Comparison of Different Reconstruction Algorithms for Decreasing the Exposure Dose during Digital Breast Tomosynthesis: A Phantom Study

We compared reconstruction algorithms [filtered back projection (FBP), maximum likelihood expectation maximization (MLEM), and the simultaneous iterative reconstruction technique (SIRT)] in terms of the radiation dose and image quality, for exploring the possibility of decreasing the radiation dose during digital breast tomosynthesis (DBT). The three algorithms were implemented using a DBT system and experimentally evaluated using measurements, such as signal differenceto-noise ratio (SDNR) and intensity profile, on a BR3D phantom (in-focus plane image). The possible radiation dose reduction, contrast improvement, and artifact reduction in DBT were evaluated using different exposure levels and the three reconstruction techniques. We performed statistical analysis (one-way analysis of variance) of the SDNR data. The effectiveness of each technique for enhancing the visibility of the BR3D phantom was quantified with regard to SDNR (FBP versus MLEM, P < 0.05; FBP vs. SIRT, P < 0.05; MLEM vs. SIRT, P = 0.945); the artifact reduction was quantified with regard to the intensity profile. MLEM and SIRT produced reconstructed images with SDNR values indicative of low-contrast visibility. The SDNR value for the half-radiation dose MLEM and SIRT images was close to that of the FBP reference radiation dose image. Artifacts were decreased in the MLEM and SIRT images (in the in-focus plane) according to the intensity profiles that we obtained. With MLEM and SIRT, the radiation dose may be decreased to half comparison with FBP.