Digital Tomosynthesis

  • Euclid Seeram


The purpose of this chapter is to present a brief description of digital tomosynthesis, a three-dimensional (3D) imaging technique that overcomes the problems of conventional two-dimensional (2D) tomography. The technique involves image acquisition, image reconstruction, and image display and communication. While image acquisition is such that the X-ray tube rotates through a limited angle about the detector which is often stationary, to obtain a number of projection data are taken from different angles. These data are subsequently reconstructed to produce individual slices of the volume of tissue scanned, using algorithms specially developed for tomosynthesis. There are two types of designs for image acquisition in digital tomosynthesis: step-and-shoot system and continuous scan system. While, in the former method, the X-ray tube that moves to every angular position stops, an exposure is taken and the tube then moves to the next angular position; in the latter system, the X-ray tube moves during the scanning of the object. Digital tomosynthesis (DT) is being applied to general radiographic imaging and to digital breast imaging referred to as digital breast tomosynthesis (DBT).

Major imaging system components include the X-ray tube and housing designed to rotate during the data acquisition, collimation and filtration, breast support, breast compression device, and either a full-field indirect flat-panel digital detector {amorphous silicon (a-Si) cesium iodide (CsI)} or a full-field direct flat-panel digital detector (a-Selenium). Furthermore DT is characterized by several parameters such as the sweep angle, sweep direction, patient barrier-object distance, number of projections, and total radiation dose. Additionally an overview of image reconstruction methods of DT, image display and communication, and radiation dose considerations is presented. Finally, this chapter concludes with an outline of synthesized 2D digital mammography (DM) and clinical applications of DT.


