{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T08:51:21Z","timestamp":1773391881931,"version":"3.50.1"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"3\u20134","license":[{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100000266","name":"Engineering and Physical Sciences Research Council","doi-asserted-by":"publisher","award":["EP\/W004445\/1"],"award-info":[{"award-number":["EP\/W004445\/1"]}],"id":[{"id":"10.13039\/501100000266","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Accelerate Programme for Scientific Discovery"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,13]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>This investigation aimed to compare perceived lesion detectability and visibility between limited-angle cone-beam computed tomography (CBCT) photon-counting (PC) and flat-panel (FP) mammography at equivalent radiation-dose levels. Projection data were collected by rotating a lesion-containing, humanlike breast phantom and acquiring images at every other degree using both a PC and an FP system, resulting in 5\u201313 projections over an 8\u201324\u00b0 angular range. Feldkamp\u2013Davis\u2013Kress (FDK) and simultaneous iterative reconstruction technique (SIRT) algorithms were used to reconstruct three-dimensional (3D) volumes for each system. A reader study evaluated lesion detectability and visibility in the 3D data. PC-CBCT showed better detectability and visibility of masses compared to FP-CBCT, with 90% sensitivity versus 70% and an area under the visual grading curve (AUCVGC) of 0.66\u20130.71 (P\u00a0&amp;lt;\u00a0.05). FDK image volumes demonstrated improved calcification visibility (P\u00a0&amp;lt;\u00a0.05) with PC-CBCT over FP-CBCT; however, for SIRT, calcification visibility was lower (AUCVGC\u00a0=\u00a00.46). This study emphasizes the need to reassess photon-counting in 3D mammography to improve lesion detection and visibility.<\/jats:p>","DOI":"10.1093\/rpd\/ncaf181","type":"journal-article","created":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T12:57:45Z","timestamp":1769086665000},"page":"346-357","source":"Crossref","is-referenced-by-count":0,"title":["A comparison of limited-angle CBCT photon-counting and flat-panel digital mammography in perceived detection and visualization of breast lesions"],"prefix":"10.1093","volume":"202","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4754-9626","authenticated-orcid":false,"given":"Tony Martin","family":"Svahn","sequence":"first","affiliation":[{"name":"Centre for Research and Development, Uppsala University\/Region G\u00e4vleborg , Lasarettsv\u00e4gen 1, 801 88 G\u00e4vle ,","place":["Sweden"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Radu","family":"Lesanu","sequence":"additional","affiliation":[{"name":"Department of Mammography, G\u00e4vle Hospital, Region G\u00e4vleborg , Lasarettsv\u00e4gen 1, 80188 G\u00e4vle ,","place":["Sweden"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ander","family":"Biguri","sequence":"additional","affiliation":[{"name":"Department of Applied Mathematics and Theoretical Physics (DAMTP), University of Cambridge , Wilberforce Rd, Cambridge, CB3 0WA ,","place":["United Kingdom"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Ast","sequence":"additional","affiliation":[{"name":"Klockargatan 10 , Uppsala 752 20 ,","place":["Sweden"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,3,13]]},"reference":[{"key":"2026031302442362000_ref1","doi-asserted-by":"publisher","first-page":"356","DOI":"10.1016\/j.ejca.2018.07.005","article-title":"Cancer incidence and mortality patterns in Europe: estimates for 40 countries and 25 major cancers in 2018","volume":"103","author":"Ferlay","year":"2018","journal-title":"Eur J Cancer"},{"key":"2026031302442362000_ref2","doi-asserted-by":"publisher","first-page":"314","DOI":"10.1093\/rpd\/ncv078","article-title":"Digital breast tomosynthesis in one or two views as a replacement or adjunct technique to full-field digital mammography","volume":"165","author":"Svahn","year":"2015","journal-title":"Radiat Prot Dosim"},{"key":"2026031302442362000_ref3","doi-asserted-by":"publisher","first-page":"927","DOI":"10.1007\/s00330-013-3091-8","article-title":"Letter to the editor re: diagnostic accuracy of digital breast tomosynthesis versus digital mammography for benign and malignant lesions in breasts: a meta-analysis","volume":"24","author":"Svahn","year":"2014","journal-title":"Eur Radiol"},{"key":"2026031302442362000_ref4","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1016\/j.breast.2013.01.017","article-title":"Overview of the evidence on digital breast tomosynthesis in breast cancer detection","volume":"22","author":"Houssami","year":"2013","journal-title":"Breast"},{"key":"2026031302442362000_ref5","doi-asserted-by":"publisher","first-page":"e221571","DOI":"10.1148\/radiol.221571","article-title":"Mammographic screening in routine practice: multisite study of digital breast tomosynthesis and digital mammography