• Korean Journal of Radiology
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• v.24 no.4
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• pp.274-283
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• 2023

Objective: To compare the outcomes of digital breast tomosynthesis (DBT) screening combined with ultrasound (US) with those of digital mammography (DM) combined with US in women with dense breasts. Materials and Methods: A retrospective database search identified consecutive asymptomatic women with dense breasts who underwent breast cancer screening with DBT or DM and whole-breast US simultaneously between June 2016 and July 2019. Women who underwent DBT + US (DBT cohort) and DM + US (DM cohort) were matched using 1:2 ratio according to mammographic density, age, menopausal status, hormone replacement therapy, and a family history of breast cancer. The cancer detection rate (CDR) per 1000 screening examinations, abnormal interpretation rate (AIR), sensitivity, and specificity were compared. Results: A total of 863 women in the DBT cohort were matched with 1726 women in the DM cohort (median age, 53 years; interquartile range, 40-78 years) and 26 breast cancers (9 in the DBT cohort and 17 in the DM cohort) were identified. The DBT and DM cohorts showed comparable CDR (10.4 [9 of 863; 95% confidence interval {CI}: 4.8-19.7] vs. 9.8 [17 of 1726; 95% CI: 5.7-15.7] per 1000 examinations, respectively; P = 0.889). DBT cohort showed a higher AIR than the DM cohort (31.6% [273 of 863; 95% CI: 28.5%-34.9%] vs. 22.4% [387 of 1726; 95% CI: 20.5%-24.5%]; P < 0.001). The sensitivity for both cohorts was 100%. In women with negative findings on DBT or DM, supplemental US yielded similar CDRs in both DBT and DM cohorts (4.0 vs. 3.3 per 1000 examinations, respectively; P = 0.803) and higher AIR in the DBT cohort (24.8% [188 of 758; 95% CI: 21.8%-28.0%] vs. 16.9% [257 of 1516; 95% CI: 15.1%-18.9%; P < 0.001). Conclusion: DBT screening combined with US showed comparable CDR but lower specificity than DM screening combined with US in women with dense breasts.

• Journal of the Korean Society of Radiology
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• v.81 no.4
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• pp.886-898
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• 2020

Purpose The purpose of our study was to evaluate digital breast tomosynthesis as a breast cancer screening modality for women with gynecologic cancer. Materials and Methods This retrospective study included patients with underlying gynecologic malignancies who underwent screening digital breast tomosynthesis for breast cancer. The cancer detection rate, recall rate, sensitivity, specificity, and positive predictive value (PPV) were calculated. PPV1 was defined as the percentage of all positive screening exams that have a tissue diagnosis of cancer within a year. PPV2 was defined as the percentage of all diagnostic exams (and Breast Imaging Reporting and Data System category 4, 5 from screening setting) with a recommendation for tissue diagnosis that have cancer within a year. PPV3 was defined as the percentage of all known biopsies actually performed that resulted in a tissue diagnosis of cancer within the year. For each case of screen-detected cancer, we analyzed the age, type of underlying gynecologic malignancy, breast density, imaging features, final Breast Imaging Reporting and Data System assessment, histologic type, T and N stages, molecular subtype, and Ki-67 index. Results Among 508 patients, 7 with breast cancer were identified after a positive result. The cancer detection rate was 13.8 per 1000 screening exams, and the recall rate was 17.9%. The sensitivity was 100%, and the specificity was 83.2%. The false negative rate was 0 per 1000 exams. The PPV1, PPV2, and PPV3 were 7.7, 31.8, and 31.8, respectively. Conclusion Digital breast tomosynthesis may be a promising breast cancer screening modality for women with gynecologic cancer, based on the high cancer detection rate, high sensitivity, high PPV, and high detection rate of early-stage cancer observed in our study.

• Journal of radiological science and technology
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• v.39 no.4
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• pp.483-491
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• 2016

The conditions after exposure to digital mammography and digital breast tomosynthesis were analyzed. The examinations for the ACR phantom were done using manual exposure, not auto exposure, to examine image discrimination and patient dose. As a result, the following results were derived: In the CC exposure, the kVp was 2kVp higher while mAs decreased to 58.6% for the 3D tomography. Such result showed an approximate decrease of 60mAs. At that time, the patients' Average Glandular Dose (AGD) was 1.65mGy in 2D and 1.87mGy in 3D; thus, AGD of 3D was shown to have about 1.13times higher. The result of the manual exposure revealed a reduced mAs of up to 80%; there was no effect in the assessment standard in terms of image discrimination, resulting in more than 10 points. When mAs was reduced to 80% in the manual exposure for ACR phantom, AGD was decreased to 0.66mGy. The diagnostic values of images were maintained and patients dose was reduced in the manual exposure in the AEC condition for 3D. Since the use of 3D has recently increased, using the manual exposure has been recommended in this study to improve the diagnostic value, while, simultaneously reducing patients dose.

