{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T13:45:17Z","timestamp":1792071917609,"version":"4.4.0"},"reference-count":22,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:00:00Z","timestamp":1787616000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:00:00Z","timestamp":1787616000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01CA196528"],"award-info":[{"award-number":["R01CA196528"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R37CA273959"],"award-info":[{"award-number":["R37CA273959"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007929","name":"Institute for Translational Medicine and Therapeutics","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007929","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Medical Physics"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The EUREF protocol measures the z\u2010resolution of a digital breast tomosynthesis (DBT) system via a ball bearing's (BB) point\u2010spread function (PSF) and is quantified as the full\u2010width at half\u2010maximum (FWHM) of the associated artifact spread function (ASF). PSF is largely governed by the apparent angle (), defined as the radian angle subtended by the BB across the X\u2010ray sources, which in turn depends on the BB's location and acquisition geometry. Under fixed DBT geometry and reconstruction conditions, the FWHM is therefore expected to follow a predictable spatial trend. However, we found that the EUREF protocol does not consistently reproduce this behavior; it fails to capture the gradual rise in FWHM for anteriorly displaced BBs expected from a narrowing  (with which FWHM is inversely correlated) and exhibits a systematic bias to the stochastic noise in the reconstruction image.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The purpose of this work was to develop a z\u2010resolution metric that more rigorously reflects the underlying local PSF's  without incurring a sensitivity to stochastic noise. We propose a protocol that uses multiplanar reconstruction to track the oblique BB signal in its natural spatial scale, uses means instead of maxima to generate the ASF, and employs a functional fit to estimate the FWHM more robustly\u2014hereafter referred to as the Modified Protocol.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The protocol was evaluated using analytically simulated and experimentally acquired DBT reconstructions of BBs displaced anteriorly and superiorly and compared against the EUREF protocol. The percent change in FWHM due to stochastic noise was used to quantify systematic noise susceptibility. The strength of the anti\u2010correlation between FWHM and apparent angle \u03b1 was used to assess each protocol's agreement with the PSF geometry.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>By demonstrating a consistent linear anti\u2010correlation between FWHM and \u03b1 for both superior and anterior BB displacements, the Modified protocol faithfully captures the spatial variation in PSF. The Modified protocol also substantially reduces the noise\u2010induced FWHM shift\u2014by 98% in simulations and 84% in physical experiments\u2014relative to the EUREF protocol.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The EUREF protocol exhibits systematic errors which can limit its reliability in characterizing the z\u2010resolution. Our Modified protocol mitigates these shortcomings and restores concordance between measured z\u2010resolution and the underlying local PSF geometry (), while also improving precision by reducing the susceptibility to stochastic noise. The Modified protocol thus offers an alternative to the existing EUREF framework, providing a z\u2010resolution metric that serves as a more reliable surrogate for the PSF while remaining more robust to image noise.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mp.70625","type":"journal-article","created":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T07:07:52Z","timestamp":1787641672000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Modified Z\u2010resolution protocol for digital breast tomosynthesis"],"prefix":"10.1002","volume":"53","author":[{"given":"Priyash","family":"Singh","sequence":"first","affiliation":[{"name":"Department of Radiology University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nyasha G.","family":"Maforo","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Barufaldi","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew D. A.","family":"Maidment","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymond J.","family":"Acciavatti","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,25]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"vanEngenRE BosmansH BouwmanR et\u00a0al.Protocol for the quality control of the physical and technical aspects of digital breast tomosynthesis systems. EUREF;2018.https:\/\/www.researchgate.net\/publication\/276202841_Protocol_for_the_Quality_Control_of_the_Physical_and_Technical_Aspects_of_Digital_Breast_Tomosynthesis_Systems"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejmp.2018.08.009"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.6009\/jjrt.2023\u20101395"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejmp.2016.05.001"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.4764908"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.2558160"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.2996110"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.3090889"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejmp.2024.103300"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.4959539"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1117\/12.2608811"},{"key":"e_1_2_10_13_1","first-page":"97","volume-title":"Medical imaging 2021: physics of medical imaging","author":"Vent TL","year":"2021"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1117\/12.2511990"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1117\/12.2294931"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/mp.16981"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-94-011-5318-8_46"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1117\/12.2626272"},{"key":"e_1_2_10_19_1","volume-title":"Digital mammography quality control manual","author":"Berns EA","year":"2020"},{"key":"e_1_2_10_20_1","first-page":"10","volume-title":"Medical imaging 2019: physics of medical imaging","author":"Acciavatti RJ","year":"2019"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1117\/1.JMI.12.S1.S13010"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1117\/12.3026749"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1117\/1.JMI.12.S1.S13009"}],"container-title":["Medical Physics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mp.70625","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/mp.70625","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mp.70625","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T12:54:22Z","timestamp":1792068862000},"score":1,"resource":{"primary":{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/10.1002\/mp.70625"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,25]]},"references-count":22,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1002\/mp.70625"],"URL":"https:\/\/doi.org\/10.1002\/mp.70625","archive":["Portico"],"relation":{},"ISSN":["0094-2405","2473-4209"],"issn-type":[{"value":"0094-2405","type":"print"},{"value":"2473-4209","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,25]]},"assertion":[{"value":"2026-05-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-17","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-25","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70625"}}