APPLICATION OF THREE-PASS METAL ARTEFACT REDUCTION TO PHOTON-COUNTING BREAST TOMOSYNTHESIS

Digital breast tomosynthesis is a rising modality in breast cancer screening and diagnosis. As such, there is also increasing interest in employing breast tomosynthesis in diagnostic tasks like tomosynthesis-guided stereotactic breast biopsy, which includes imaging in presence of metal objects. Since reconstruction techniques in tomosynthesis operate on projection data from a limited angular range, highly attenuating metal objects create strong streak-like tomosynthesis artefacts, which are accompanied by strong undershoots at the object boundaries in the focal and adjacent slices. These artefacts can significantly hamper image quality by obscuring anatomical detail in the vicinity of the metal object. In this contribution, we therefore present an approach for reducing such metal artefacts by means of a three-pass reconstruction method. The method analyzes the reconstructed tomosynthesis volume for metal contributions. It eventually determines corresponding pixels in the projection data, and decomposes the projections accordingly into metal and nonmetal projections. After each projection set is reconstructed independently, the final, enhanced tomosynthesis volume is obtained by a non-linear blending operation. The proposed approach was evaluated on a set of eight clinical cases. Each breast contained a metal clip, which is typically left as marker after biopsy. The proposed method achieved to retain the appearance of the metal object in the focal and its adjacent slices. At the same time complete removal of streak artefacts in all distant slices was achieved. Efficacy of the method in presence of larger objects was demonstrated in phantom studies, where visibility of microcalcifications was completely restored.