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Sample records for breast tomosynthesis system

  1. Three-dimensional linear system analysis for breast tomosynthesis

    Science.gov (United States)

    Zhao, Bo; Zhao, Wei

    2008-01-01

    The optimization of digital breast tomosynthesis (DBT) geometry and reconstruction is crucial for the clinical translation of this exciting new imaging technique. In the present work, the authors developed a three-dimensional (3D) cascaded linear system model for DBT to investigate the effects of detector performance, imaging geometry, and image reconstruction algorithm on the reconstructed image quality. The characteristics of a prototype DBT system equipped with an amorphous selenium flat-panel detector and filtered backprojection reconstruction were used as an example in the implementation of the linear system model. The propagation of signal and noise in the frequency domain was divided into six cascaded stages incorporating the detector performance, imaging geometry, and reconstruction filters. The reconstructed tomosynthesis imaging quality was characterized by spatial frequency dependent presampling modulation transfer function (MTF), noise power spectrum (NPS), and detective quantum efficiency (DQE) in 3D. The results showed that both MTF and NPS were affected by the angular range of the tomosynthesis scan and the reconstruction filters. For image planes parallel to the detector (in-plane), MTF at low frequencies was improved with increase in angular range. The shape of the NPS was affected by the reconstruction filters. Noise aliasing in 3D could be introduced by insufficient voxel sampling, especially in the z (slice-thickness) direction where the sampling distance (slice thickness) could be more than ten times that for in-plane images. Aliasing increases the noise at high frequencies, which causes degradation in DQE. Application of a reconstruction filter that limits the frequency components beyond the Nyquist frequency in the z direction, referred to as the slice thickness filter, eliminates noise aliasing and improves 3D DQE. The focal spot blur, which arises from continuous tube travel during tomosynthesis acquisition, could degrade DQE significantly

  2. An Object-Oriented Simulator for 3D Digital Breast Tomosynthesis Imaging System

    Directory of Open Access Journals (Sweden)

    Saeed Seyyedi

    2013-01-01

    Full Text Available Digital breast tomosynthesis (DBT is an innovative imaging modality that provides 3D reconstructed images of breast to detect the breast cancer. Projections obtained with an X-ray source moving in a limited angle interval are used to reconstruct 3D image of breast. Several reconstruction algorithms are available for DBT imaging. Filtered back projection algorithm has traditionally been used to reconstruct images from projections. Iterative reconstruction algorithms such as algebraic reconstruction technique (ART were later developed. Recently, compressed sensing based methods have been proposed in tomosynthesis imaging problem. We have developed an object-oriented simulator for 3D digital breast tomosynthesis (DBT imaging system using C++ programming language. The simulator is capable of implementing different iterative and compressed sensing based reconstruction methods on 3D digital tomosynthesis data sets and phantom models. A user friendly graphical user interface (GUI helps users to select and run the desired methods on the designed phantom models or real data sets. The simulator has been tested on a phantom study that simulates breast tomosynthesis imaging problem. Results obtained with various methods including algebraic reconstruction technique (ART and total variation regularized reconstruction techniques (ART+TV are presented. Reconstruction results of the methods are compared both visually and quantitatively by evaluating performances of the methods using mean structural similarity (MSSIM values.

  3. Stereotactic vacuum-assisted biopsies on a digital breast 3D-tomosynthesis system.

    Science.gov (United States)

    Viala, Juliette; Gignier, Pierre; Perret, Baudouin; Hovasse, Claudie; Hovasse, Denis; Chancelier-Galan, Marie-Dominique; Bornet, Gregoire; Hamrouni, Adel; Lasry, Jean-Louis; Convard, Jean-Paul

    2013-01-01

    The purpose of this study was to describe our operating process and to report results of 118 stereotactic vacuum-assisted biopsies performed on a digital breast 3D-tomosynthesis system. From October 2009 to December 2010, 118 stereotactic vacuum assisted biopsies have been performed on a digital breast 3D-tomosynthesis system. Informed consent was obtained for all patients. A total of 106 patients had a lesion, six had two lesions. Sixty-one lesions were clusters of micro-calcifications, 54 were masses and three were architectural distortions. Patients were in lateral decubitus position to allow shortest skin-target approach (or sitting). Specific compression paddle, adapted on the system, performed, and graduated, allowing localization in X-Y. Tomosynthesis views define the depth of lesion. Graduated Coaxial localization kit determines the beginning of the biopsy window. Biopsies were performed with an ATEC-Suros, 9 Gauge handpiece. All biopsies, except one, have reached the lesions. Five hemorrhages were incurred in the process, but no interruption was needed. Eight breast hematomas, were all spontaneously resolved. One was an infection. About 40% of patients had a skin ecchymosis. Processing is fast, easy, and requires lower irradiation dose than with classical stereotactic biopsies. Histology analysis reported 45 benign clusters of micro-calcifications, 16 malignant clusters of micro-calcifications, 24 benign masses, and 33 malignant masses. Of 13 malignant lesions, digital 2D-mammography failed to detect eight lesions and underestimated the classification of five lesions. Digital breast 3D-tomosynthesis depicts malignant lesions not visualized on digital 2D-mammography. Development of tomosynthesis biopsy unit integrated to stereotactic system will permit histology analysis for suspicious lesions.

  4. Comparison of mean glandular dose values provided by a digital breast tomosynthesis system in Brazil

    International Nuclear Information System (INIS)

    Studies are needed to determine the radiation dose of patients that are undergoing Digital breast tomosynthesis (DBT) procedures. Mean glandular dose (DG) values were derived from the incident air kerma (Ki) measurements and tabulated conversion coefficients. Ki values were obtained through an ionization chamber positioned in a Hologic Selenia Dimensions system using appropriate exposure parameters. This work contributes to determine the reliable radiation dose received by the patients and compare DG values provided by this DBT system images. - Highlights: • Studies are needed to determine the dose of tomosynthesis (DBT) procedures. • Mean glandular dose (DG) results derived from the incident air kerma (Ki). • Ki values were obtained through an ionization chamber. • A DBT system was used with appropriate exposure parameters. • This work contributes to compare DG values provided by this DBT system images

  5. Monte Carlo simulation for the estimation of the glandular breast dose for a digital breast tomosynthesis system

    International Nuclear Information System (INIS)

    Digital breast tomosynthesis (DBT) is a screening and diagnostic modality that acquires images of the breast at multiple angles during a short scan. The Selenia Dimensions (Hologic, Bedford, Mass) DBT system can perform both full-field digital mammography and DBT. The system acquires 15 projections over a 15 deg. angular range (from -7.5 deg. to +7.5 deg.). An important factor in determining the optimal imaging technique for breast tomosynthesis is the radiation dose. In breast imaging, the radiation dose of concern is that deposited in the glandular tissue of the breast because this is the tissue that has a risk of developing cancer. The concept of the normalised mean glandular dose (DgN) has been introduced as the metric for the dose in breast imaging. The DgN is difficult to measure. The Monte Carlo techniques offer an alternative method for a realistic estimation of the radiation dose. The purpose of this work was to use the Monte Carlo code MCNPX technique to generate monoenergetic glandular dose data for estimating the breast tissue dose in tomosynthesis for arbitrary spectra as well as to observe the deposited radiation dose by projection on the glandular portion of the breast in a Selenia Dimensions DBT system. A Monte Carlo simulation of the system was developed to compute the DgN in a craniocaudal view. Monoenergetic X-ray beams from 10 to 49 keV in 1-keV increments were used. The simulation utilised the assumption of a homogeneous breast composition and three compositions (0 % glandular, 50 % glandular and 100 % glandular). The glandular and adipose tissue compositions were specified according ICRU Report 44. A skin layer of 4 mm was assumed to encapsulate the breast on all surfaces. The breast size was varied using the chest wall-to-nipple distance (CND) and compressed breast thickness (t). In this work, the authors assumed a CND of 5 cm and the thicknesses ranged from 2 to 8 cm, in steps of 2 cm. The fractional energy absorption increases (up to 44

  6. Quality control in breast tomosynthesis

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    Jakubiak, R.R.; Messias, P.C.; Santos, M.F., E-mail: requi@utfpr.edu.br [Universidade Tecnologia Federal do Parana (UTFPR), Curitiba, PR (Brazil). Departamento Academico de Fisica; Urban, L.A.B.D., E-mail: lineiurban@hotmail.com [Diagnostico Avancado por Imagem, Curitiba, PR (Brazil)

    2015-07-01

    In Brazil, breast cancer is the most common and the leading cause of death among women, with estimated 57,000 new cases in 2014. The mammography (2D) plays an important role in the early detection of breast cancer, but in some cases can be difficult to detect malignant lesions due overlap of breast tissues. The Digital Breasts Tomosynthesis (DBT: 3D) reduces the effects of overlap, providing improved characterization of mammographic findings. However, the dose may double as compared with mammography. This study presents results of Contrast to Noise Ratio (CNR) and image quality evaluation on Siemens mammography equipment Mammomat Inspiration with tomosynthesis. The CNR was determined with Polymethylmethacrylate (PMMA) layers of 20 to 70 mm thick and an aluminum foils of 0,2 mm thickness and area of 10 mm². Image quality was assessed with the ACR Breast Simulator. In the evaluation of image quality, the detectability of fibers and masses was identical in 2D and 3D systems. Displaying fibers were 4,5 and 4 mass in both modes. In 2D mode were identified 3,5 microcalcifications groups, and 3D showed 3 groups. The Mean Glandular Dose (MGD) for the simulator in 2D mode was 1,17 mGy and 2,35 mGy for the 3D mode. The result reinforces the importance of quality control in the process of obtaining the images and obtained in accordance CNR values, ensuring image quality and compatible dose in 2D and 3D processes. (author)

