ABSTRACT
Systems for digital breast tomosynthesis (DBT) are now being used for clinical work in several parts of the world, including Europe, Asia, the United States, and Canada. Early findings from trials suggest that tomosynthesis may replace digital mammography as the standard tool for screening because of its improved sensitivity and specificity. The role of breast computed tomography (CT) versus DBT is still unclear; however, because of the true isotropic three-dimensional (3D) nature of CT, but with inferior x-y spatial resolution to DBT, CT may be found very useful for diagnostic applications, particularly with the use of contrast media. The technology of DBT and CT is still quite young and there is ample scope for further optimization and development. Areas for possible improvement of DBT are discussed in the previous chapters and include the choice of angular range and increment for acquisition of projections, the distribution of radiation dose among the projections (dose budgeting), the reconstruction algorithm, image processing, detector technology, and the overall user interface. The potential benefits that are worth pursuing and would facilitate the acceptance of tomosynthesis are dose reduction from current
levels and improved efficiency for the radiologist in working with the image sets. There are also opportunities for the extraction of additional useful information from the examination by the use of contrast media, density measurement, and computer-assisted diagnostic techniques. Finally, there may be value in systems that provide fusion of tomosynthesis with other complementary breast imaging modalities.
