Cone-beam breast computed tomography with a displaced flat panel detector array

Purpose: In cone-beam computed tomography (CBCT), and in particular in cone-beam breast computed tomography (CBBCT), an important issue is the reduction of the image artifacts produced by photon scatter and the reduction of patient dose. In this work, the authors propose to apply the detector displacement technique (also known as asymmetric detector or “extended view” geometry) to approach this goal. Potentially, this type of geometry, and the accompanying use of a beam collimator to mask the unirradiated half-object in each projection, permits some reduction of radiation dose with respect to conventional CBBCT and a sizeable reduction of the overall amount of scatter in the object, for a fixed contrast-to-noise ratio (CNR). Methods: The authors consider a scan configuration in which the projection data are acquired from an asymmetrically positioned detector that covers only one half of the scan field of view. Monte Carlo simulations and measurements, with their CBBCT laboratory scanner, were performed using PMMA phantoms of cylindrical (70-mm diameter) and hemiellipsoidal (140-mm diameter) shape simulating the average pendant breast, at 80 kVp. Image quality was evaluated in terms of contrast, noise, CNR, contrast-to-noise ratio per unit of dose (CNRD), and spatial resolution as width of line spread function for high contrast details. Results: Reconstructed images with the asymmetric detector technique deviate less than 1% from reconstruction with a conventional symmetric detector (detector view) and indicate a reduction of the cupping artifact in CT slices. The maximum scatter-to-primary ratio at the center of the phantom decreases by about 50% for both small and large diameter phantoms (e.g., from 0.75 in detector view to 0.40 in extended view geometry at the central axis of the 140-mm diameter PMMA phantom). Less cupping produces an increase of the CT number accuracy and an improved image detail contrast, but the associated increase of noise observed may produce a decrease of detail CNR. By simulating the energy deposited inside the phantoms, the authors evaluated a maximum 50% reduction of the absorbed dose at the expense of a decrease of CNR, for the half beam irradiation of the object performed with the displaced detector technique with respect to full beam irradiation. The decrease in CNR, and in absorbed dose as well, translates into a detail CNRD showing values comparable to or higher than the ones obtained for a conventional symmetric detector technique, attributed to the effect of decreased scatter in particular at the axis of the irradiated object. An estimate is provided (about 12%) for the average dose reduction possible in CBBCT at constant CNR for the average uncompressed breast (14 cm diameter, 50% glandularity), in case of minimum image overlapping in extended view. Conclusions: Simulations and experiments show that CBCT reconstructions with the displaced detector technique and with a half beam collimator are less affected by scatter artifacts, which could lead to some decrease of the radiation dose to the irradiated object with respect to a conventional reconstruction. This dose reduction is associated with increase of noise, decrease of CNR, but equal or improved CNRD values. The use of a small area detector would allow also to reduce the apparatus cost and to improve the data transfer speed with a corresponding increment of frame rate.