• Journal of radiological science and technology
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• v.38 no.4
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• pp.347-353
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• 2015

The purpose of this study is to suggest proper additional filtration by comparisons patient dose and image quality among additional filters in digital chest tomosynthesis (DTS). We measured the effective dose, dose area product (DAP) by changing thickness of Cu, Al and Ni filter to compare image quality by CD curve and SNR, CNR. Cu, Al and Ni exposure dose were similar thickness 0.3 mm, 3 mm and 0.3 mm respectively. The exposure dose using filter was decreased average about 33.1% than non filter. The DAP value of 0.3 mm Ni were decreased 72.9% compared to non filter and the lowest dose among 3 filter. The effective dose of 0.3 mm Ni were decreased 48% compared to 0.102 mSv effective dose of non filter. At the result of comparison of image quality through CD curve there were similar aspect graph among Cu, Al and Ni. SNR was decreased average 19.07%, CNR was average decreased 18.17% using 3 filters. In conclusion, Ni filtration was considered to be most suitable when considered comprehensive thickness, character, sort of filter, dose reduction and image quality evaluation in DTS.

• Journal of the Korea Convergence Society
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• v.10 no.2
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• pp.29-34
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• 2019

In this study, we measure dose against various density and thickness using phantom to compare FFDM to DBT of Digital mammography equipment and evaluate usefulness of DBT through compare the image quality of FFDM and DBT. We use mammography equipment, Selenia Dimensions ; this is able to examine breast by both FFDM and DBT, The results are that when the thickness of phantom is 6cm or more and density is 70% or more and the thickness of phantom is 7cm or more and density is 50% or more, AGD of DBT is lower than that of FFDM. The evaluation results of image quality are that in the tumor and small calcification group that composed by mammary tissue and fat, FFDM is great and in fibrin, DBT is great. But in the all thicknesses of BR3D phantom that reflected overlapped tissue of breasts, DBT is great in calcification group, fibrin and tumor. DBT is greater image quality and lower dose more than FFDM in Thick and high density breast, Therefore, DBT is more useful in Korean women's breast that is characterized dense breast than FFDM.

• Progress in Medical Physics
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• v.23 no.4
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• pp.261-268
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• 2012

Breast cancer is the second leading cause of women cancer death in Korea. The key for reducing disease mortality is early detection. Although digital mammography (DM) has been credited as one of the major reasons for the early detection to decrease in breast cancer mortality observed in the last 20 years, DM is far from perfect for several limitations. Digital breast tomosynthesis (DBT) is expected to overcome some inherent limitations of conventional mammography caused by overlapping of normal tissue and pathological tissue during the standard 2D projections for the improved lesion margin visibility and early breast cancer detection. In this study, we compared a DM system and DBT system acquired with different thickness of breast phantom. We acquired breast phantom data with same average glandular dose (AGD) from 1 mGy to 4 mGy under same experimental condition. The contrast, micro-calcification measurement accuracy and observer study were conducted with breast phantom images. As a result, the higher accuracy of lesion detection with DBT system compared to DM system was demonstrated in this study. Furthermore, the pain of patients caused by severe compression can be reduced with DBT system. In conclusion, the results indicated that DBT system play an important role in breast cancer detection.

• Progress in Medical Physics
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• v.27 no.1
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• pp.1-7
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• 2016

In this work, we considered a compressed-sensing (CS)-based image deblurring scheme with a total-variation (TV) regularization penalty for improving image characteristics in digital tomosynthesis (DTS). We implemented the proposed image deblurring algorithm and performed a systematic simulation to demonstrate its viability. We also performed an experiment by using a table-top setup which consists of an x-ray tube operated at $90kV_p$, 6 mAs and a CMOS-type flat-panel detector having a $198-{\mu}m$ pixel resolution. In the both simulation and experiment, 51 projection images were taken with a tomographic angle range of ${\theta}=60^{\circ}$ and an angle step of ${\Delta}{\theta}=1.2^{\circ}$ and then deblurred by using the proposed deblurring algorithm before performing the common filtered-backprojection (FBP)-based DTS reconstruction. According to our results, the image sharpness of the recovered x-ray images and the reconstructed DTS images were significantly improved and the cross-plane spatial resolution in DTS was also improved by a factor of about 1.4. Thus the proposed deblurring scheme appears to be effective for the blurring problems in both conventional radiography and DTS and is applicable to improve the present image characteristics.

