International Congress Series 1268 (2004) 13 – 18

www.ics-elsevier.com

The impact of acquisition angular range on the

z-resolution of radiographic tomosynthesis
Baojun Li a,*, Gopal B. Avinash a, Renuka Uppaluri a,
Jeffrey W. Eberhard b, Bernhard E.H. Claus b
a
Global Diagnostic X-ray, General Electric Medical Systems, 3000 N. Grandview Blvd., W-622,
Waukesha, WI 53188, USA
b
General Electric Global Research Center, Schenectady, NY 12309, USA

Abstract. The z-resolution is an important image quality metric for a tomosynthesis system. The
relationship between the acquisition angular range and z-resolution has yet been carefully
investigated, mainly due to the lacking of a tomosynthesis system capable of fully automated
acquisitions in a variety of angular ranges. We utilized a newly developed flat-panel based
tomosynthesis prototype system to investigate this relationship through a phantom study at an
angular range from 20j (+/ 10j), 40j (+/ 20j), and 60j (+/ 30j). In addition to the phantom
study, a simulation study was also performed to investigate the relationship in a wider angular range
(from 2.5j to 60j). The phantom study results are highly correlated with the simulation results
(correlation coefficient = 0.998, p-value = 0.022). These studies have revealed overall nonlinear
relationships between the angular range and the z-resolution. However, within a certain angular range
(i.e., 20j to 60j), their relationship can be considered as linear. Results have shown that increasing
the angular range from 20j to 40j reduced the z spread (i.e., increases z-resolution) by 49.1%;
further increasing the angular range to 60j reduced the z spread by another 21.1%. D 2004 Published
by Elsevier B.V.

Keywords: Tomosynthesis; Image quality; Z-resolution; Angular range

1. Introduction
Tomosynthesis in X-ray radiographic imaging allows retrospective reconstruction of an
arbitrary number of tomographic planes of anatomies from a set of low-dose projection
images acquired over a limited angle. Tomosynthesis improves clinical diagnosis (e.g.,
nodule detection [1,2], joint arthritis assessment [3,4], radiation therapy [5], etc.) by
removing overlying structures, enhancing local tissue separation, and providing depth
information about the structure of interest.

* Corresponding author. Tel.: +1-262-548-2442; fax: +1-262-544-3889.

E-mail address: Baojun.Li@med.ge.com (B. Li).

0531-5131/ D 2004 Published by Elsevier B.V.

doi:10.1016/j.ics.2004.03.298
14 B. Li et al. / International Congress Series 1268 (2004) 13–18

Tomosynthesis was first introduced by Grant [6] and Miller et al.[7] in 1970s based on
the work of traditional tomography [8,9]. It soon became popular because of its advantages
over traditional tomography (see a complete review of this subject in Ref. [10]):
retrospective reconstruction of an arbitrary number of tomographic planes, enhanced
contrast of structures of interest, reduced dose, and removal of the need to couple the
motion of X-ray tube with the motion of the receptor.
With the introduction of digital flat-panel X-ray detectors, which are capable of low
electronic noise and fast-read out times, it is possible to acquire many discrete projections
at low overall patient dose within a breathold. As a result, there have been renewed
interests in digital tomosynthesis in most recent years [11 –16].
Fig. 1 illustrates a typical digital tomosynthesis acquisition system. The z-resolution of
the reconstructed tomographic plane determines the capability to resolve adjacent
structures in z-dimension (perpendicular to the detector plane) and thus would greatly
affect nodule identification and reduce false-positives. For this reason, the z-resolution is
one of the most important image quality metrics for a Tomosynthesis system. The
relationship between the angular range at acquisition and the z-resolution in the
reconstructed planes has yet to be carefully investigated due to the lack of a tomosynthesis
system capable of fully automated acquisitions in a variety of angular ranges.

