Design, development and use of a deformable breast phantom to assess the relationship between thickness and lesion visibility in full field digital mammography

Ossati, MS

Abstract

Aim of research:
This research aimed to design and develop a synthetic anthropomorphic breast
phantom with cancer mimicking lesions and use this phantom to assess the relationship
between lesion visibility and breast thickness in mammography.

Due to the risk of cancer induction associated with the use of ionising radiation on
breast tissues, experiments on human breast tissue was not practical. Therefore, a
synthetic anthropomorphic breast phantom with cancer mimicking lesions was needed to
be designed and developed in order to provide a safe platform to evaluate the relationship
between lesion visibility and breast thickness in mammography.

Method:
As part of this research custom Polyvinyl alcohol (PVAL) breast phantoms with
embedded PVAL lesions doped with contrast agent were fabricated and utilised. These
breast phantoms exhibited mechanical and X-ray properties which were similar to female
breast/breast cancer tissues. In order for this research to be useful for human studies,
patient safety factors have constrained the extent of this research. These factors include
compression force and radiation dose.

After acquiring mammograms of phantoms with varying thicknesses, the image
quality of the embedded lesions were evaluated both perceptually and mathematically.
The two-alternative forced choice (2AFC) perceptual method was used to evaluate image
quality of the lesions. For mathematical evaluation the following methods were utilised:
line profile analysis, contrast-to noise ratio (CNR), signal-to noise ratio (SNR) and figure
of merit (FOM).

Results:
The results of the visual perception analysis of the mammograms demonstrate that
as breast compressed thickness reduces the image quality increases. Additionally, the
results display a correlation in the reduction in the level of noise with the reduction in
breast thickness. This noise reduction was also demonstrated in the profile plots of the
lesions. The line profile analysis, in agreement with visual perception, shows
improvement of sharpness of the lesion edge in relation to the reduction of the phantom
thickness. The intraclass correlation coefficient (ICC) has shown a great consistency and
agreement among the observers for visibility, sharpness, contrast and noise. The ICC
results are not as conclusive for the size criterion.

Mathematical evaluation results also show a correlation of improvement in the
image quality with the reduction in breast thickness. The results show that for the
measures CNR, SNR, and FOM, the increase in image quality has a threshold after which
the image quality ceases to improve and instead begins to reduce. CNR and FOM
dropped when the breast phantom thickness was reduced approximately 40% of its initial
thickness. This consistently happened at the point where the filter changed from rhodium
(Rh) to molybdenum (Mo).

Conclusion:
This breast phantom study successfully designed and developed an
anthropomorphic compressible breast phantom with cancer mimicking lesions with
mechanical and X-ray properties similar to human breast tissue. This study also
demonstrates that as breast compressed thickness reduces the visibility of the perceived
lesion increases. The radiation dose generally decreases up to the point that the filter
changes from rhodium to molybdenum. After this point, the radiation dose increases
regardless of the phantom thickness. The results from this thesis are likely to have
implications for clinical practice, as they support the need for compression/thickness
reduction to enhance lesion visibility

Citation

Ossati, M. (in press). Design, development and use of a deformable breast phantom to assess the relationship between thickness and lesion visibility in full field digital mammography. (Thesis). University of Salford Manchester

• Thesis Type: Thesis
• Acceptance Date: Aug 21, 2015
• Deposit Date: Oct 20, 2015
• Publicly Available Date: Oct 20, 2015
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