This study presents a method synthesizing a two-dimensional (2D) mammographic image of reasonable quality directly from a 3D digital breast tomosynthesis (DBT) image, reconstructed using an advanced compressed sensing (CS)-based algorithm. This approach aims to reduce the radiation dose required for complementary imaging technologies of digital mammography (DM) and DBT, eliminating the need for additional DM examinations. The method involves three main steps: projection data acquisition from a DBT system, CS-based DBT reconstruction, and synthesis of a 2D mammographic image from the reconstructed DBT image. To verify the efficacy of the proposed method, we conducted both a simulation and an experiment on a numerical breast and commercially available BR3D phantoms, respectively, prior to practical implementation in real-world DBT systems. Our simulation and experimental results indicated that the CS-based algorithm yielded markedly improved DBT reconstruction quality, preserving superior image homogeneity, better edge contour and sharpening, and fewer image artifacts. The measured contrast-to-noise ratio and structural similarity values of the CS-reconstructed DBT images were 10.31 and 0.78, respectively, which were approximately 2.2 and 3.1 times larger, respectively, than those of the filtered-backprojection-reconstructed DBT images in the simulation. The quality of the synthetic mammographic images using the CS-reconstructed DBT images was similar to that of conventional mammographic images obtained using a full dose, indicating the efficacy of the proposed method. Consequently, we successfully reconstructed DBT images of substantially high quality using the CS-based algorithm and synthesised 2D mammographic images of reasonable quality, potentially reducing the radiation dose to patients in the complementary imaging technologies of DM and DBT.
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