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Method for Simulating Dose Reduction in Digital Breast Tomosynthesis

Research output: Contribution to journalArticleScientificpeer-review


Original languageEnglish
Pages (from-to)2331-2342
JournalIEEE Transactions on Medical Imaging
Issue number11
Publication statusPublished - 2017
Publication typeA1 Journal article-refereed


This work proposes a new method of simulating dose reduction in digital breast tomosynthesis (DBT), starting from a clinical image acquired with a standard radiation dose. It considers both signal-dependent quantum and signal-independent electronic noise. Furthermore, the method accounts for pixel crosstalk, which causes the noise to be frequency-dependent, thus increasing the simulation accuracy. For an objective assessment, simulated and real images were compared in terms of noise standard deviation, signal-to-noise ratio (SNR) and normalized noise power spectrum (NNPS). A two-alternative forced-choice (2-AFC) study investigated the similarity between the noise strength of low-dose simulated and real images. Six experienced medical physics specialists participated on the study, with a total of 2,160 readings. Objective assessment showed no relevant trends with the simulated noise. The relative error in the standard deviation of the simulated noise was less than 2% for every projection angle. The relative error of the SNR was less than 1.5%, and the NNPS of the simulated images had errors less than 2.5%. The 2-AFC human observer experiment yielded no statistically significant difference (p=0.84) in the perceived noise strength between simulated and real images. Furthermore, the observer study also allowed the estimation of a dose difference at which the observer perceived a just-noticeable difference (JND) in noise levels. The estimated JND value indicated that a change of 17% in the current-time product was sufficient to cause a noticeable difference in noise levels. The observed high accuracy, along with the flexible calibration, make this method an attractive tool for clinical image-based simulations of dose reduction.


  • Biomedical imaging, Breast, Calibration, digital breast tomosynthesis, dose reduction, Electronic noise, Estimation, Image reconstruction, quantum noise, Signal to noise ratio, Standards

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