An X-ray tomosynthesis apparatus accurately extracts a region of a small high absorber in a subject on 2D measurement projection data. When pieces of the 2D measurement projection data for each of a plurality of projection angles are arranged in a projection angle direction, the 2D measurement projection data is shifted in a 2D plane so that part or all of a range of a high absorber region included in the 2D measurement projection data overlaps at least a range of the high absorber region included in 2D measurement projection data at an adjacent projection angle in an in-plane direction of the 2D plane. The 2D measurement projection data for each of the plurality of projection angles after shifting is arranged in the projection angle direction to obtain 3D measurement projection data, and a 3D region is obtained from a first start point by a region expansion process.