Improving Digital Breast Tomosynthesis: Developing a Novel Phantom for StandardizedMicrocalcification Detection Using Crystalline Growth System

Background: /Objectives: Accurate detection of microcalcifications in mammograms is critical for the early detection of breast cancer. However, variability between different manufacturers is significant, particularly with digital breast tomosynthesis (DBT). Manufacturers have many design differences, including sweep angles, detector types, reconstruction techniques, filters, and focal spot size. This study describes developing a novel phantom model based on crystallizations to standardize microcalcification detection in DBT, aiming to create consistency in the evaluation, which can lead to inconsistent interpretations and patient management. Methods: We created a novel phantom model that simulates different types of breast tissue density with calcifications. Further, these crystalline-grown phantoms can more accurately represent microcalcification’s physiological shapes and compositions than other available phantoms for calcifications and can be evaluated on different systems. Microcalcification patterns were generated using evaporation of sodium chloride, transplantation of calcium carbonate crystals, and/or injection of hydroxyapatite. These patterns were embedded in multiple layers within the wax to simulate various depths and distributions of calcifications with the ability to generate a large variety of patterns. Results: Tomosynthesis imaging revealed that phantoms utilizing calcium carbonate crystals showed demonstrable visualization differences between the 3D DBT reconstructions and the magnification/2D view, illustrating the model's value. The phantom was able to highlight changes in contrast and resolution, which is crucial for accurate microcalcification evaluation. Conclusions: Based on crystalline growth, this phantom model offers an important new standardized target for evaluating DBT systems.  By promoting standardization, especially through the development of advanced breast calcification phantoms, this work and design aims to contribute to improving earlier and more accurate breast cancer detection.