Type:
Educational Exhibit
Keywords:
Breast, Mammography, Physics, Diagnostic procedure, Artifacts, Calcifications / Calculi
Authors:
K. Rangarajan1, S. Hari2; 1New Delhi/IN, 2NEW DELHI, DELHI/IN
DOI:
10.1594/ecr2013/C-1711
Conclusion
CONCLUSION
- Tomosynthesis is a modality intrinsically prone to artifacts due to limited sampling of tissue
- Artifacts are thus here to stay in DBT in its present avatar,
thus their awareness,
and identification is the key to correct interpretation
5 POINTS TO REMEMBER WHILE INTERPRETING TOMOSYNTHESIS
- Reduction of artifacts represent a trade-off between depth resolution,
in-plane resolution and radiation exposure
- The various artifacts are summarized below for a quick recapitulation
Bright area
Fig. 4
|
Bright areas at the edges of tissue due to attenuation by tissue outside the detector’s view
|
Staircase
Fig. 6
|
Multiple lines at the extremes of the breast due to breast tissue outside the projection Field Of View
|
Blur-Ripple
Fig. 8,
Fig. 10
|
Incomplete cancellation of a high density structure outside its plane of existence
|
Halo
Fig. 13
|
Low density halo around high density objects such as calcifications
|
- All artifacts can obscure lesions located where they occur,
thus these regions must be examined carefully on the 2D mammogram (view orthogonal to the tomosynthesis view)
- The last artifact- blur- ripple can cause interpretation of a prominent trabecular as a suspicious lesion or over-estimation of size of a lesion Fig. 11 ,Fig. 12
- Examining every suspected lesion in all the slices it is visible in is thus essential to avoid misinterpretation.
Examples of all artifacts described are displayed in the side bar for quick recapitulation.