Feasibility of stationary digital breast tomosynthesis as an effective screening tool for patients with augmentation mammoplasty

Conventional mammography techniques used for imaging patients that have undergone augmentation mammoplasty produce substandard images, incomplete evaluation of breast tissue, and can cause discomfort to the patient. Typically, four images of each breast are acquired (double the amount of a patient without implants), two with the implant in view and two "pushback" views, which moves the implant posteriorly out of the field of view. The "pushback" view can be difficult to perform when there is encapsulation of the breast tissue around the implant. In severe cases, performing the technique can cause unwarranted pain to the patient. This technique can also result in up to a three times increase in procedure time which leads to lower patient throughput. Using 2D mammography, it is difficult to interpret tissue above and below implants due to the overlap of breast tissue and implant. Recently, Digital Breast Tomosynthesis (DBT) has been shown to aid in the localization and diagnosis of breast masses by removing underlying and overlying tissue from the plane of interest in 3D space. However, commercial DBT systems have motion blurring of the projection images associated with x-ray source motion. To overcome this limitation, stationary DBT (s-DBT) has been developed. Here we report the feasibility of using s-DBT as an effective screening tool for patients who have undergone augmentation mammoplasty. Qualitative image analysis is completed on reconstruction images of tomosynthesis phantoms combined with implants. Reconstruction images show that it is possible to locate lesions above and below the implant using a clinically relevant entrance dose.