas that require increased scrutiny, such as breast cancers, architectural distortions, and dense clusters. In this paper, virtual clinical trial techniques were used to analyze whether a finding or area at high risk of masking cancers can be detected in a single low-dose projection and thus be used for motion planning. This represents a step towards customizing the subsequent low-dose projection acquisitions autonomously, guided by the first low-dose projection; we call this technique "self-steering tomosynthesis." A U-Net was used to classify the low-dose projections into "risk classes" in simulated breasts with soft-tissue lesions; class probabilities were modified using post hoc Dirichlet calibration (DC). DC improved the multiclass segmentation (Dice = 0.43 vs. 0.28 before DC) and significantly reduced false positives (FPs) from the class of the highest risk of masking (sensitivity = 81.3% at 2 FPs per image vs. 76.0%). This simulation-based study demonstrated the feasibility of identifying suspicious areas using a single low-dose projection for self-steering tomosynthesis.

A 3D Mathematical Breast Texture Model With Parameters Automatically Inferred From Clinical Breast CT Images

A numerical realistic 3D anthropomorphic breast model is useful for evaluating breast imaging applications. A method is proposed to model small and medium-scale fibroglandular and intra-glandular adipose tissues observed in the center part of clinical breast CT images. The method builds upon a previously proposed model formulated as stochastic geometric processes with mathematically tractable parameters. In this work, the medium-scale parameters were automatically and objectively inferred from breast CT images. We hypothesized that a set of random ellipsoids exhibiting cluster interaction is representative to model the medium-scale intra-glandular adipose compartments. The ellipsoids were reconstructed using a multiple birth, death and shift algorithm. Then, a Matérn cluster process was used to fit the reconstructed ellipsoid centers. Finally, distributions of the ellipsoid shapes and orientations were estimated using maximum likelihood estimators. Feasibility was demonstrated on 16 volumes of interests (VOI). To assess the realism of the 3D breast texture model, β and LFE metrics computed in simulated projection images of simulated texture realizations and clinical images were compared. Visual realism was illustrated. For 12 out of 16 VOIs, our hypothesis on clustering interaction process is confirmed. The average β values from simulated texture images (3.7 to 4.2) of the 12 different VOIs are higher than the average β value from 2D clinical images (2.87). LFE of simulated texture images and clinical mammograms are similar. Compared to our previous model, whereby simulation parameters were based upon empirical observations, our inference method substantially augments the ability to generate textures with higher visual realism and larger morphological variety.

Performance evaluation of digital breast tomosynthesis systems: physical methods and experimental data

Digital breast tomosynthesis (DBT) has become a well-established breast imaging technique, whose performance has been investigated in many clinical studies, including a number of prospective clinical trials. Results from these studies generally point to non-inferiority in terms of microcalcification detection and superior mass-lesion detection for DBT imaging compared to digital mammography (DM). This modality has become an essential tool in the clinic for assessment and ad-hoc screening but is not yet implemented in most breast screening programmes at a state or national level. While evidence on the clinical utility of DBT has been accumulating, there has also been progress in the development of methods for technical performance assessment and quality control of these imaging systems. DBT is a relatively complicated ‘pseudo-3D’ modality whose technical assessment poses a number of difficulties. This paper reviews methods for the technical performance assessment of DBT devices, starting at the component level in part one and leading up to discussion of system evaluation with physical test objects in part two. We provide some historical and basic theoretical perspective, often starting from methods developed for DM imaging. Data from a multi-vendor comparison are also included, acquired under the medical physics quality control protocol developed by EUREF and currently being consolidated by a European Federation of Organisations for Medical Physics working group. These data and associated methods can serve as a reference for the development of reference data and provide some context for clinical studies.