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Evaluation of a novel collimator for molecular breast tomosynthesis

Purpose: This study investigated a novel gamma camera for molecular breast tomosynthesis (MBT), which is a nuclear breast imaging method that uses limited angle tomography. The camera is equipped with a variable angle, slant‐hole (VASH) collimator that allows the camera to remain close to the breast throughout the acquisition. The goal of this study was to evaluate the spatial resolution and count sensitivity of this camera and to compare contrast and contrast‐to‐noise ratio (CNR) with conventional planar imaging using an experimental breast phantom. Methods: The VASH collimator mounts to a commercial gamma camera for breast imaging that uses a pixelated (3.2 mm), 15 × 20 cm NaI crystal. Spatial resolution was measured in planar images over a range of distances from the collimator (30–100 mm) and a range of slant angles (−25° to 25°) using 99mTc line sources. Spatial resolution was also measured in reconstructed MBT images including in the depth dimension. The images were reconstructed from data acquired over the −25° to 25° angular range using an iterative algorithm adapted to the slant‐hole geometry. Sensitivity was measured over the range of slant angles using a disk source. Measured spatial resolution and sensitivity were compared to theoretical values. Contrast and CNR were measured using a breast phantom containing spherical lesions (6.2 mm and 7.8 mm diameter) and positioned over a range of depths in the phantom. The MBT and planar methods had equal scan time, and the count density in the breast phantom data was similar to that in clinical nuclear breast imaging. The MBT method used an iterative reconstruction algorithm combined with a postreconstruction Metz filter. Results: The measured spatial resolution in planar images agreed well with theoretical calculations over the range of distances and slant angles. The measured FWHM was 9.7 mm at 50 mm distance. In reconstructed MBT images, the spatial resolution in the depth dimension was approximately 2.2 mm greater than the other two dimensions due to the limited angle data. The measured count sensitivity agreed closely with theory over all slant angles when using a wide energy window. At 0° slant angle, measured sensitivity was 19.7 counts sec−1 μCi−1 with the open energy window and 11.2 counts sec−1 μCi−1 with a 20% wide photopeak window (126 to 154 keV). The measured CNR in the MBT images was significantly greater than in the planar images for all but the lowest CNR cases where the lesion detectability was extremely low for both MBT and planar. The 7.8 mm lesion at 37 mm depth was marginally detectable in the planar image but easily visible in the MBT image. The improved CNR with MBT was due to a large improvement in contrast, which out‐weighed the increase in image noise. Conclusion: The spatial resolution and count sensitivity measurements with the prototype MBT system matched theoretical calculations, and the measured CNR in breast phantom images was generally greater with the MBT system compared to conventional planar imaging. These results demonstrate the potential of the proposed MBT system to improve lesion detection in nuclear breast imaging.