• Journal of the Korean Society of Radiology
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• v.14 no.4
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• pp.477-486
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• 2020

The purpose of this study was to evaluate the effects of reconstruction filters, X-ray source trajectories and intervals in the quality of digital tomosynthesis (DT) images, and the results was clinically validated. The filtered back-projection was implemented by using Ramp, Shepp-Logan, Cosine, Hamming, Hann and Blackman filters, and the X-ray source trajectories were simulated with 1 × 36, 2 × 18, 3 × 12, 4 × 9 and 6 × 6 arrays. The X-ray source intervals were 5, 10, 20, 30 and 40 mm. The depth resolution, spatial resolution and noise of DT image were evaluated by measuring artifact spread function (ASF), full width at half maximum (FWHM) and signal-to-noise ratio (SNR), respectively. The results showed that the spatial resolution and noise properties of DT images were maximized by the Ramp and Blackman filters, respectively, and the depth resolution and noise properties of the DT images obtained with a 1 × 36 X-ray source trajectory were superior to the other trajectories. The depth resolution and noise properties of DT images improved with an increase of X-ray source intervals, and the high X-ray source intervals degraded the spatial resolution of DT images. Therefore, the characteristics of DT images are highly dependent on reconstruction filters, X-ray source trajectories and intervals, and it is necessary to use optimal imaging parameters in accordance with diagnostic purpose.

• Korean Journal of Radiology
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• v.22 no.8
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• pp.1240-1252
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• 2021

Objective: To compare the accuracy for detecting breast cancer in the diagnostic setting between the use of digital breast tomosynthesis (DBT), defined as DBT alone or combined DBT and digital mammography (DM), and the use of DM alone through a systematic review and meta-analysis. Materials and Methods: Ovid-MEDLINE, Ovid-Embase, Cochrane Library and five Korean local databases were searched for articles published until March 25, 2020. We selected studies that reported diagnostic accuracy in women who were recalled after screening or symptomatic. Study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. A bivariate random effects model was used to estimate pooled sensitivity and specificity. We compared the diagnostic accuracy between DBT and DM alone using meta-regression and subgroup analyses by modality of intervention, country, existence of calcifications, breast density, Breast Imaging Reporting and Data System category threshold, study design, protocol for participant sampling, sample size, reason for diagnostic examination, and number of readers who interpreted the studies. Results: Twenty studies (n = 44513) that compared DBT and DM alone were included. The pooled sensitivity and specificity were 0.90 (95% confidence interval [CI] 0.86-0.93) and 0.90 (95% CI 0.84-0.94), respectively, for DBT, which were higher than 0.76 (95% CI 0.68-0.83) and 0.83 (95% CI 0.73-0.89), respectively, for DM alone (p < 0.001). The area under the summary receiver operating characteristics curve was 0.95 (95% CI 0.93-0.97) for DBT and 0.86 (95% CI 0.82-0.88) for DM alone. The higher sensitivity and specificity of DBT than DM alone were consistently noted in most subgroup and meta-regression analyses. Conclusion: Use of DBT was more accurate than DM alone for the diagnosis of breast cancer. Women with clinical symptoms or abnormal screening findings could be more effectively evaluated for breast cancer using DBT, which has a superior diagnostic performance compared to DM alone.

• Progress in Medical Physics
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• v.21 no.3
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• pp.281-290
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• 2010

Cone-beam digital tomosynthesis (CBDT) has greatly been paid attention in the image-guided radiation therapy because of its attractive advantages such as low patient dose and less motion artifact. Image quality of tomograms is, however, dependent on the imaging conditions such as the scan angle (${\beta}_{scan}$) and the number of projection views. In this paper, we describe the principle of CBDT based on filtered-backprojection technique and investigate the optimization of imaging conditions. As a system performance, we have defined the figure-of-merit with a combination of signal difference-to-noise ratio, artifact spread function and floating-point operations which determine the computational load of image reconstruction procedures. From the measurements of disc phantom, which mimics an impulse signal and thus their analyses, it is concluded that the image quality of tomograms obtained from CBDT is improved as the scan angle is wider than 60 degrees with a larger step scan angle (${\Delta}{\beta}$). As a rule of thumb, the system performance is dependent on $\sqrt{{\Delta}{\beta}}{\times}{\beta}^{2.5}_{scan}$. If the exact weighting factors could be assigned to each image-quality metric, we would find the better quantitative imaging conditions.