  7. Quality control in breast tomosynthesis

    International Nuclear Information System (INIS)

    In Brazil, breast cancer is the most common and the leading cause of death among women, with estimated 57,000 new cases in 2014. The mammography (2D) plays an important role in the early detection of breast cancer, but in some cases can be difficult to detect malignant lesions due overlap of breast tissues. The Digital Breasts Tomosynthesis (DBT: 3D) reduces the effects of overlap, providing improved characterization of mammographic findings. However, the dose may double as compared with mammography. This study presents results of Contrast to Noise Ratio (CNR) and image quality evaluation on Siemens mammography equipment Mammomat Inspiration with tomosynthesis. The CNR was determined with Polymethylmethacrylate (PMMA) layers of 20 to 70 mm thick and an aluminum foils of 0,2 mm thickness and area of 10 mm². Image quality was assessed with the ACR Breast Simulator. In the evaluation of image quality, the detectability of fibers and masses was identical in 2D and 3D systems. Displaying fibers were 4,5 and 4 mass in both modes. In 2D mode were identified 3,5 microcalcifications groups, and 3D showed 3 groups. The Mean Glandular Dose (MGD) for the simulator in 2D mode was 1,17 mGy and 2,35 mGy for the 3D mode. The result reinforces the importance of quality control in the process of obtaining the images and obtained in accordance CNR values, ensuring image quality and compatible dose in 2D and 3D processes. (author)

  8. Quality control in breast tomosynthesis

    International Nuclear Information System (INIS)

    In Brazil breast cancer is the most common and the leading cause of death among women, with estimated 57,000 new cases in 2014. The mammography (2D) plays an important role in the early detection of breast cancer, but in some cases can be difficult to detect malignant lesions due overlap of breast tissues. The Breast Digital Tomosynthesis (BDT: 3D) reduces the effects of overlap, providing improved characterization of mammographic findings. However, the dose may double as compared to the mammography. This study presents results of Contrast Ratio Noise tests (CRN) and quality image on a Siemens mammography equipment Mammomat Inspiration with tomosynthesis. The CRN was determined with plates Polymethylmethacrylate (PMMA) of 20 to 70 mm thickness and an aluminum plate of 10 mm2 and 0.2 mm thickness. Image quality was assessed with the ACR Breast Simulator. In assessment of image quality, the detectability of fibers and masses was identical in 2D and 3D systems. Were visualized 4.5 fibers and 4 mass in both modes. In 2D mode groups have been identified 3.5 microcalcifications, and 3D were 3 groups. The Mean Glandular Dose for the simulator in 2D mode was 1.17 mGy and 2.35 mGy for the 3D mode. The result reinforces the importance of quality control in the process of obtaining the images and obtained in accordance CRN values, ensuring image quality and dose compatible in 2D and 3D processes

  9. Design and performance of the prototype full field breast tomosynthesis system with selenium based flat panel detector

    Science.gov (United States)

    Ren, Baorui; Ruth, Chris; Stein, Jay; Smith, Andrew; Shaw, Ian; Jing, Zhenxue

    2005-04-01

    We have developed a breast tomosynthesis system utilizing a selenium-based direct conversion flat panel detector. This prototype system is a modification of Selenia, Hologic"s full field digital mammography system, using an add-on breast holding device to allow 3D tomosynthetic imaging. During a tomosynthesis scan, the breast is held stationary while the x-ray source and detector mounted on a c-arm rotate continuously around the breast over an angular range up to 30 degrees. The x-ray tube is pulsed to acquire 11 projections at desired c-arm angles. Images are reconstructed in planes parallel to the breastplate using a filtered backprojection algorithm. Processing time is typically 1 minute for a 50 mm thick breast at 0.1 mm in-plane pixel size, 1 mm slice-to-slice separation. Clinical studies are in progress. Performance evaluations were carried out at the system and the subsystem levels including spatial resolution, signal-to-noise ratio, spectra optimization, imaging technique, and phantom and patient studies. Experimental results show that we have successfully built a tomosynthesis system with images showing less structure noise and revealing 3D information compared with the conventional mammogram. We introduce, for the first time, the definition of "Depth of Field" for tomosynthesis based on a spatial resolution study. This parameter is used together with Modulation Transfer Function (MTF) to evaluate 3D resolution of a tomosynthesis system as a function of system design, imaging technique, and reconstruction algorithm. Findings from the on-going clinical studies will help the design of the next generation tomosynthesis system offering improved performance.

  10. Design and feasibility studies of a stationary digital breast tomosynthesis system

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    Yang, G., E-mail: yangg@email.unc.edu [Department of Physics and Astronomy, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599 (United States); Qian, X. [Department of Physics and Astronomy, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599 (United States); Phan, T. [Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599 (United States); Sprenger, F. [XinRay Systems LLC, Research Triangle Park, NC 27709 (United States); Sultana, S.; Calderon-Colon, X. [Curriculum in Applied Sciences and Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599 (United States); Kearse, B.; Spronk, D. [XinRay Systems LLC, Research Triangle Park, NC 27709 (United States); Lu, J. [Department of Physics and Astronomy, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599 (United States); Curriculum in Applied Sciences and Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599 (United States); Zhou, O., E-mail: zhou@physics.unc.edu [Department of Physics and Astronomy, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599 (United States); Curriculum in Applied Sciences and Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599 (United States); Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599 (United States)

    2011-08-21

    Studies have shown that digital breast tomosynthesis (DBT) can improve breast cancer diagnosis by reconstructing 3D images. However, DBT scanners based on rotation gantry prolong the imaging time and reduce spatial resolution due to motion comparing with the regular two-view mammography. To obtain three dimension reconstruction images and maintain the high image quality of conventional mammography, we proposed a prototype stationary digital breast tomosynthesis system (s-DBT). The proposed s-DBT system acquires projection images without mechanical movement. The core component of the s-DBT system is a specially designed spatially distributed multi-beam X-ray tube based on the carbon nanotube field emission X-ray technology. The multi-beam X-ray source array enables collection of all projection images from different viewing angles without mechanical motion. Preliminary results show the s-DBT system can achieve a scan time comparable with the regular two-view mammography, and improve the spatial resolution comparing with rotating gantry DBT.

  11. Workload and transmission data for the installation of a digital breast tomosynthesis system

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    Li Xinhua; Zhang Da; Liu, Bob [Division of Diagnostic Imaging Physics and Webster Center for Advanced Research and Education in Radiation, Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts 02114 (United States)

    2013-06-15

    Purpose: Digital breast tomosynthesis (DBT) differs from conventional mammography in target/filter, kVp range, and imaging geometry. The aim of this study was to assess the breast input exposure of a DBT system by completing a workload survey of DBT installations, and to determine the parameters {alpha}, {beta}, and {gamma} in the Archer equation for the primary radiation generated by the clinical workload distributions. Methods: The authors conducted a retrospective survey of the x-ray breast imaging performed between September 2011 and September 2012 in three clinical DBT rooms equipped with Selenia Dimensions systems (Hologic Inc., Bedford, MA). A total of 343 examinations were analyzed to calculate the workload (mA-minute) and the primary air kerma at 1 m from the source (K{sup 1}). Transmission curves were calculated for the primary radiation generated by the workload distributions of the DBT rooms, and were fitted to the Archer equation. Results: There were large variations in patient volume and workload in the three examination rooms. In all these rooms, the average tube voltage (kVp) was about 31, the average K{sup 1} per patient was 16-21 mGy, and the average mA-minute per patient was 1.4-2.2 times higher than that of the mammography room described in NCRP Report No. 147. Most DBT screening examinations consisted of four two-dimensional mammographic views plus four tomosynthesis scans; the numbers of views acquired in diagnostic examinations varied widely. Tomosynthesis scans contributed about 30% of total mA-minute and about 50% of K{sup 1}. For the primary radiation generated by the clinical workload distributions, {alpha} was similar to that of 40-45 kVp W/Al (target/filter), and {alpha}+{beta} was similar to that of 30 kVp W/Al. Conclusions: The workload (mA-minute and K{sup 1}) distributions of mammographic examinations with DBT differ from conventional mammography. A field survey of patient volume and x-ray tube usage is important for the shielding

  12. Digital Mammography and Digital Breast Tomosynthesis.

    Science.gov (United States)

    Moseley, Tanya W

    2016-06-01

    Breast imaging technology has advanced significantly from the 1930s until the present. American women have a 1 in 8 chance of developing breast cancer. Mammography has been proven in multiple clinical trials to reduce breast cancer mortality. Although a mainstay of breast imaging and improved from film-screen mammography, digital mammography is not a perfect examination. Overlapping obscuring breast tissue limits mammographic interpretation. Breast digital tomosynthesis reduces and/or eliminates overlapping obscuring breast tissue. Although there are some disadvantages with digital breast tomosynthesis, this relatively lost-cost technology may be used effectively in the screening and diagnostic settings. PMID:27101241

  13. Digital breast tomosynthesis; Digitale Tomosynthese der Brust

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    Haegele, Julian; Barkhausen, Joerg [Universtiaetsklinikum Schleswig-Holstein, Luebeck (Germany). Klinik fuer Radiologie und Nuklearmedizin; Pursche, Telja [Universtiaetsklinikum Schleswig-Holstein, Luebeck (Germany). Brustzentrum; Schaefer, Fritz K.W. [Universtiaetsklinikum Schleswig-Holstein, Kiel (Germany). Bereich Mammadiagnostik und Intervention

    2015-09-15

    In digital breast tomosynthesis a digital tomographic data set with a very high spatial resolution is reconstructed from low-dose projections collected over a limited rotation angle. This allows a very detailed assessment of e. g. masses and architectural distortions. The average glandular dose is comparable to 2 D mammography. First clinical studies demonstrated that tomosynthesis is able to supply important additional information in suspicious mammographic findings. In comparison to projection mammography, tomosynthesis shows an at least comparable diagnostic accuracy. In everyday practice, tomosynthesis is currently mostly used for further evaluation of suspicious findings in mammography.

