RESUMEN

Virtual clinical trials (VCTs) have been used widely to evaluate digital breast tomosynthesis (DBT) systems. VCTs require realistic simulations of the breast anatomy (phantoms) to characterize lesions and to estimate risk of masking cancers. This study introduces the use of Perlin-based phantoms to optimize the acquisition geometry of a novel DBT prototype. These phantoms were developed using a GPU implementation of a novel library called Perlin-CuPy. The breast anatomy is simulated using 3D models under mammography cranio-caudal compression. In total, 240 phantoms were created using compressed breast thickness, chest-wall to nipple distance, and skin thickness that varied in a {[35, 75], [59, 130), [1.0, 2.0]} mm interval, respectively. DBT projections and reconstructions of the phantoms were simulated using two acquisition geometries of our DBT prototype. The performance of both acquisition geometries was compared using breast volume segmentations of the Perlin phantoms. Results show that breast volume estimates are improved with the introduction of posterior-anterior motion of the x-ray source in DBT acquisitions. The breast volume is overestimated in DBT, varying substantially with the acquisition geometry; segmentation errors are more evident for thicker and larger breasts. These results provide additional evidence and suggest that custom acquisition geometries can improve the performance and accuracy in DBT. Perlin phantoms help to identify limitations in acquisition geometries and to optimize the performance of the DBT prototypes.