Realism of mammography tissue patches simulated using perlin noise: A forced choice reading study

Magnus Dustler, Predrag Bakic, Debra M. Ikeda, Kristina Lång, Reyer Zwiggelaar

Research output: Chapter in Book/Report/Conference proceedingConference Proceeding (Non-Journal item)


Software breast phantoms are central to the optimization of breast imaging, where in many cases the use of real images would be inefficient - or impossible. Establishing the realism of such phantoms is critical. For this study, patches of simulated breast tissue with different composition - fatty, scattered, heterogenous and dense tissue - were generated using a method based on Perlin noise. The composition of the patches is controlled by numerical parameters derived from input by radiologists and medical physicists with experience of breast imaging. Separate Perlin noise-based methods were used to simulate skin pores, high-frequency noise (representing quantum and electronic noise) and ligaments and vascular structures. In a forced choice reading study, the realism of the simulated tissue patches compared to patches from real mammograms was determined. Patches of 200-500 pixels were extracted from radiolucent, linear, nodular or homogenous (10 per category) mammograms randomly selected from a previously acquired dataset. Eighteen simulated patches in the same size range were added. Four readers, two radiologists and two medical physicists were shown the images in random order and asked to rate them as real or simulated. All readers accepted a substantial fraction of simulated images as real, ranging from 22% to 72%. Only two readers showed a significant difference in the number of images rated real in the real and simulated groups, 22% vs 73% (P=.0003) and 33% vs 63% (P=.04), respectively. These results suggest that the method employed can create images that are almost indistinguishable from patches of real mammograms.

Original languageEnglish
Title of host publicationMedical Imaging 2021
Subtitle of host publicationPhysics of Medical Imaging
EditorsHilde Bosmans, Wei Zhao, Lifeng Yu
ISBN (Electronic)9781510640191
Publication statusPublished - 15 Feb 2021
EventMedical Imaging 2021: Physics of Medical Imaging - Virtual, Online, United States of America
Duration: 15 Feb 202119 Feb 2021

Publication series

NameProgress in Biomedical Optics and Imaging - Proceedings of SPIE
ISSN (Print)1605-7422


ConferenceMedical Imaging 2021: Physics of Medical Imaging
Country/TerritoryUnited States of America
CityVirtual, Online
Period15 Feb 202119 Feb 2021


  • Breast imaging
  • Mammography
  • Perlin noise
  • Reading study
  • Tissue simulation


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