Methodology to simulate temporal changes in breast tumors and parenchyma using Perlin noise

Simulation of temporal changes in breast tissue has been a challenging task, despite significant development in virtual clinical trials. This study aims to enable virtual trials over time. We present a framework for simulating 3D voxel phantoms and breast lesions, using our algorithm based on Perlin Noise, in three modules. In the Population Creator, users can simulate cases based on real population characteristics. In Phantom Creator and Lesion Creator, users select the breast and lesion shape, size, and density. Perlin Noise parameters are selected to match the appearance of different tissue types. We used open-source software to project and reconstruct phantom DBT images. Assuming the volumetric breast density of 10.7% at 57 years and an exponential decrease over time, we simulate the anatomy at the inclusion and exclusion in the screening program (40 and 74 years in Sweden). The breast density was calculated to be 16.0% and 7.2%, respectively. Similarly, we simulate lesions at different times, assuming a doubling time of 282 days. We present a framework for simulating temporal changes in breast tissue, to support the use of virtual trials over time.