2. Method and apparatus

2.1. Phantom study

A newly developed Tomosynthesis prototype system was utilized to investigate
relationship between angular range and z-resolution through a phantom study. This
prototype system consists of an automatic X-ray tube motion control, an automatic
exposure control synchronized with tube motion, and an amorphous silicon flat panel
digital X-ray detector which is capable of fast readout times. The X-ray detector has low

Fig. 1. A typical digital radiographic tomosynthesis acquisition system. A sequence of discrete projection images
is acquired over a limited angular range, which allows the retrospective reconstruction of an arbitrary number of
tomographic planes (parallel to the detector plane) through the anatomy of interest. The acquisition is done
typically within a breathold with low overall patient dose.
 B. Li et al. / International Congress Series 1268 (2004) 13–18 15

electronic noise at low dose. This fully automated system is capable of acquiring
projection images at an angular range up to 70j (+/ 35j). An optimized filtered
backprojection (FBP) reconstruction technique was used in this study.
Three experiments were performed using this system with an anthropomorphic chest
phantom. The chest phantom was positioned in an anterior –posterior (AP) view mode and
the scanning direction was along the spine. The angular ranges were 20j (+/ 10j), 40j
(+/ 20j), and 60j (+/ 30j), respectively. After each acquisition, 49 tomographic planes
were reconstructed in parallel to the detector plane, covering about 24 cm in distance in the

Fig. 2. Reconstructed tomosynthesis planes of the anthropomorphic chest phantom. (Columns, from the left to the
right) Acquisition angular range was 20j, 40j, and 60j, respectively. (Rows, from the top to the bottom) Distance
from the surface of detector container was 7.5, 8.5, 9.5, 10.5, and 11.5 cm, respectively. An 8.8-cm non-calcified
nodule is located in the right upper lobe. Although visible in all angular ranges, the nodule spreads out more in the
z-dimension at smaller angular range than at bigger one. A customized filtered backprojection algorithm (FBP)
was used to reconstruct all images shown.
16 B. Li et al. / International Congress Series 1268 (2004) 13–18

z-dimension. The height of the first plane was selected to be just above the detector face
plate, and the inter-plane spacing was selected to be 5 mm. The image size of each
reconstructed plane was 2048  2048 with a pixel pitch of 200 Am. An AP image of the
chest phantom was also taken using the regular protocol and was used later as a reference.
In order to measure the z-resolution, a few objects of interest in the chest phantom were
carefully selected, and their spread in the z-dimension was measured. These objects
included a 2-mm calcified ‘‘nodule’’ and an 8.8-mm non-calcified ‘‘nodule,’’ both
invisible in the regular AP image due to overlying structures (i.e., spine, ribs, heart).
Multiple human observers, who are familiar with chest X-ray images, were asked to look
through the reconstructed planes to determine on how many planes these structures were
visible. Results were averaged over the observers.

2.2. Simulation study

In addition to the phantom study, a simulation study was performed to investigate the
relationship in a controlled scenario. This study involved a computerized phantom of a

Fig. 3. Simulation study results. (a) The z-profile (impulse response in z-dimension) of a simulated one-pixel wire
phantom at different acquisition angles. (b) FWHM (z-resolution) as a function of angular ranges.
 B. Li et al. / International Congress Series 1268 (2004) 13–18 17

Table 1
Z-resolution versus angular range for different phantoms
Angular 2-mm nodule 8.8-mm nodule 1-pixel wire
range (deg) (mm, average) (mm, average) (pixels)
2.5 – – 48.0
5 – – 25.2
10 – – 20.9
20 15 43.4 11.4
30 – – 7.1
40 7.5 23.3 5.8
50 – – 4.6
60 <5 13.4 3.4
Correlation coefficient (I, III) = 0.997, p-value = 0.034; correlation coefficient (II, III) = 0.998, p-value = 0.022.

wire (one-pixel in diameter) placed in parallel to the detector plane, and a simulation
software which could generate a set of projection images based on the given geometry
(angular range, signal-to-image distance, etc.) and material property (e.g., attenuation
coefficients). After the projections were generated, a number of planes were reconstructed
in parallel to the detector plane with 200-Am inter-plane spacing. The z-resolution was
finally measured using the full-width-half-maximum (FWHM) method. This procedure
was repeated in a number of experiments performed at the angular range 2.5j, 5j, 10j,
20j, 30j, 40j, 50j, and 60j.

3. Results
In the phantom study, all human observers agreed that the nodules, no matter the size,
were visible in more slices at smaller angular range than a larger one (Fig. 2). This is
consistent with the results from the simulation study (Fig. 3). Results are summarized in
Table 1. The regression analysis indicated that the results from the phantom and simulation
studies were highly correlated (correlation coefficient = 0.998, p-value = 0.022) between
20j and 60j. Results have shown that increasing the angular range from 20j to 40j
reduced the z spread (i.e., increases z-resolution) by 49.1%; further increasing the angular
range to 60j reduced the z spread by another 21.1%.
Moreover, due to the higher z spread, reconstructed tomographic planes tend to contain
more structures from the slices above and below, which are usually termed as ‘‘out-of-
focus’’ structures. This can be clearly seen in Fig. 2.

