Reproducing 2D Breast Mammography Images with 3D Printed Phantoms

Mammography is currently the standard imaging modality used to screen women for breast abnormalities and, as a result, it is a tool of great importance for the early detection of breast cancer. Physical phantoms are commonly used as surrogates of breast tissue to evaluate some aspects of the performance of mammography systems. However, most phantoms do not reproduce the anatomic heterogeneity of real breasts. New fabrication technologies, such as 3D printing, have created the opportunity to build more complex, anatomically realistic breast phantoms that could potentially assist in the evaluation of mammography systems. The primary objective of this work is to present a simple, easily reproducible methodology to design and print 3D objects that replicate the attenuation profile observed in real 2D mammograms. The secondary objective is to evaluate the capabilities and limitations of the competing 3D printing technologies, and characterize the x-ray properties of the different materials they use. Printable phantoms can be created using the open-source code introduced in this work, which processes a raw mammography image to estimate the amount of x-ray attenuation at each pixel, and outputs a triangle mesh object that encodes the observed attenuation map. The conversion from the observed pixel gray value to a column of printed material with equivalent attenuation requires certain assumptions and knowledge of multiple imaging system parameters, such as x-ray energy spectrum, source-to-object distance, compressed breast thickness, and average breast material attenuation. A detailed description of the new software, a characterization of the printed materials using x-ray spectroscopy, and an evaluation of the realism of the sample printed phantoms are presented.