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Review
. 2025 Jan;12(Suppl 1):S13012.
doi: 10.1117/1.JMI.12.S1.S13012. Epub 2025 Feb 12.

Evolution of tomosynthesis

Mitchell M Goodsitt  1 , Andrew D A Maidment  2
Affiliations
Review

Evolution of tomosynthesis

Mitchell M Goodsitt et al. J Med Imaging (Bellingham). 2025 Jan.

Abstract

Purpose: Tomosynthesis is a limited-angle multi-projection method that was conceived to address a significant limitation of conventional single-projection x-ray imaging: the overlap of structures in an image. We trace the historical evolution of tomosynthesis.

Approach: Relevant papers are discussed including descriptions of technical advances and clinical applications.

Results: We start with the invention of tomosynthesis by Ziedses des Plantes in the Netherlands and Kaufman in the United States in the mid-1930s and end with our predictions of future technical advances. Some of the other topics that are covered include a respiratory-gated chest tomosynthesis system of the late 1930s, film-based systems of the 1960s and 1970s, coded aperture tomosynthesis, fluoroscopy tomosynthesis, digital detector-based tomosynthesis for imaging the breast and body, orthopedic, dental and radiotherapy applications, optimization of acquisition parameters for breast and body tomosynthesis, reconstruction methods, characteristics of present-day tomosynthesis systems, x-ray tubes, and promising new applications including contrast-enhanced and multimodal breast imaging systems.

Conclusion: Tomosynthesis has had an exciting history that continues today. This should serve as a foundation for other papers in the special issue "Celebrating Digital Tomosynthesis: Past, Present and Future" in the Journal of Medical Imaging.

Keywords: imaging; tomosynthesis; x-ray.

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Figures

Fig. 1
Fig. 1
Illustration of tomosynthesis projection image (film) acquisition from different angles (left) and the method of shifting and adding those images to display different focal planes within the body (right). Note that the tomosynthesis methods are distinct from film tomography in which the x-ray source and detector (initially film) are moved in opposition about a fulcrum; the film tomography methods yield a single slice image per acquisition. Today, modern digital tomosynthesis systems employ digital radiographs and sophisticated reconstruction algorithms akin to those used in CT.
Fig. 2
Fig. 2
Custom high-intensity light box film viewer for Dynatome tomosynthesis system.
Fig. 3
Fig. 3
Combined tomosynthesis and automated ultrasound breast imaging system developed at the University of Michigan is shown in the ultrasound image acquisition position while scanning a breast-simulating phantom (a). A closeup of the ultrasound transducer scanning mechanism and dual-modality mesh paddle (b). This mechanism is flipped up out-of-view for DBT acquisition.
Fig. 4
Fig. 4
Historical evolution of tomosynthesis timeline.
See this image and copyright information in PMC

References

    1. Ziedses des Plantes B. G., “Seriescopy, Een Rontgenographische method welke het mogelijk maakt achtereenvolgens een oneindig aantal evenwijdige vlakken van het te onderzoeken voorwerp afzonderlijk te beschouwen (Seriescopy, a Roentgenographic method which allows an infinite number of successive parallel planes of the test object to be considered separately (English translation),” Ned. Tijdschr. Geneesk 51, 5852–5856 (1935).
    1. Ziedses des Plantes B. G., “Rontgenologic method and apparatus for consecutively observing a plurality of planes of an object,” UK patent 487389 (1936).
    1. Ziedses des Plantes B. G., “Serisocopy: Ein röntgenographische Methode welke ermöglicht mit Hilfe einiger Aufnahmen eine unendlich Reihe paralleler Ebenen in Reichenfolge gesondert zu betrachten (A fading X-ray method which allows using some recordings to consider an infinite number of parallel planes in rich sequence separately) (English translation),” Geb. Röntgenstr. 57, 605–619 (1938).
    1. Webb S., From the Watching of Shadows, the Origins of Radiological Tomography, Adam Hilger, Bristol, England: (1990).
    1. Kaufman J., “Planeogrpahy, localization, and mensuration: “Standard Depth curves”,” Radiology 27, 168–174 (1936. a). 10.1148/27.2.168 - DOI