  14. Characterizing X-ray detectors for prototype digital breast tomosynthesis systems

    International Nuclear Information System (INIS)

    The digital breast tomosynthesis (DBT) system is a newly developed 3-D imaging technique that overcomes the tissue superposition problems of conventional mammography. Therefore, it produces fewer false positives. In DBT system, several parameters are involved in image acquisition, including geometric components. A series of projections should be acquired at low exposure. This makes the system strongly dependent on the detector's characteristic performance. This study compares two types of x-ray detectors developed by the Korea Electrotechnology Research Institute (KERI). The first prototype DBT system has a CsI (Tl) scintillator/CMOS based flat panel digital detector (2923 MAM, Dexela Ltd.), with a pixel size of 0.0748 mm. The second uses a-Se based direct conversion full field detector (AXS 2430, analogic) with a pixel size of 0.085 mm. The geometry of both systems is same, with a focal spot 665.8 mm from the detector, and a center of rotation 33 mm above the detector surface. The systems were compared with regard to modulation transfer function (MTF), normalized noise power spectrum (NNPS), detective quantum efficiency (DQE) and a new metric, the relative object detectability (ROD). The ROD quantifies the relative performance of each detector at detecting specified objects. The system response function demonstrated excellent linearity (R2>0.99). The CMOS-based detector had a high sensitivity, while the Anrad detector had a large dynamic range. The higher MTF and noise power spectrum (NPS) values were measured using an Anrad detector. The maximum DQE value of the Dexela detector was higher than that of the Anrad detector with a low exposure level, considering one projection exposure for tomosynthesis. Overall, the Dexela detector performed better than did the Anrad detector with regard to the simulated Al wires, spheres, test objects of ROD with low exposure level. In this study, we compared the newly developed prototype DBT system with two different types of

  15. Validation of mean glandular dose values provided by a digital breast tomosynthesis system in Brazil

    Energy Technology Data Exchange (ETDEWEB)

    Beraldo O, B.; Paixao, L.; Donato da S, S. [Centro de Desenvolvimento da Tecnologia Nuclear / CNEN, Post-graduation in Sciences and Technology of Radiations Minerals and Materials, Pte. Antonio Carlos 6627, 31270-901 Belo Horizonte (Brazil); Araujo T, M. H. [Dr Maria Helena Araujo Teixeira Clinic, Guajajaras 40, 30180-100 Belo Horizonte (Brazil); Nogueira, M. S., E-mail: bbo@cdtn.br [Centro de Desenvolvimento da Tecnologia Nuclear / CNEN, Pte. Antonio Carlos 6627, 31270-901 Belo Horizonte (Brazil)

    2014-08-15

    Digital breast tomosynthesis (DBT) is an emerging imaging modality that provides quasi-three-dimensional structural information of the breast and has strong promise to improve the differentiation of normal tissue and suspicious masses reducing the tissue overlaps. DBT images are reconstructed from a sequence of low-dose X-ray projections of the breast acquired at a small number of angles over a limited angular range. The Ho logic Selen ia Dimensions system is equipped with an amorphous Selenium (a-Se) detector layer of 250 μm thickness and a 70 μm pixel pitch. Studies are needed to determine the radiation dose of patients that are undergoing this emerging procedure to compare with the results obtained in DBT images. The mean glandular dose (D{sub G}) is the dosimetric quantity used in quality control of the mammographic systems. The aim of this work is to validate D{sub G} values for different breast thicknesses provided by a Ho logic Selen ia Dimensions system using a DBT mode in comparison with the same results obtained by a calibrated 90 X 5-6M-model Radcal ionization chamber. D{sub G} values were derived from the incident air kerma (K{sub i}) measurements and tabulated conversion coefficients that are dependent on the half value layer (HVL) of the X-ray spectrum. Voltage and tube loading values were recorded in irradiations using W/Al anode/filter combination, automatic exposure control mode and polymethyl methacrylate (PMMA) slabs which simulate different breast thicknesses. For K{sub i} measurements, the ionization chamber was positioned at 655 mm from the focus and the same radiographic technique values were selected with the manual mode. D{sub G} values for a complete procedure ranged from 0.9 ± 0.1 to 3.7 ± 0.4 mGy. The results for different breast thicknesses are in accordance with values obtained by DBT images and with acceptable levels established by the Commission of the European Communities (Cec) and the International Atomic Energy Agency (IAEA

  16. Breast MRI, digital mammography and breast tomosynthesis: comparison of three methods for early detection of breast cancer

    Directory of Open Access Journals (Sweden)

    Dragana Roganovic

    2015-11-01

    Full Text Available Breast cancer is the most common malignancy in women and early detection is important for its successful treatment. The aim of this study was to investigate the sensitivity and specificity of three methods for early detection of breast cancer: breast magnetic resonance imaging (MRI, digital mammography, and breast tomosynthesis in comparison to histopathology, as well as to investigate the intraindividual variability between these modalities.  We included 57 breast lesions, each detected by three diagnostic modalities: digital mammography, breast MRI, and breast tomosynthesis, and subsequently confirmed by histopathology. Breast Imaging-Reporting and Data System (BI-RADS was used for characterizing the lesions. One experienced radiologist interpreted all three diagnostic modalities. Twenty-nine of the breast lesions were malignant while 28 were benign. The sensitivity for digital mammography, breast MRI, and breast tomosynthesis, was 72.4%, 93.1%, and 100%, respectively; while the specificity was 46.4%, 60.7%, and 75%, respectively. Receiver operating characteristics (ROC curve analysis showed an overall diagnostic advantage of breast tomosynthesis over both breast MRI and digital mammography. The difference in performance between breast tomosynthesis and digital mammography was significant (p < 0.001, while the difference between breast tomosynthesis and breast MRI was not significant (p = 0.20. 

  17. Characterization of lesions in dense breasts: Does tomosynthesis help?

    Directory of Open Access Journals (Sweden)

    Krithika Rangarajan

    2016-01-01

    Full Text Available Context: Mammography in dense breasts is challenging due to lesion obscuration by tissue overlap. Does tomosynthesis offers a solution? Aims: To study the impact of digital breast tomosynthesis (DBT in characterizing lesions in breasts of different mammographic densities. Settings and Design: Prospective blinded study comparing mammography in two views with Mammography + Tomosynthesis. Methods and Material: Tomosynthesis was performed in 199 patients who were assigned Breast imaging reporting and data system (BIRADS categories 0, 3, 4, or 5 on two-dimensional (2D mammogram. Mammograms were first categorized into one of 4 mammographic breast densities in accordance with the American College of Radiology (ACR. Three radiologists independently analyzed these images and assigned a BIRADS category first based on 2D mammogram alone, and then assigned a fresh BIRADS category after taking mammography and tomosynthesis into consideration. A composite gold-standard was used in the study (histopathology, ultrasound, follow-up mammogram, magnetic resonance imaging. Each lesion was categorized into 3 groups—superior categorization with DBT, no change in BIRADS, or inferior BIRADS category based on comparison with the gold-standard. The percentage of lesions in each group was calculated for different breast densities. Results: There were 260 lesions (ages 28–85. Overall, superior categorization was seen in 21.2% of our readings on addition of DBT to mammography. DBT was most useful in ACR Densities 3 and 4 breasts where it led to more appropriate categorization in 27 and 42% of lesions, respectively. DBT also increased diagnostic confidence in 54.5 and 63.6% of lesions in ACR Densities 3 and 4, respectively. Conclusions: In a diagnostic setting, the utility of tomosynthesis increases with increasing breast density. This helps in identifying the sub category of patients where DBT can actually change management.

