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. <p> </p>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. <p> </p>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.
With the emergence of energy-resolved x-ray photon counting detectors multi-material spectral x-ray imaging has been made possible. This form of imaging allows the discrimination and quantification of individual materials comprising an inspected anatomical area. However, the acquisition of quantitative material data puts strong requirements on the performance capabilities of a given x-ray system. Scattered radiation is one of the key sources of influencing the quality of material quantification accuracy. The aim of the present investigation was to assess the impact of x-ray scatter on quantitative spectral CT imaging using a pre-clinical photon counting scanner prototype. Acquisitions of a cylindrical phantom with and without scatter were performed. The phantom contained iodine and gadolinium inserts placed at various locations. The projection data was then decomposed onto a water-iodine-gadolinium material basis and reconstructed. An analysis of the resulting iodine and gadolinium material images with and without scatter was conducted. It was concluded that, at an SPR level of up to 3.5%, scatter does not compromise material quantification for all investigated gadolinium concentrations, but for iodine a substantial underestimation was observed. The findings in this study suggest that scatter has a lower impact on K-edge material imaging in comparison with material imaging not featuring a K-edge.