  1. 1.
    Vallebona A. Radiography with great enlargement (microradiography) and a technical method for radiographic dissociation of the shadow. Radiology. 1931;17:340–1.CrossRefGoogle Scholar
  2. 2.
    Bocage E. M. Patent No. 536, 464, Paris. History of tomography. Medicamundi, 1974; 19: 106–115.Google Scholar
  3. 3.
    Grant DG. Tomosynthesis: a three-dimensional radiographic imaging technique. IEEE Trans Biomed EngBME. 1972;19:20–8.CrossRefGoogle Scholar
  4. 4.
    Maidment ADA. The future of medical imaging. Radiat Prot Dosim. 2010;139(1–3):3–7.CrossRefGoogle Scholar
  5. 5.
    Machida H, Yuhara T, Mori T, Ueno E, Moribe Y, Sabol JM. Whole-body clinical applications of digital Tomosynthesis. Radiographics. 2010;30:549–62.CrossRefGoogle Scholar
  6. 6.
    Tingberg A. X-ray Tomosynthesis: a review of its use for breast and chest imaging. Radiol Clin N Am. 2010;52:489–97.Google Scholar
  7. 7.
    Yaffe MJ, Mainprize JG. Digital Tomosynthesis. Technique Radiol Clin North Am. 2014;52:489–97.CrossRefGoogle Scholar
  8. 8.
    Smith A. Fundamentals of breast tomosynthesis. Improving the performance of mammography. White Paper, Bedford, MA. Hologic, Inc™. 2012.Google Scholar
  9. 9.
    Smith A. Design considerations in optimizing a breast tomosynthesis system. White Paper, Bedford, MA. Hologic, Inc™. 2011.Google Scholar
  10. 10.
    Sechopoulos I. A review of breast tomosynthesis. Part I. the image acquisition process. Med Phys. 2013;40(1):014301-1–014301-12.Google Scholar
  11. 11.
    Bushong S. Radiologic science for technologists. 11th ed. St Louis: MO. Elsevier; 2017.Google Scholar
  12. 12.
    Gomi T. A comparison of reconstruction algorithms regarding exposure dose reductions during digital breast Tomosynthesis. J Biomed Sci Eng. 2014;7:516–25.CrossRefGoogle Scholar
  13. 13.
    Vedantham S, Karellas A, Vijayaraghavan GR, Kopans DB. Digital breast Tomosynthesis: state-of-the-art. Radiology. 2015;277:663–84.CrossRefGoogle Scholar
  14. 14.
    Machida H, Yuhara T, Tamura M, Ishikawa T, Tate E, Ueno E, Nye K, Sabol JM. Whole-body clinical applications of digital Tomosynthesis. Radiographics. 2016;36:735–50.CrossRefGoogle Scholar
  15. 15.
    Dobbins JT 3rd, Godfrey DJ. Digital X-ray tomosynthesis: current state of the art and clinical potential. Phys Med Biol. 2003;48(19):R65–R106.CrossRefGoogle Scholar
  16. 16.
    Sechopoulos I. A review of breast tomosynthesis. Part II. Image reconstruction, processing and analysis, and advanced applications. Med Phys. 2013;40(1):014302.CrossRefGoogle Scholar
  17. 17.
    Rodriguez-Ruiz A, Teuwen J, Vreemann S, Bouwman RW, van Engen RE, Karssemeijer N, Mann RM, Gubern-Merida A, Sechopoulos I. New reconstruction algorithm for digital breast tomosynthesis: better image quality for humans and computers. Acta Radiol. 2017;0(0):1–9.Google Scholar
  18. 18.
    Bushberg JT, Seibert JA, Leidholdt EM Jr, Boone JM. The essential physics of medical imaging. Philadelphia, PA: Wolters Kluwer/Lippincott Williams & Wilkins; 2012.Google Scholar
  19. 19.
    Gennaro G, Bernardi D, Houssami N. Radiation dose with digital breast tomosynthesis compared to digital mammography: per-view analysis. Eur Radiol. 2018;28(2):573–81.CrossRefGoogle Scholar
  20. 20.
    Alakhras MM, Mello-Thoms C, Bourne R, Rickard M, Diffey J, Brennan PC. Relationship between radiation dose and image quality in digital breast tomosynthesis. Radiat Prot Dosim. 2017;173(I4):351–60.Google Scholar
  21. 21.
    James JR, Pavlicek W, Hanson JA, Boltz TF, Patel BK. Breast radiation dose with CESM compared with 2D FFDM and 3D Tomosynthesis mammography. AJR Am J Roentgenol. 2017;208:2–9.CrossRefGoogle Scholar
  22. 22.
    Gilbert FJ, Tucker L, Young KC. Digital breast tomosynthesis (DBT): a review of the evidence for use as a screening tool. Clin Radiol. 2016;71:141–50.CrossRefGoogle Scholar
  23. 23.
    Svahn TM, Houssami N, Sechopoulos I, Mattsson S. Review of radiation dose estimates in digital breast tomosynthesis relative to those in two-view full-field digital mammography. Breast. 2015;24(2):93–9.CrossRefGoogle Scholar
  24. 24.
    Olgar T, Kahn T, Gosch D. Average glandular dose in digital mammography and breast tomosynthesis. Rofo. 2012;184(10):911–8.CrossRefGoogle Scholar
  25. 25.
    Nelson JS, Wells JR, Baker JA, Samei E. How does c-view image quality compare with conventional 2D FFDM? Med Phys. 2016;43(5):2538–47.CrossRefGoogle Scholar
  26. 26.
    Skaane P, Bandos A, Eben E. Two-view digital breast Tomosynthesis screening with synthetically reconstructed projection images: comparison with digital breast Tomosynthesis with full-field digital mammographic images. Radiology. 2014;271(3):655–63.CrossRefGoogle Scholar
  27. 27.
    Zuckerman SP, Maidment ADA, Weinstein SP, McDonald ES, Conant EF. Imaging with synthesized 2D mammography: differences, advantages, and pitfalls compared with digital mammography. AJR Am J Roentgenol. 2017;209(1):222–9.CrossRefGoogle Scholar
  28. 28.
    Smith A. Synthesized 2D mammographic imaging. White Paper, Bedford, MA. Hologic, Inc™. 2016.Google Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  • Euclid Seeram
    • 1
    • 2
    • 3
    • 4
    • 5
  1. 1.Medical Radiation Sciences University of SydneySydneyAustralia
  2. 2.Medical Radiation Sciences, Faculty of Health SciencesUniversity of SydneySydneyAustralia
  3. 3.Adjunct Associate Professor, Medical Imaging and Radiation SciencesMonash UniversityClaytonAustralia
  4. 4.Adjunct Professor, Faculty of ScienceCharles Sturt UniversityWagga WaggaAustralia
  5. 5.Adjunct Associate Professor, Medical Radiation Sciences, Faculty of HealthUniversity of CanberraBruceAustralia

Personalised recommendations