  18. Characterization of lesions in dense breasts: Does tomosynthesis help?

    Science.gov (United States)

    Rangarajan, Krithika; Hari, Smriti; Thulkar, Sanjay; Sharma, Sanjay; Srivastava, Anurag; Parshad, Rajinder

    2016-01-01

    Context: Mammography in dense breasts is challenging due to lesion obscuration by tissue overlap. Does tomosynthesis offers a solution? Aims: To study the impact of digital breast tomosynthesis (DBT) in characterizing lesions in breasts of different mammographic densities. Settings and Design: Prospective blinded study comparing mammography in two views with Mammography + Tomosynthesis. Methods and Material: Tomosynthesis was performed in 199 patients who were assigned Breast imaging reporting and data system (BIRADS) categories 0, 3, 4, or 5 on two-dimensional (2D) mammogram. Mammograms were first categorized into one of 4 mammographic breast densities in accordance with the American College of Radiology (ACR). Three radiologists independently analyzed these images and assigned a BIRADS category first based on 2D mammogram alone, and then assigned a fresh BIRADS category after taking mammography and tomosynthesis into consideration. A composite gold-standard was used in the study (histopathology, ultrasound, follow-up mammogram, magnetic resonance imaging). Each lesion was categorized into 3 groups—superior categorization with DBT, no change in BIRADS, or inferior BIRADS category based on comparison with the gold-standard. The percentage of lesions in each group was calculated for different breast densities. Results: There were 260 lesions (ages 28–85). Overall, superior categorization was seen in 21.2% of our readings on addition of DBT to mammography. DBT was most useful in ACR Densities 3 and 4 breasts where it led to more appropriate categorization in 27 and 42% of lesions, respectively. DBT also increased diagnostic confidence in 54.5 and 63.6% of lesions in ACR Densities 3 and 4, respectively. Conclusions: In a diagnostic setting, the utility of tomosynthesis increases with increasing breast density. This helps in identifying the sub category of patients where DBT can actually change management.

  19. Experimental validation of a three-dimensional linear system model for breast tomosynthesis

    Science.gov (United States)

    Zhao, Bo; Zhou, Jun; Hu, Yue-Houng; Mertelmeier, Thomas; Ludwig, Jasmina; Zhao, Wei

    2009-01-01

    A three-dimensional (3D) linear model for digital breast tomosynthesis (DBT) was developed to investigate the effects of different imaging system parameters on the reconstructed image quality. In the present work, experimental validation of the model was performed on a prototype DBT system equipped with an amorphous selenium (a-Se) digital mammography detector and filtered backprojection (FBP) reconstruction methods. The detector can be operated in either full resolution with 85 μm pixel size or 2×1 pixel binning mode to reduce acquisition time. Twenty-five projection images were acquired with a nominal angular range of ±20°. The images were reconstructed using a slice thickness of 1 mm with 0.085×0.085 mm in-plane pixel dimension. The imaging performance was characterized by spatial frequency-dependent parameters including a 3D noise power spectrum (NPS) and in-plane modulation transfer function (MTF). Scatter-free uniform x-ray images were acquired at four different exposure levels for noise analysis. An aluminum (Al) edge phantom with 0.2 mm thickness was imaged to measure the in-plane presampling MTF. The measured in-plane MTF and 3D NPS were both in good agreement with the model. The dependence of DBT image quality on reconstruction filters was investigated. It was found that the slice thickness (ST) filter, a Hanning window to limit the high-frequency components in the slice thickness direction, reduces noise aliasing and improves 3D DQE. An ACR phantom was imaged to investigate the effects of angular range and detector operational modes on reconstructed image quality. It was found that increasing the angular range improves the MTF at low frequencies, resulting in better detection of large-area, low-contrast mass lesions in the phantom. There is a trade-off between noise and resolution for pixel binning and full resolution modes, and the choice of detector mode will depend on radiation dose and the targeted lesion. PMID:19235392

  20. Molecular Breast Imaging Using Emission Tomosynthesis

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    Gopan, O. [University of Florida; Gilland, D. [University of Florida; Weisenberger, Andrew G. [JLAB; Kross, Brian J. [JLAB; Welch, Benjamin L. [Dilon Technologies

    2013-06-01

    Purpose: Tour objective is to design a novel SPECT system for molecular breast imaging (MBI) and evaluate its performance. The limited angle SPECT system, or emission tomosynthesis, is designed to achieve 3D images of the breast with high spatial resolution/sensitivity. The system uses a simplified detector motion and is conducive to on-board biopsy and mult-modal imaging with mammography. Methods: The novel feature of the proposed gamma camera is a variable-angle, slant-hole (VASH) collimator, which is well suited for limited angle SPECT of a mildly compressed breast. The collimator holes change slant angle while the camera surface remains flush against the compression paddle. This allows the camera to vary the angular view ({+-}30{degrees}, {+-}45{degrees}) for tomographic imaging while keeping the camera close to the object for high spatial resolution and/or sensitivity. Theoretical analysis and Monte Carlo simulations were performed assuming a point source and isolated breast phantom. Spatial resolution, sensitivity, contrast and SNR were measured. Results were compared to single-view, planar images and conventional SPECT. For both conventional SPECT and VASH, data were reconstructed using iterative algorithms. Finally, a proof-of-concept VASH collimator was constructed for experimental evaluation. Results: Measured spatial resolution/sensitivity with VASH showed good agreement with theory including depth-of-interaction (DOI) effects. The DOI effect diminished the depth resolution by approximately 2 mm. Increasing the slant angle range from {+-}30{degrees} to {+-}45{degrees} resulted in an approximately 1 mm improvement in the depth resolution. In the breast phantom images, VASH showed improved contrast and SNR over conventional SPECT and improved contrast over planar scintimmammography. Reconstructed images from the proof-of-concept VASH collimator demonstrated reasonable depth resolution capabilities using limited angle projection data. Conclusion: We

  1. Experimental investigation for determination of optimal X-ray beam tube voltages in a newly developed digital breast tomosynthesis system

    Energy Technology Data Exchange (ETDEWEB)

    Park, Hye-Suk, E-mail: radiosugar@yonsei.ac.kr [Department of Radiological Science and Research Institute of Health Science, Yonsei University, Wonju, Gangwon 220-710 (Korea, Republic of); Kim, Ye-Seul, E-mail: radiohesugar@gmail.com [Department of Radiological Science and Research Institute of Health Science, Yonsei University, Wonju, Gangwon 220-710 (Korea, Republic of); Choi, Young-Wook, E-mail: ywchoi@keri.re.kr [Korea Electrotechnology Research Institute (KERI), Ansan, Geongki 426-170 (Korea, Republic of); Choi, JaeGu, E-mail: jgchoi88@paran.com [Korea Electrotechnology Research Institute (KERI), Ansan, Geongki 426-170 (Korea, Republic of); Rhee, Yong-Chun, E-mail: ycrhee@yonsei.ac.kr [Department of Radiological Science and Research Institute of Health Science, Yonsei University, Wonju, Gangwon 220-710 (Korea, Republic of); Kim, Hee-Joung, E-mail: hjk1@yonsei.ac.kr [Department of Radiological Science and Research Institute of Health Science, Yonsei University, Wonju, Gangwon 220-710 (Korea, Republic of)

    2014-11-01

    Our purpose was to investigate optimal tube voltages (kVp) for a newly developed digital breast tomosynthesis (DBT) process and to determine tube current–exposure time products (mA s) for the average glandular dose (AGD), which is similar to that of the two views in conventional mammography (CM). In addition, the optimal acquisition parameters for this system were compared with those of CM. The analysis was based on the contrast-to-noise ratio (CNR) from the simulated micro-calcifications on homogeneous phantoms, and the figure of merit (FOM) was retrieved from the CNR and AGD at X-ray tube voltages ranging from 24 to 40 kVp at intervals of 2 kV. The optimal kVp increased more than 2 kV with increasing glandularity for thicker (≥50 mm) breast phantoms. The optimal kVp for DBT was found to be 4–7 kV higher than that calculated for CM with breast phantoms thicker than 50 mm. This is likely due to the greater effect of noise and dose reduction by kVp increment when using the lower dose per projection in DBT. It is important to determine optimum acquisition conditions for a maximally effective DBT system. The results of our study provide useful information to further improve DBT for high quality imaging.

  2. Experimental investigation for determination of optimal X-ray beam tube voltages in a newly developed digital breast tomosynthesis system

    International Nuclear Information System (INIS)

    Our purpose was to investigate optimal tube voltages (kVp) for a newly developed digital breast tomosynthesis (DBT) process and to determine tube current–exposure time products (mA s) for the average glandular dose (AGD), which is similar to that of the two views in conventional mammography (CM). In addition, the optimal acquisition parameters for this system were compared with those of CM. The analysis was based on the contrast-to-noise ratio (CNR) from the simulated micro-calcifications on homogeneous phantoms, and the figure of merit (FOM) was retrieved from the CNR and AGD at X-ray tube voltages ranging from 24 to 40 kVp at intervals of 2 kV. The optimal kVp increased more than 2 kV with increasing glandularity for thicker (≥50 mm) breast phantoms. The optimal kVp for DBT was found to be 4–7 kV higher than that calculated for CM with breast phantoms thicker than 50 mm. This is likely due to the greater effect of noise and dose reduction by kVp increment when using the lower dose per projection in DBT. It is important to determine optimum acquisition conditions for a maximally effective DBT system. The results of our study provide useful information to further improve DBT for high quality imaging

  3. Digital Mammography Imaging: Breast Tomosynthesis and Advanced Applications

    Science.gov (United States)

    Helvie, Mark A.

    2011-01-01

    Synopsis This article discusses recent developments in advanced derivative technologies associated with digital mammography. Digital breast tomosynthesis – its principles, development, and early clinical trials are reviewed. Contrast enhanced digital mammography and combined imaging systems with digital mammography and ultrasound are also discussed. Although all these methods are currently research programs, they hold promise for improving cancer detection and characterization if early results are confirmed by clinical trials. PMID:20868894

  4. The Adjunctive Digital Breast Tomosynthesis in Diagnosis of Breast Cancer

    OpenAIRE

    Tsung-Lung Yang; Huei-Lung Liang; Chen-Pin Chou; Jer-Shyung Huang; Huay-Ben Pan

    2013-01-01

    Purpose. To compare the diagnostic performance of digital breast tomosynthesis (DBT) and digital mammography (DM) for breast cancers. Materials and Methods. Fifty-seven female patients with pathologically proved breast cancer were enrolled. Three readers gave a subjective assessment superiority of the index lesions (mass, focal asymmetry, architectural distortion, or calcifications) and a forced BIRADS score, based on DM reading alone and with additional DBT information. The relevance between...

