Analysis of lung nodule detectability and anatomical clutter in tomosynthesis imaging of the chest

Tomosynthesis is an imaging technique that has gained renewed interest with recent advancements of flat-panel digital detectors. Because of the wide range of potential applications, a systematic analysis of 3D tomosynthesis imaging systems would contribute to the understanding and development. This paper extends a systematic evaluation of thoracic tomosynthetic imaging performance as a function of imaging parameters, such as the number of projections, tomosynthesis orbital extent, and reconstruction filters. We evaluate lung nodule detectability and anatomical clutter as a function of tomosynthesis orbital extent using anthropomorphic phantoms and a table-top acquisition system. Tomosynthesis coronal slices were reconstructed using the FDK algorithm for cone-beam geometry from 91 projections uniformly distributed over acquisition orbital extents (θ) ranging from 10° to 180°. Visual comparisons of different tomosynthesis reconstructions of a lung nodule show the progressive decrease of anatomical clutter as θ increases. Additionally, three quantitative figures of merit were computed and compared: signal-difference-to-noise ratio (SDNR), anatomical clutter power spectrum (PS), and theoretical detectability index (DI). Lung nodule SDNR increases as θ increases from 0° to 120°. Anatomical clutter PS shows that the clutter magnitude and correlation decrease as θ increases, increasing detectability. Similarly, 2D and 3D DI increase as θ increases in the anatomical dominated exposure ranges. On the other hand, 2D slice DI is lower than the 3D DI for larger θ (e.g. 120°), because of the information loss in the depth direction for 2D slices. In other words, inspecting 3D is better for larger acquisition orbital extents, because the extra information acquired at larger angles cannot be fully recovered from 2D tomosynthesis reconstruction slices. In summary, detectability in tomosynthesis reconstructions for thoracic imaging increases as fixed dose is distributed over a larger acquisition orbital extent (up to 120°).