Purpose: Digital breast tomosynthesis ͑DBT͒ has been shown to improve mass detection. Detection of microcalcifications is more challenging because of the large breast volume to be searched for subtle signals. The simultaneous algebraic reconstruction technique ͑SART͒ was found to provide good image quality for DBT, but the image noise is amplified with an increasing number of iterations. In this study, the authors developed a selective-diffusion ͑SD͒ method for noise regularization with SART to improve the contrast-to-noise ratio ͑CNR͒ of microcalcifications in the DBT slices for human or machine detection.
Methods:The SD method regularizes SART reconstruction during updating with each projection view. Potential microcalcifications are differentiated from the noisy background by estimating the local gradient information. Different degrees of regularization are applied to the signal or noise classes, such that the microcalcifications will be enhanced while the noise is suppressed. The new SD method was compared to several current methods, including the quadratic Laplacian ͑QL͒ method, the total variation ͑TV͒ method, and the nonconvex total p-variation ͑TpV͒ method for noise regularization with SART. A GE GEN2 prototype DBT system with a stationary digital detector was used for the acquisition of DBT scans at 21 angles in 3°increments over a Ϯ30°r ange. The reconstruction image quality without regularization and that with the different regularization methods were compared using the DBT scans of an American College of Radiology phantom and a human subject. The CNR and the full width at half maximum ͑FWHM͒ of the line profiles of microcalcifications within the in-focus DBT slices were used as image quality measures. Results: For the comparison of large microcalcifications in the DBT data of the subject, the SD method resulted in comparable CNR to the nonconvex TpV method. Both of them performed better than the other two methods. For subtle microcalcifications, the SD method was superior to other methods in terms of CNR. In both the subject and phantom DBT data, for large microcalcifications, the FWHM of the SD method was comparable to that without regularization, which was wider than that of the TV type methods. For subtle microcalcifications, the SD method had comparable FWHM values to the TV type methods. All three regularization methods were superior to the QL method in terms of FWHM. Conclusions: The SART regularized by the selective-diffusion method enhanced the CNR and preserved the sharpness of microcalcifications. In comparison with three existing regularization methods, the selective-diffusion regularization was superior to the other methods for subtle microcalcifications.