  5. Quantification of resolution in multiplanar reconstructions for digital breast tomosynthesis

    Science.gov (United States)

    Vent, Trevor L.; Acciavatti, Raymond J.; Kwon, Young Joon; Maidment, Andrew D. A.

    2016-03-01

    Multiplanar reconstruction (MPR) in digital breast tomosynthesis (DBT) allows tomographic images to be portrayed in various orientations. We have conducted research to determine the resolution of tomosynthesis MPR. We built a phantom that houses a star test pattern to measure resolution. This phantom provides three rotational degrees of freedom. The design consists of two hemispheres with longitudinal and latitudinal grooves that reference angular increments. When joined together, the hemispheres form a dome that sits inside a cylindrical encasement. The cylindrical encasement contains reference notches to match the longitudinal and latitudinal grooves that guide the phantom's rotations. With this design, any orientation of the star-pattern can be analyzed. Images of the star-pattern were acquired using a DBT mammography system at the Hospital of the University of Pennsylvania. Images taken were reconstructed and analyzed by two different methods. First, the maximum visible frequency (in line pairs per millimeter) of the star test pattern was measured. Then, the contrast was calculated at a fixed spatial frequency. These analyses confirm that resolution decreases with tilt relative to the breast support. They also confirm that resolution in tomosynthesis MPR is dependent on object orientation. Current results verify that the existence of super-resolution depends on the orientation of the frequency; the direction parallel to x-ray tube motion shows super-resolution. In conclusion, this study demonstrates that the direction of the spatial frequency relative to the motion of the x-ray tube is a determinant of resolution in MPR for DBT.

  6. A review of breast tomosynthesis. Part I. The image acquisition process

    Energy Technology Data Exchange (ETDEWEB)

    Sechopoulos, Ioannis [Department of Radiology and Imaging Sciences, Hematology and Medical Oncology and Winship Cancer Institute, Emory University, 1701 Upper Gate Drive Northeast, Suite 5018, Atlanta, Georgia 30322 (United States)

    2013-01-15

    Mammography is a very well-established imaging modality for the early detection and diagnosis of breast cancer. However, since the introduction of digital imaging to the realm of radiology, more advanced, and especially tomographic imaging methods have been made possible. One of these methods, breast tomosynthesis, has finally been introduced to the clinic for routine everyday use, with potential to in the future replace mammography for screening for breast cancer. In this two part paper, the extensive research performed during the development of breast tomosynthesis is reviewed, with a focus on the research addressing the medical physics aspects of this imaging modality. This first paper will review the research performed on the issues relevant to the image acquisition process, including system design, optimization of geometry and technique, x-ray scatter, and radiation dose. The companion to this paper will review all other aspects of breast tomosynthesis imaging, including the reconstruction process.

  7. Task-based assessment and optimization of digital breast tomosynthesis

    Science.gov (United States)

    Young, Stefano

    Digital breast tomosynthesis (DBT) is a new technology for breast cancer screening that promises to complement mammography or supersede it to become the standard for breast imaging. DBT involves taking multiple images in order to synthesize a new image that represents a slice through the breast volume---hence the term tomosynthesis. The primary advantage of this paradigm is that it can reduce the amount of overlapping anatomy in the data, leading to improved visualization of potentially-cancerous findings. The difficulty in DBT is quantifying the advantages of the technology and determining the optimal conditions for its clinical use. This dissertation describes a virtual trial framework for assessing and optimizing DBT technology for the specific task of detecting small, low-contrast masses in the breast. It addresses each component of the imaging chain to some degree, from the patients/phantoms to the imaging hardware to the model observers used to measure signal detectability. The main focus, however, is on quantifying tradeoffs between three key parameters that affect image quality: (1) scan angle, (2) number of projections, and (3) exposure. We show that in low-density breast phantoms, detectability generally increases with both scan angle and number of projections in the anatomical-variability-limited (high-exposure) regime. We also investigate how breast density affects the optimal DBT scan parameters. We show task-specific results that support using an adaptive paradigm in DBT, where the imaging system reconfigures itself in response to information about the patient's breast density. The virtual framework described in this dissertation provides a platform for further investigations of image quality in 3D breast imaging.

  8. Mean glandular dose estimation using MCNPX for a digital breast tomosynthesis system with tungsten/aluminum and tungsten/aluminum+silver x-ray anode-filter combinations

    Energy Technology Data Exchange (ETDEWEB)

    Ma, Andy K. W.; Darambara, Dimitra G.; Stewart, Alexander; Gunn, Spencer; Bullard, Edward [Joint Department of Physics, Institute of Cancer Research and The Royal Marsden Hospital, Fulham Road, London SW3 6JJ (United Kingdom); Dexela Ltd., 1 Water Lane, Camden Town, London NW1 8NZ (United Kingdom)

    2008-12-15

    Breast cancer screening with x-ray mammography, using one or two projection images of the breast, is an indispensible tool in the early detection of breast cancer in women. Digital breast tomosynthesis (DBT) is a 3D imaging technique that promises higher sensitivity and specificity in breast cancer screening at a similar radiation dose to conventional two-view screening mammography. In DBT a 3D volume is reconstructed with anisotropic voxels from a limited number of x-ray projection images acquired over a limited angle. Although the benefit of early cancer detection through screening mammography outweighs the potential risks associated with radiation, the radiation dosage to women in terms of mean glandular dose (MGD) is carefully monitored. This work studies the MGD arising from a prototype DBT system under various parameters. Two anode/filter combinations (W/Al and W/Al+Ag) were investigated; the tube potential ranges from 20 to 50 kVp; and the breast size varied between 4 and 10 cm chest wall-to-nipple distance and between 3 and 7 cm compressed breast thickness. The dosimetric effect of breast positioning with respect to the imaging detector was also reviewed. It was found that the position of the breast can affect the MGD by as much as 5% to 13% depending on the breast size.

  9. Evaluation of the technical performance of three different commercial digital breast tomosynthesis systems in the clinical environment.

    Science.gov (United States)

    Rodríguez-Ruiz, A; Castillo, M; Garayoa, J; Chevalier, M

    2016-06-01

    The aim of this work was to research and evaluate the performance of three different digital breast tomosynthesis (DBT) systems in the clinical environment (Siemens Mammomat Inspiration, Hologic Selenia Dimensions, and Fujifilm Amulet Innovality). The characterization included the study of the detector, the automatic exposure control, and the resolution of DBT projections and reconstructed planes. The modulation transfer function (MTF) of the DBT projections was measured with a 1mm thick steel edge, showing a strong anisotropy (30-40% lower MTF0.5 frequencies in the tube travel direction). The in-plane MTF0.5, measured with a 25μm tungsten wire, ranges from 1.3 to 1.8lp/mm in the tube-travel direction and between 2.4 and 3.7lp/mm in the chest wall-nipple. In the latter direction, the MTF peak shift is more emphasized for large angular range systems (2.0 versus 1.0lp/mm). In-depth resolution of the planes, via the full width at half maximum (FWHM) from the point spread function of a 25μm tungsten wire, is not only influenced by angular range and yields 1.3-4.6mm among systems. The artifact spread function from 1mm diameter tungsten beads depends mainly on angular range, yielding two tendencies whether large (FWHM is 4.5mm) or small (FWHM is 10mm) angular range is used. DBT delivers per scan a mean glandular dose between 1.4 and 2.7mGy for a 45mm thick polymethyl methacrylate (PMMA) block. In conclusion, we have identified and analysed specific metrics that can be used for quality assurance of DBT systems.

  10. Characterization of Breast Lesions: Comparison of Digital Breast Tomosynthesis and Ultrasonography

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sun Ah [Department of Radiology, Human Medical Imaging & Intervention Center, Seoul 135-120 (Korea, Republic of); Chang, Jung Min; Cho, Nariya [Department of Radiology, Seoul National University Hospital, Seoul 110-744 (Korea, Republic of); Yi, Ann [Department of Radiology, Seoul National University Hospital Healthcare System Gangnam Center, Seoul 135-984 (Korea, Republic of); Moon, Woo Kyung [Department of Radiology, Seoul National University Hospital, Seoul 110-744 (Korea, Republic of)

    2015-11-01

    To compare the diagnostic performance of digital breast tomosynthesis (DBT) and conventional breast ultrasound (US) to characterize breast lesions as benign or malignant. A total of 332 women, presenting for screening examinations or for breast biopsy between March and June 2012 were recruited to undergo digital mammography (DM), DBT, and breast US examination. Among them, 113 patients with 119 breast lesions depicted on DM were finally included. Three blinded radiologists performed an enriched reader study and reviewed the DBT and US images. Each reader analyzed the lesions in random order, assigned Breast Imaging Reporting and Data System (BI-RADS) descriptors, rated the images for the likelihood of malignancy (%) and made a BI-RADS final assessment. Diagnostic accuracy, as assessed by the area under the receiver operating characteristic curve, sensitivity, and specificity of DBT and US were compared. Among the 119 breast lesions depicted on DM, 75 were malignant and the remaining 44 were benign. The average diagnostic performance for characterizing breast lesions as benign or malignant in terms of area under the curve was 0.899 for DBT and 0.914 for US (p = 0.394). Mean sensitivity (97.3% vs. 98.7%, p = 0.508) and specificity (44.7% vs. 39.4%, p = 0.360) were also not significantly different. Digital breast tomosynthesis may provide similar reader lesion characterization performance to that of US for breast lesions depicted on DM.