screenings","volume":"307","author":"Conant","year":"2023","journal-title":"Radiology"},{"key":"2026031302442362000_ref6","doi-asserted-by":"publisher","first-page":"345","DOI":"10.1148\/radiol.13131181","article-title":"Digital mammography screening with photon-counting technique: can a high diagnostic performance be realized at low mean glandular dose?","volume":"271","author":"Weigel","year":"2014","journal-title":"Radiology"},{"key":"2026031302442362000_ref7","doi-asserted-by":"publisher","first-page":"788","DOI":"10.1148\/radiol.11103514","article-title":"Two-view and single-view tomosynthesis versus full-field digital mammography: high-resolution X-ray imaging observer study","volume":"262","author":"Wallis","year":"2012","journal-title":"Radiology"},{"key":"2026031302442362000_ref8","doi-asserted-by":"publisher","DOI":"10.1007\/s11547-025-02115-7","article-title":"Low dose photon-counting digital breast tomosynthesis: comparison with a commercially available tomosynthesis unit in the detection and characterization of breast carcinomas","author":"Venturini","year":"2025","journal-title":"Radiol Med"},{"key":"2026031302442362000_ref9","doi-asserted-by":"publisher","first-page":"454","DOI":"10.1093\/rpd\/ncab104","article-title":"Comparison of photon-counting and flat-panel digital mammmography for the purpose of 3D imaging using a novel image processing method","volume":"195","author":"Svahn","year":"2021","journal-title":"Radiat Prot Dosim"},{"key":"2026031302442362000_ref10","doi-asserted-by":"publisher","first-page":"549","DOI":"10.1002\/mp.12684","article-title":"Characterization of photon-counting multislit breast tomosynthesis","volume":"45","author":"Berggren","year":"2018","journal-title":"Med Phys"},{"key":"2026031302442362000_ref11","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1016\/j.breast.2014.12.002","article-title":"Review of radiation dose estimates in digital breast tomosynthesis relative to those in two-view full-field digital mammography","volume":"24","author":"Svahn","year":"2015","journal-title":"Breast"},{"key":"2026031302442362000_ref12","doi-asserted-by":"publisher","first-page":"1124","DOI":"10.1002\/1097-0142(197609)38:3&lt;1124::AID-CNCR2820380312&gt;3.0.CO;2-P","article-title":"Single view mammography: a simple and efficient approach to breast cancer screening","volume":"38","author":"Lundgren","year":"1976","journal-title":"Cancer"},{"key":"2026031302442362000_ref13","doi-asserted-by":"publisher","first-page":"614","DOI":"10.1093\/annonc\/mdm481","article-title":"European guidelines for quality assurance in breast cancer screening and diagnosis. Fourth edition\u2014summary document","volume":"19","author":"Perry","year":"2008","journal-title":"Ann Oncol"},{"key":"2026031302442362000_ref14","doi-asserted-by":"publisher","first-page":"3225","DOI":"10.1088\/0031-9155\/45\/11\/308","article-title":"Additional factors for the estimation of mean glandular breast dose using the UK mammography dosimetry protocol","volume":"45","author":"Dance","year":"2000","journal-title":"Phys Med Biol"},{"key":"2026031302442362000_ref15","doi-asserted-by":"publisher","first-page":"453","DOI":"10.1088\/0031-9155\/56\/2\/011","article-title":"Estimation of mean glandular dose for breast tomosynthesis: factors for use with the UK, European and IAEA breast dosimetry protocols","volume":"56","author":"Dance","year":"2011","journal-title":"Phys Med Biol"},{"key":"2026031302442362000_ref16","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1016\/j.jpdc.2020.07.004","article-title":"Arbitrarily large tomography with iterative algorithms on multiple GPUs using the TIGRE toolbox","volume":"146","author":"Biguri","year":"2020","journal-title":"J Parallel Distributed Comput"},{"key":"2026031302442362000_ref17","doi-asserted-by":"publisher","first-page":"612","DOI":"10.1364\/JOSAA.1.000612","article-title":"Practical cone-beam algorithm","volume":"1","author":"Feldkamp","year":"1984","journal-title":"J Opt Soc Am A"},{"key":"2026031302442362000_ref18","doi-asserted-by":"publisher","first-page":"331","DOI":"10.1093\/rpd\/ncv079","article-title":"Evaluation of time-efficient reconstruction methods in digital breast tomosynthesis","volume":"165","author":"Svahn","year":"2015","journal-title":"Radiat Prot Dosim"},{"key":"2026031302442362000_ref19","doi-asserted-by":"publisher","first-page":"e1074","DOI":"10.1259\/bjr\/53282892","article-title":"Breast tomosynthesis and digital mammography: a comparison of diagnostic accuracy","volume":"85","author":"Svahn","year":"2012","journal-title":"Br J Radiol"},{"key":"2026031302442362000_ref20","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1093\/rpd\/ncq044","article-title":"The diagnostic accuracy of dual-view digital mammography, single-view breast tomosynthesis and a dual-view combination of breast tomosynthesis and digital mammography in a free-response observer performance study","volume":"139","author":"Svahn","year":"2010","journal-title":"Radiat Prot Dosim"},{"key":"2026031302442362000_ref21","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1109\/TNS.1974.6499238","article-title":"A