Virtual assessment of stereoscopic viewing of digital breast tomosynthesis projection images

Digital breast tomosynthesis (DBT) acquires a series of projection images from different angles as an x-ray source rotates around the breast. Such imaging geometry lends DBT naturally to stereoscopic viewing as two projection images with a reasonable separation angle can easily form a stereo pair. This simulation study assessed the efficacy of stereo viewing of DBT projection images. Three-dimensional computational breast phantoms with realistically shaped synthetic lesions were scanned by three simulated DBT systems. The projection images were combined into a sequence of stereo pairs and presented to a stereomatching-based model observer for deciding lesion presence. Signal-to-noise ratio was estimated, and the detection performance with stack viewing of reconstructed slices was the benchmark. We have shown that: (1) stereo viewing of projection images may underperform stack viewing of reconstructed slices for current DBT geometries; (2) DBT geometries may impact the efficacy of the two viewing modes differently: narrow-arc and wide-arc geometries may be better for stereo viewing and stack viewing, respectively; (3) the efficacy of stereo viewing may be more robust than stack viewing to reductions in dose. While in principle stereo viewing is potentially effective for visualizing DBT data, effective stereo viewing may require specifically optimized DBT image acquisition.