  11. Radiation dosimetry in digital breast tomosynthesis: Report of AAPM Tomosynthesis Subcommittee Task Group 223

    Energy Technology Data Exchange (ETDEWEB)

    Sechopoulos, Ioannis, E-mail: isechop@emory.edu [Departments of Radiology and Imaging Sciences, Hematology and Medical Oncology and Winship Cancer Institute, Emory University, 1701 Uppergate Drive Northeast, Suite 5018, Atlanta, Georgia 30322 (United States); Sabol, John M. [GE Healthcare, Global Diagnostic X-Ray, Mailstop W-701, 3000 North Grandview Boulevard, Waukesha, Wisconsin 53188 (United States); Berglund, Johan [Research and Development, Philips Women' s Healthcare, Solna (Sweden); Bolch, Wesley E. [J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, Florida 32611 (United States); Brateman, Libby [University of Florida, Gainesville, Florida 32611 (United States); Christodoulou, Emmanuel; Goodsitt, Mitchell [Department of Radiology, University of Michigan, 1500 East Medical Center Drive, Ann Arbor, Michigan 48109 (United States); Flynn, Michael [Department of Radiology, Henry Ford Health System, Radiology Research 2F, 1 Ford Place, Detroit, Michigan 48202 (United States); Geiser, William [Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030-4009 (United States); Kyle Jones, A. [Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030 (United States); Lo, Joseph Y.; Paul Segars, W. [Department of Radiology, Medical Physics Graduate Program, and Department of Biomedical Engineering, Carl E. Ravin Advanced Imaging Laboratories, Duke University, Durham, North Carolina 27705 (United States); Maidment, Andrew D. A. [Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania 19104-4206 (United States); Nishino, Kazuyoshi [R and D X-ray Products Group, Shimadzu Corporation, Tokyo (Japan); Nosratieh, Anita [Biomedical Engineering Graduate Group, Department of Radiology, University of California, Davis, California 95817 (United States); and others

    2014-09-15

    The radiation dose involved in any medical imaging modality that uses ionizing radiation needs to be well understood by the medical physics and clinical community. This is especially true of screening modalities. Digital breast tomosynthesis (DBT) has recently been introduced into the clinic and is being used for screening for breast cancer in the general population. Therefore, it is important that the medical physics community have the required information to be able to understand, estimate, and communicate the radiation dose levels involved in breast tomosynthesis imaging. For this purpose, the American Association of Physicists in Medicine Task Group 223 on Dosimetry in Tomosynthesis Imaging has prepared this report that discusses dosimetry in breast imaging in general, and describes a methodology and provides the data necessary to estimate mean breast glandular dose from a tomosynthesis acquisition. In an effort to maximize familiarity with the procedures and data provided in this Report, the methodology to perform the dose estimation in DBT is based as much as possible on that used in mammography dose estimation.

  12. Evaluation of scatter effects on image quality for breast tomosynthesis

    Energy Technology Data Exchange (ETDEWEB)

    Wu Gang; Mainprize, James G.; Boone, John M.; Yaffe, Martin J. [Imaging Research, Sunnybrook Health Sciences Centre, S-657, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5 (Canada) and Department of Medical Biophysics, University of Toronto, Toronto, Ontario M4N 3M5 (Canada); Department of Medical Biophysics, University of Toronto, Toronto, Ontario M4N 3M5 (Canada); Department of Radiology, X-ray Imaging Laboratory, U. C. Davis Medical Center, 4701 X Street, Sacramento, California 95817 and Department of Biomedical Engineering, University of California, Davis, California 95616 (United States); Imaging Research, Sunnybrook Health Sciences Centre, S-657, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5 (Canada) and Department of Medical Biophysics, University of Toronto, Toronto, Ontario M4N 3M5 (Canada)

    2009-10-15

    Digital breast tomosynthesis uses a limited number (typically 10-20) of low-dose x-ray projections to produce a pseudo-three-dimensional volume tomographic reconstruction of the breast. The purpose of this investigation was to characterize and evaluate the effect of scattered radiation on the image quality for breast tomosynthesis. In a simulation, scatter point spread functions generated by a Monte Carlo simulation method were convolved over the breast projection to estimate the distribution of scatter for each angle of tomosynthesis projection. The results demonstrate that in the absence of scatter reduction techniques, images will be affected by cupping artifacts, and there will be reduced accuracy of attenuation values inferred from the reconstructed images. The effect of x-ray scatter on the contrast, noise, and lesion signal-difference-to-noise ratio (SDNR) in tomosynthesis reconstruction was measured as a function of the tumor size. When a with-scatter reconstruction was compared to one without scatter for a 5 cm compressed breast, the following results were observed. The contrast in the reconstructed central slice image of a tumorlike mass (14 mm in diameter) was reduced by 30%, the voxel value (inferred attenuation coefficient) was reduced by 28%, and the SDNR fell by 60%. The authors have quantified the degree to which scatter degrades the image quality over a wide range of parameters relevant to breast tomosynthesis, including x-ray beam energy, breast thickness, breast diameter, and breast composition. They also demonstrate, though, that even without a scatter rejection device, the contrast and SDNR in the reconstructed tomosynthesis slice are higher than those of conventional mammographic projection images acquired with a grid at an equivalent total exposure.

  13. Comparative study between breast tomosynthesis and classic digital mammography in the evaluation of different breast lesions

    Directory of Open Access Journals (Sweden)

    Sahar Mansour

    2014-09-01

    Conclusion: Three-dimensional tomosynthesis significantly enhanced the detection and characterization of breast lesions on digital mammography especially in the context of dense breast parenchyma (ACR 3&4.

  14. Digital breast tomosynthesis (3D-mammography) screening: A pictorial review of screen-detected cancers and false recalls attributed to tomosynthesis in prospective screening trials.

    Science.gov (United States)

    Houssami, Nehmat; Lång, Kristina; Bernardi, Daniela; Tagliafico, Alberto; Zackrisson, Sophia; Skaane, Per

    2016-04-01

    This pictorial review highlights cancers detected only at tomosynthesis screening and screens falsely recalled in the course of breast tomosynthesis screening, illustrating both true-positive (TP) and false-positive (FP) detection attributed to tomosynthesis. Images and descriptive data were used to characterise cases of screen-detection with tomosynthesis, sourced from prospective screening trials that performed standard (2D) digital mammography (DM) and tomosynthesis (3D-mammography) in the same screening participants. Exemplar cases from four trials highlight common themes of relevance to screening practice including: the type of lesions frequently made more conspicuous or perceptible by tomosynthesis (spiculated masses, and architectural distortions); the histologic findings (both TP and FP) of tomosynthesis-only detection; and the need to extend breast work-up protocols (additional imaging including ultrasound and MRI, and tomosynthesis-guided biopsy) if tomosynthesis is adopted for primary screening. PMID:27017251

  15. The simulation of 3D mass models in 2D digital mammography and breast tomosynthesis

    Energy Technology Data Exchange (ETDEWEB)

    Shaheen, Eman, E-mail: eman.shaheen@uzleuven.be; De Keyzer, Frederik; Bosmans, Hilde; Ongeval, Chantal Van [Department of Radiology, University Hospitals Leuven, Herestraat 49, 3000 Leuven (Belgium); Dance, David R.; Young, Kenneth C. [National Coordinating Centre for the Physics of Mammography, Royal Surrey County Hospital, Guildford GU2 7XX, United Kingdom and Department of Physics, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford GU2 7XH (United Kingdom)

    2014-08-15

    Purpose: This work proposes a new method of building 3D breast mass models with different morphological shapes and describes the validation of the realism of their appearance after simulation into 2D digital mammograms and breast tomosynthesis images. Methods: Twenty-five contrast enhanced MRI breast lesions were collected and each mass was manually segmented in the three orthogonal views: sagittal, coronal, and transversal. The segmented models were combined, resampled to have isotropic voxel sizes, triangularly meshed, and scaled to different sizes. These masses were referred to as nonspiculated masses and were then used as nuclei onto which spicules were grown with an iterative branching algorithm forming a total of 30 spiculated masses. These 55 mass models were projected into 2D projection images to obtain mammograms after image processing and into tomographic sequences of projection images, which were then reconstructed to form 3D tomosynthesis datasets. The realism of the appearance of these mass models was assessed by five radiologists via receiver operating characteristic (ROC) analysis when compared to 54 real masses. All lesions were also given a breast imaging reporting and data system (BIRADS) score. The data sets of 2D mammography and tomosynthesis were read separately. The Kendall's coefficient of concordance was used for the interrater observer agreement assessment for the BIRADS scores per modality. Further paired analysis, using the Wilcoxon signed rank test, of the BIRADS assessment between 2D and tomosynthesis was separately performed for the real masses and for the simulated masses. Results: The area under the ROC curves, averaged over all observers, was 0.54 (95% confidence interval [0.50, 0.66]) for the 2D study, and 0.67 (95% confidence interval [0.55, 0.79]) for the tomosynthesis study. According to the BIRADS scores, the nonspiculated and the spiculated masses varied in their degrees of malignancy from normal (BIRADS 1) to highly