tutorial on ART (algebraic reconstruction techniques)","volume":"21","author":"Gordon","year":"1974","journal-title":"IEEE Trans Nucl Sci"},{"key":"2026031302442362000_ref22","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1177\/016173468400600107","article-title":"Simultaneous algebraic reconstruction technique (SART): a superior implementation of the art algorithm","volume":"6","author":"Andersen","year":"1984","journal-title":"Ultrason Imaging"},{"key":"2026031302442362000_ref23","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1093\/rpd\/ncq057","article-title":"VIEWDEX: an efficient and easy-to-use software for observer performance studies","volume":"139","author":"Hakansson","year":"2010","journal-title":"Radiat Prot Dosim"},{"key":"2026031302442362000_ref24","doi-asserted-by":"publisher","first-page":"372","DOI":"10.1093\/rpd\/ncab014","article-title":"Viewdex 3.0-recent development of a software application facilitating assessment of image quality and observer performance","volume":"195","author":"Svalkvist","year":"2021","journal-title":"Radiat Prot Dosim"},{"key":"2026031302442362000_ref25","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1016\/0169-2607(95)01703-8","article-title":"MedCalc: a new computer program for medical statistics","volume-title":"Comput Methods Programs Biomed.","author":"Schoonjans","year":"1995"},{"key":"2026031302442362000_ref26","doi-asserted-by":"publisher","first-page":"283","DOI":"10.1016\/S0001-2998(78)80014-2","article-title":"Basic principles of ROC analysis","volume":"8","author":"Metz","year":"1978","journal-title":"Semin Nucl Med"},{"key":"2026031302442362000_ref27","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1093\/rpd\/ncv542","article-title":"Vgc analyzer: a software for statistical analysis of fully crossed multiple-reader multiple-case visual grading characteristics studies","volume":"169","author":"Bath","year":"2016","journal-title":"Radiat Prot Dosim"},{"key":"2026031302442362000_ref28","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1053\/j.semnuclmed.2011.07.001","article-title":"New developments in observer performance methodology in medical imaging","volume":"41","author":"Chakraborty","year":"2011","journal-title":"Semin Nucl Med"},{"key":"2026031302442362000_ref29","doi-asserted-by":"publisher","first-page":"03TR01","DOI":"10.1088\/1361-6560\/abc5a5","article-title":"Photon-counting X-ray detectors for CT","volume":"66","author":"Danielsson","year":"2021","journal-title":"Phys Med Biol"},{"key":"2026031302442362000_ref30","doi-asserted-by":"publisher","first-page":"4315","DOI":"10.1007\/s00330-018-5849-5","article-title":"Dose estimation of ultra-low-dose chest CT to different sized adult patients","volume":"29","author":"Svahn","year":"2019","journal-title":"Eur Radiol"},{"key":"2026031302442362000_ref31","doi-asserted-by":"publisher","first-page":"487","DOI":"10.1016\/0022-2496(69)90019-4","article-title":"Maximum-likelihood estimation of parameters of signal-detection theory and determination of confidence intervals\u2014rating-method data","volume":"6","author":"Dorfman","year":"1969","journal-title":"J Math Psychol"},{"key":"2026031302442362000_ref32","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1109\/TNSRE.2025.3646472","article-title":"The magical number seven, plus or minus two: some limits on our capacity for processing information","volume":"63","author":"Miller","year":"1956","journal-title":"Psychol Rev"},{"key":"2026031302442362000_ref33","doi-asserted-by":"publisher","first-page":"20190345","DOI":"10.1259\/sbjr.20190345","article-title":"Evaluation of a new image reconstruction method for digital breast tomosynthesis: effects on the visibility of breast lesions and breast density","volume":"92","author":"Krammer","year":"2019","journal-title":"Br J Radiol"},{"key":"2026031302442362000_ref34","doi-asserted-by":"crossref","first-page":"e70247","DOI":"10.1002\/mco2.70247","article-title":"Deep learning in digital breast tomosynthesis: current status, challenges, and future trends","volume":"6","author":"Wang","year":"2020","journal-title":"MedComm"}],"container-title":["Radiation Protection Dosimetry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/rpd\/article-pdf\/202\/3%E2%80%934\/346\/67333123\/ncaf181.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/rpd\/article-pdf\/202\/3%E2%80%934\/346\/67333123\/ncaf181.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T06:44:27Z","timestamp":1773384267000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/rpd\/article\/202\/3%E2%80%934\/346\/8518608"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":34,"journal-issue":{"issue":"3\u20134","published-online":{"date-parts":[[2026,3,13]]},"published-print":{"date-parts":[[2026,3,13]]}},"URL":"https:\/\/doi.org\/10.1093\/rpd\/ncaf181","relation":{},"ISSN":["0144-8420","1742-3406"],"issn-type":[{"value":"0144-8420","type":"print"},{"value":"1742-3406","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,3]]},"published":{"date-parts":[[2026,3]]}}}