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The breast phantom is composed of breast surface, duct system and terminal ductal lobular units, Cooper's ligaments, lymphatic and blood vessel systems, pectoral muscle, skin, 3D mammographic background texture, and breast abnormalities. The key improvement is the development of a new algorithm for 3D mammographic texture generation. Simulated images of the enhanced 3D breast model without lesions were produced by simulating mammographic image acquisition and were evaluated subjectively and quantitatively. For evaluation purposes, a database with regions of interest taken from simulated and real mammograms was created. Four experienced radiologists participated in a visual subjective evaluation trial, as they judged the quality of the simulated mammograms, using the new algorithm compared to mammograms, obtained with the old modeling approach. In addition, extensive quantitative evaluation included power spectral analysis and calculation of fractal dimension, skewness, and kurtosis of simulated and real mammograms from the database.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p>The results from the subjective evaluation strongly suggest that the new methodology for mammographic breast texture creates improved breast models compared to the old approach. Calculated parameters on simulated images such as<jats:inline-graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"graphic\/mp1812-math-0001.png\" xlink:title=\"urn:x-wiley:00942405:media:mp1812:mp1812-math-0001\"\/> exponent deducted from the power law spectral analysis and fractal dimension are similar to those calculated on real mammograms. The results for the kurtosis and skewness are also in good coincidence with those calculated from clinical images. Comparison with similar calculations published in the literature showed good agreement in the majority of cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions:<\/jats:title><jats:p>The improved methodology generated breast models with increased realism compared to the older model as shown in evaluations of simulated images by experienced radiologists. It is anticipated that the realism will be further improved using an advanced image simulator so that simulated images may be used in feasibility studies in mammography.<\/jats:p><\/jats:sec>","DOI":"10.1118\/1.3491812","type":"journal-article","created":{"date-parts":[[2010,11,2]],"date-time":"2010-11-02T13:04:46Z","timestamp":1288703086000},"page":"5604-5617","source":"Crossref","is-referenced-by-count":59,"title":["Evaluation of an improved algorithm for producing realistic 3D breast software phantoms: Application for mammography"],"prefix":"10.1002","volume":"37","author":[{"given":"K.","family":"Bliznakova","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Suryanarayanan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Karellas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Pallikarakis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2010,10,6]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.38313.639236.82"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa050518"},{"key":"e_1_2_9_4_1","first-page":"62","article-title":"Whole\u2010breast volume perfusion images using 256\u2010row multislice computed tomography: Visualization of lesions with ductal spread","volume":"16","author":"Akashi\u2010Tanaka S.","year":"2009","journal-title":"Breast Cancer Res. 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