  16. The simulation of 3D mass models in 2D digital mammography and breast tomosynthesis

    International Nuclear Information System (INIS)

    Purpose: This work proposes a new method of building 3D breast mass models with different morphological shapes and describes the validation of the realism of their appearance after simulation into 2D digital mammograms and breast tomosynthesis images. Methods: Twenty-five contrast enhanced MRI breast lesions were collected and each mass was manually segmented in the three orthogonal views: sagittal, coronal, and transversal. The segmented models were combined, resampled to have isotropic voxel sizes, triangularly meshed, and scaled to different sizes. These masses were referred to as nonspiculated masses and were then used as nuclei onto which spicules were grown with an iterative branching algorithm forming a total of 30 spiculated masses. These 55 mass models were projected into 2D projection images to obtain mammograms after image processing and into tomographic sequences of projection images, which were then reconstructed to form 3D tomosynthesis datasets. The realism of the appearance of these mass models was assessed by five radiologists via receiver operating characteristic (ROC) analysis when compared to 54 real masses. All lesions were also given a breast imaging reporting and data system (BIRADS) score. The data sets of 2D mammography and tomosynthesis were read separately. The Kendall's coefficient of concordance was used for the interrater observer agreement assessment for the BIRADS scores per modality. Further paired analysis, using the Wilcoxon signed rank test, of the BIRADS assessment between 2D and tomosynthesis was separately performed for the real masses and for the simulated masses. Results: The area under the ROC curves, averaged over all observers, was 0.54 (95% confidence interval [0.50, 0.66]) for the 2D study, and 0.67 (95% confidence interval [0.55, 0.79]) for the tomosynthesis study. According to the BIRADS scores, the nonspiculated and the spiculated masses varied in their degrees of malignancy from normal (BIRADS 1) to highly

  17. Image artifacts in digital breast tomosynthesis: Investigation of the effects of system geometry and reconstruction parameters using a linear system approach

    Science.gov (United States)

    Hu, Yue-Houng; Zhao, Bo; Zhao, Wei

    2008-01-01

    Digital breast tomosynthesis (DBT) is a three-dimensional (3D) x-ray imaging modality that reconstructs image slices parallel to the detector plane. Image acquisition is performed using a limited angular range (less than 50 degrees) and a limited number of projection views (less than 50 views). Due to incomplete data sampling, image artifacts are unavoidable in DBT. In this preliminary study, the image artifacts in DBT were investigated systematically using a linear system approximation. A cascaded linear system model of DBT was developed to calculate the 3D presampling modulation transfer function (MTF) with different image acquisition geometries and reconstruction filters using a filtered backprojection (FBP) algorithm. A thin, slanted tungsten (W) wire was used to measure the presampling MTF of the DBT system in the cross-sectional plane defined by the thickness (z-) and tube travel (x-) directions. The measurement was in excellent agreement with the calculation using the model. A small steel bead was used to calculate the artifact spread function (ASF) of the DBT system. The ASF was correlated with the convolution of the two-dimensional (2D) point spread function (PSF) of the system and the object function of the bead. The results showed that the cascaded linear system model can be used to predict the magnitude of image artifacts of small, high-contrast objects with different image acquisition geometry and reconstruction filters. PMID:19175083

  18. The Adjunctive Digital Breast Tomosynthesis in Diagnosis of Breast Cancer

    Directory of Open Access Journals (Sweden)

    Tsung-Lung Yang

    2013-01-01

    Full Text Available Purpose. To compare the diagnostic performance of digital breast tomosynthesis (DBT and digital mammography (DM for breast cancers. Materials and Methods. Fifty-seven female patients with pathologically proved breast cancer were enrolled. Three readers gave a subjective assessment superiority of the index lesions (mass, focal asymmetry, architectural distortion, or calcifications and a forced BIRADS score, based on DM reading alone and with additional DBT information. The relevance between BIRADS category and index lesions of breast cancer was compared by chi-square test. Result. A total of 59 breast cancers were reviewed, including 17 (28.8% mass lesions, 12 (20.3% focal asymmetry/density, 6 (10.2% architecture distortion, 23 (39.0% calcifications, and 1 (1.7% intracystic tumor. Combo DBT was perceived to be more informative in 58.8% mass lesions, 83.3% density, 94.4% architecture distortion, and only 11.6% calcifications. As to the forced BIRADS score, 84.4% BIRADS 0 on DM was upgraded to BIRADS 4 or 5 on DBT, whereas only 27.3% BIRADS 4A on DM was upgraded on DBT, as BIRADS 4A lesions were mostly calcifications. A significant P value (<0.001 between the BIRADS category and index lesions was noted. Conclusion. Adjunctive DBT gives exquisite information for mass lesion, focal asymmetry, and/or architecture distortion to improve the diagnostic performance in mammography.

  19. Digital breast tomosynthesis versus digital mammography: a clinical performance study

    Energy Technology Data Exchange (ETDEWEB)

    Gennaro, Gisella; Baldan, Enrica; Bezzon, Elisabetta; Polico, Ilaria; Proietti, Alessandro; Toffoli, Aida [Venetian Oncological Institute (IOV), IRCCS, Department of Radiology, Padua (Italy); Toledano, Alicia [Statistics Collaborative Inc., Washington, DC (United States); Di Maggio, Cosimo [Padua University, Department of Oncological and Surgical Sciences, Padua (Italy); La Grassa, Manuela [Aviano Oncological Reference Center (CRO), IRCCS, Department of Radiology, Aviano (Pordenone) (Italy); Pescarini, Luigi [Venetian Oncological Institute (IOV), IRCCS, Department of Radiology, Padua (Italy); Padua University, Department of Oncological and Surgical Sciences, Padua (Italy); Muzzio, Pier Carlo [Venetian Oncological Institute (IOV), IRCCS, Department of Radiology, Padua (Italy); Padua University, Department of Medical Diagnostic Sciences, Padua (Italy)

    2010-07-15

    To compare the clinical performance of digital breast tomosynthesis (DBT) with that of full-field digital mammography (FFDM) in a diagnostic population. The study enrolled 200 consenting women who had at least one breast lesion discovered by mammography and/or ultrasound classified as doubtful or suspicious or probably malignant. They underwent tomosynthesis in one view [mediolateral oblique (MLO)] of both breasts at a dose comparable to that of standard screen-film mammography in two views [craniocaudal (CC) and MLO]. Images were rated by six breast radiologists using the BIRADS score. Ratings were compared with the truth established according to the standard of care and a multiple-reader multiple-case (MRMC) receiver-operating characteristic (ROC) analysis was performed. Clinical performance of DBT compared with that of FFDM was evaluated in terms of the difference between areas under ROC curves (AUCs) for BIRADS scores. Overall clinical performance with DBT and FFDM for malignant versus all other cases was not significantly different (AUCs 0.851 vs 0.836, p = 0.645). The lower limit of the 95% CI or the difference between DBT and FFDM AUCs was -4.9%. Clinical performance of tomosynthesis in one view at the same total dose as standard screen-film mammography is not inferior to digital mammography in two views. (orig.)

  20. The simulation of 3D microcalcification clusters in 2D digital mammography and breast tomosynthesis

    Energy Technology Data Exchange (ETDEWEB)

    Shaheen, Eman; Van Ongeval, Chantal; Zanca, Federica; Cockmartin, Lesley; Marshall, Nicholas; Jacobs, Jurgen; Young, Kenneth C.; Dance, David R.; Bosmans, Hilde [Department of Radiology, University Hospitals Leuven, Herestraat 49, 3000 Leuven (Belgium); National Coordinating Centre for the Physics of Mammography, Royal Surrey County Hospital, Guildford, GU2 7XX (United Kingdom); Department of Radiology, University Hospitals Leuven, Herestraat 49, 3000 Leuven (Belgium)

    2011-12-15

    Purpose: This work proposes a new method of building 3D models of microcalcification clusters and describes the validation of their realistic appearance when simulated into 2D digital mammograms and into breast tomosynthesis images. Methods: A micro-CT unit was used to scan 23 breast biopsy specimens of microcalcification clusters with malignant and benign characteristics and their 3D reconstructed datasets were segmented to obtain 3D models of microcalcification clusters. These models were then adjusted for the x-ray spectrum used and for the system resolution and simulated into 2D projection images to obtain mammograms after image processing and into tomographic sequences of projection images, which were then reconstructed to form 3D tomosynthesis datasets. Six radiologists were asked to distinguish between 40 real and 40 simulated clusters of microcalcifications in two separate studies on 2D mammography and tomosynthesis datasets. Receiver operating characteristic (ROC) analysis was used to test the ability of each observer to distinguish between simulated and real microcalcification clusters. The kappa statistic was applied to assess how often the individual simulated and real microcalcification clusters had received similar scores (''agreement'') on their realistic appearance in both modalities. This analysis was performed for all readers and for the real and the simulated group of microcalcification clusters separately. ''Poor'' agreement would reflect radiologists' confusion between simulated and real clusters, i.e., lesions not systematically evaluated in both modalities as either simulated or real, and would therefore be interpreted as a success of the present models. Results: The area under the ROC curve, averaged over the observers, was 0.55 (95% confidence interval [0.44, 0.66]) for the 2D study, and 0.46 (95% confidence interval [0.29, 0.64]) for the tomosynthesis study, indicating no statistically

