KEYWORDS: Breast, Tissues, Computer simulations, Image processing, 3D image processing, Breast imaging, Databases, Signal attenuation, Statistical analysis, Algorithm development
An automated method has been developed to insert realistic clusters of simulated microcalcifications (MCs) into
computer models of breast anatomy. This algorithm has been developed as part of a virtual clinical trial (VCT) software
pipeline, which includes the simulation of breast anatomy, mechanical compression, image acquisition, image
processing, display and interpretation. An automated insertion method has value in VCTs involving large numbers of
images. The insertion method was designed to support various insertion placement strategies, governed by probability
distribution functions (pdf). The pdf can be predicated on histological or biological models of tumor growth, or
estimated from the locations of actual calcification clusters. To validate the automated insertion method, a 2-AFC
observer study was designed to compare two placement strategies, undirected and directed. The undirected strategy
could place a MC cluster anywhere within the phantom volume. The directed strategy placed MC clusters within
fibroglandular tissue on the assumption that calcifications originate from epithelial breast tissue. Three radiologists were
asked to select between two simulated phantom images, one from each placement strategy. Furthermore, questions were
posed to probe the rationale behind the observer’s selection. The radiologists found the resulting cluster placement to be
realistic in 92% of cases, validating the automated insertion method. There was a significant preference for the cluster to
be positioned on a background of adipose or mixed adipose/fibroglandular tissues. Based upon these results, this
automated lesion placement method will be included in our VCT simulation pipeline.
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