4. Discussion
The impact of the acquisition angular range on the z-resolution in radiographic
tomosynthesis has been investigated through both anthropomorphic phantom study and
simulation study. The results of these studies revealed overall nonlinear relationships
between the angular range and the z-resolution. However, within a certain angular range
(i.e., 20j to 60j), their relationship was linear.
Since this study assumed that the backprojection process is linear, the conclusion is in
general applicable to those algorithms based on linear or near-linear backprojection
operation, such as shift-and-add (SA), simple backprojection (SBP), filtered backprojec-
18 B. Li et al. / International Congress Series 1268 (2004) 13–18

tion (FBP), and algebraic reconstruction technique (ART). It is possible, however, to

modify the contents in reconstructed planes to suppress the out-of-focus blurring (so-called
‘‘deblurring’’) using either a priori knowledge [17], a nonlinear backprojection method
[18], or an iterative approach [19], which may result in z-resolution being less dependent
on the angular range at a cost of additional processing time.

References
[1] H. McAdams, D. Godfrey, J.T. Dobbins III, Digital tomosynthesis for improved lung nodule detection:
initial clinical experience, RSNA Scientific Programs (2003).
[2] E. Rafferty, et al., Comparison of full-field digital tomosynthesis with two view conventional film screen
mammography in the prediction of lesion malignancy, RSNA Scientific Programs (2002).
[3] J. Duryea, J.T. Dobbins III, J.A. Lynch, Digital tomosynthesis of hand joints for arthritis assessment,
Medical Physics 30 (3) (2003) 325 – 333.
[4] F.H. Fahey, et al., Application of TACT to the evaluation of total joint arthroplasty, Medical Physics 30 (3)
(2003) 454 – 460.
[5] I.B. Tutar, et al., Tomosynthesis-based localization of radioactive seeds in prostate brachytheraphy, Medical
Physics 30 (12) (2003) 3135 – 3142.
[6] D.G. Grant, Tomosynthesis: a three-dimensional radiographic imaging technique, IEEE Transactions on
Biomedical Engineering 19 (1) (1972) 20 – 28.
[7] E.R. Miller, E.M. McCurry, B. Hruska, An infinite number of laminagrams from a finite number of radio-
graphs, Radiology 98 (1971) 249 – 255.
[8] B.G. Ziedses des Plantes, Eine neue methode zur differenzierung in der roentgenographie (planigraphie),
Acta Radiologica 13 (1932) 182 – 192.
[9] J.B. Garrison, et al., Three dimensional roentgenography, American Journal of Roentgenography 105
(1969) 903 – 908.
[10] J.T. Dobbins III, D.J. Godfrey, Topical review, Digital X-ray tomosynthesis: current state of the art and
clinical potential, Physics in Medicine and Biology 48 (2003) R65 – R106.
[11] L.T. Niklason, et al., Digital tomosynthesis in breast imaging, Radiology 205 (1997) 399 – 406.
[12] R.J. Rich, D.J. Godfrey, J.T. Dobbins III, Applications of matrix inverse tomosynthesis, Proceedings of
SPIE Conference on Medical Imaging 3977 (2000) 376 – 382.
[13] http://www.mgh.harvard.edu/news/releases/121002tomosnythesis.htm.
[14] T. Wu, et al., Tomographic mammography using a limited number of low-dose cone-beam projection
images, Medical Physics 30 (2003) 365 – 380.
[15] http://www.gemedicalsystems.com/company/pressroom/releases/pr_release_9422.html.
[16] http://www.hologic.com/press-rel/press120203.shtml.
[17] J.T. Dobbins III, Matrix inversion tomosynthesis improvements in longitudinal X-ray slice imaging, US
Patent No. 4903204, 1990.
[18] B.E.H. Claus, et al., Preference study of reconstructed image quality in mammographic tomosynthesis,
Proceedings of the 6th Intl. Workshop on Digital Mammo (2002).
[19] B. Wang, K. Barner, D. Lee, Fast reconstruction for unconstrained cone beam tomosynthesis, Proceedings
of SPIE Conference on Medical Imaging 5370 (2004) (??).