  1. The simulation of 3D microcalcification clusters in 2D digital mammography and breast tomosynthesis

    International Nuclear Information System (INIS)

    Purpose: This work proposes a new method of building 3D models of microcalcification clusters and describes the validation of their realistic appearance when simulated into 2D digital mammograms and into breast tomosynthesis images. Methods: A micro-CT unit was used to scan 23 breast biopsy specimens of microcalcification clusters with malignant and benign characteristics and their 3D reconstructed datasets were segmented to obtain 3D models of microcalcification clusters. These models were then adjusted for the x-ray spectrum used and for the system resolution and simulated into 2D projection images to obtain mammograms after image processing and into tomographic sequences of projection images, which were then reconstructed to form 3D tomosynthesis datasets. Six radiologists were asked to distinguish between 40 real and 40 simulated clusters of microcalcifications in two separate studies on 2D mammography and tomosynthesis datasets. Receiver operating characteristic (ROC) analysis was used to test the ability of each observer to distinguish between simulated and real microcalcification clusters. The kappa statistic was applied to assess how often the individual simulated and real microcalcification clusters had received similar scores (''agreement'') on their realistic appearance in both modalities. This analysis was performed for all readers and for the real and the simulated group of microcalcification clusters separately. ''Poor'' agreement would reflect radiologists' confusion between simulated and real clusters, i.e., lesions not systematically evaluated in both modalities as either simulated or real, and would therefore be interpreted as a success of the present models. Results: The area under the ROC curve, averaged over the observers, was 0.55 (95% confidence interval [0.44, 0.66]) for the 2D study, and 0.46 (95% confidence interval [0.29, 0.64]) for the tomosynthesis study, indicating no statistically significant difference between real and simulated

  2. Average glandular dose in digital mammography and breast tomosynthesis

    Energy Technology Data Exchange (ETDEWEB)

    Olgar, T. [Ankara Univ. (Turkey). Dept. of Engineering Physics; Universitaetsklinikum Leipzig AoeR (Germany). Klinik und Poliklinik fuer Diagnostische und Interventionelle Radiologie; Kahn, T.; Gosch, D. [Universitaetsklinikum Leipzig AoeR (Germany). Klinik und Poliklinik fuer Diagnostische und Interventionelle Radiologie

    2012-10-15

    Purpose: To determine the average glandular dose (AGD) in digital full-field mammography (2 D imaging mode) and in breast tomosynthesis (3 D imaging mode). Materials and Methods: Using the method described by Boone, the AGD was calculated from the exposure parameters of 2247 conventional 2 D mammograms and 984 mammograms in 3 D imaging mode of 641 patients examined with the digital mammographic system Hologic Selenia Dimensions. The breast glandular tissue content was estimated by the Hologic R2 Quantra automated volumetric breast density measurement tool for each patient from right craniocaudal (RCC) and left craniocaudal (LCC) images in 2 D imaging mode. Results: The mean compressed breast thickness (CBT) was 52.7 mm for craniocaudal (CC) and 56.0 mm for mediolateral oblique (MLO) views. The mean percentage of breast glandular tissue content was 18.0 % and 17.4 % for RCC and LCC projections, respectively. The mean AGD values in 2 D imaging mode per exposure for the standard breast were 1.57 mGy and 1.66 mGy, while the mean AGD values after correction for real breast composition were 1.82 mGy and 1.94 mGy for CC and MLO views, respectively. The mean AGD values in 3 D imaging mode per exposure for the standard breast were 2.19 mGy and 2.29 mGy, while the mean AGD values after correction for the real breast composition were 2.53 mGy and 2.63 mGy for CC and MLO views, respectively. No significant relationship was found between the AGD and CBT in 2 D imaging mode and a good correlation coefficient of 0.98 in 3 D imaging mode. Conclusion: In this study the mean calculated AGD per exposure in 3 D imaging mode was on average 34 % higher than for 2 D imaging mode for patients examined with the same CBT.

  3. Computer-aided detection system for clustered microcalcifications in digital breast tomosynthesis using joint information from volumetric and planar projection images

    Science.gov (United States)

    Samala, Ravi K.; Chan, Heang-Ping; Lu, Yao; Hadjiiski, Lubomir M.; Wei, Jun; Helvie, Mark A.

    2015-11-01

    We propose a novel approach for the detection of microcalcification clusters (MCs) using joint information from digital breast tomosynthesis (DBT) volume and planar projection (PPJ) image. A data set of 307 DBT views was collected with IRB approval using a prototype DBT system. The system acquires 21 projection views (PVs) from a wide tomographic angle of 60° (60°-21PV) at about twice the dose of a digital mammography (DM) system, which allows us the flexibility of simulating other DBT acquisition geometries using a subset of the PVs. In this study, we simulated a 30° DBT geometry using the central 11 PVs (30°-11PV). The narrower tomographic angle is closer to DBT geometries commercially available or under development and the dose is matched approximately to that of a DM. We developed a new joint-CAD system for detection of clustered microcalcifications. The DBT volume was reconstructed with a multiscale bilateral filtering regularized method and a PPJ image was generated from the reconstructed volume. Task-specific detection strategies were designed to combine information from the DBT volume and the PPJ image. The data set was divided into a training set (127 views with MCs) and an independent test set (104 views with MCs and 76 views without MCs). The joint-CAD system outperformed the individual CAD systems for DBT volume or PPJ image alone; the differences in the test performances were statistically significant (p  <  0.05) using JAFROC analysis.

  4. Computer-aided detection system for clustered microcalcifications in digital breast tomosynthesis using joint information from volumetric and planar projection images

    International Nuclear Information System (INIS)

    We propose a novel approach for the detection of microcalcification clusters (MCs) using joint information from digital breast tomosynthesis (DBT) volume and planar projection (PPJ) image. A data set of 307 DBT views was collected with IRB approval using a prototype DBT system. The system acquires 21 projection views (PVs) from a wide tomographic angle of 60° (60°-21PV) at about twice the dose of a digital mammography (DM) system, which allows us the flexibility of simulating other DBT acquisition geometries using a subset of the PVs. In this study, we simulated a 30° DBT geometry using the central 11 PVs (30°-11PV). The narrower tomographic angle is closer to DBT geometries commercially available or under development and the dose is matched approximately to that of a DM. We developed a new joint-CAD system for detection of clustered microcalcifications. The DBT volume was reconstructed with a multiscale bilateral filtering regularized method and a PPJ image was generated from the reconstructed volume. Task-specific detection strategies were designed to combine information from the DBT volume and the PPJ image. The data set was divided into a training set (127 views with MCs) and an independent test set (104 views with MCs and 76 views without MCs). The joint-CAD system outperformed the individual CAD systems for DBT volume or PPJ image alone; the differences in the test performances were statistically significant (p  <  0.05) using JAFROC analysis. (paper)

  5. Breast tomosynthesis: Accuracy of tumor measurement compared with digital mammography and ultrasonography

    Energy Technology Data Exchange (ETDEWEB)

    Foernvik, Daniel; Svahn, Tony; Timberg, Pontus; Tingberg, Anders (Dept. of Medical Radiation Physics, Lund Univ., Malmoe (Sweden)), e-mail: daniel.fornvik@med.lu.se; Zackrisson, Sophia; Andersson, Ingvar (Diagnostic Centre of Imaging and Functional Medicine, Malmoe Univ. Hospital, Malmoe (Sweden)); Ljungberg, Otto (Dept. of Pathology, Malmoe Univ. Hospital, Malmoe (Sweden))

    2010-04-15

    Background: Mammographic tumor size measurement can be difficult because breast structures are superimposed onto a two-dimensional (2D) plane, potentially obscuring the tumor outline. Breast tomosynthesis (BT) is a 3D X-ray imaging technique in which low-dose images are acquired over a limited angular range at a total dose comparable to digital mammography (DM). These low-dose images are used to mathematically reconstruct a 3D image volume of the breast, thus reducing the problem of superimposed tissue. Purpose: To investigate whether breast cancer size can be more accurately assessed with breast tomosynthesis than with digital mammography and ultrasonography (United States), by reducing the disturbance effect of the projected anatomy. Material and Methods: A prototype BT system was used. The main inclusion criterion for BT examination was subtle but suspicious findings of breast cancer on 2D mammography. Sixty-two women with 73 breast cancers were included. BT, DM, and US sizes were measured independently by experienced radiologists without knowledge of the pathology results, which were used as reference. Results: The tumor outline could be determined in significantly more cases with BT (63) and US (60) than DM (49). BT and US size correlated well with pathology (R=0.86 and R=0.85, respectively), and significantly better than DM size (R=0.71). Accordingly, staging was significantly more accurate with BT than with DM. Conclusion: The study indicates that BT is superior to DM in the assessment of breast tumor size and stage

  6. Digital breast tomosynthesis (DBT): initial experience in a clinical setting

    International Nuclear Information System (INIS)

    Background: Digital breast tomosynthesis (DBT) is a promising new technology. Some experimental clinical studies have shown positive results, but the future role and indications of this new technique, whether in a screening or clinical setting, need to be evaluated. Purpose: To compare digital mammography and DBT in a side-by-side feature analysis for cancer conspicuity, and to assess whether there is a potential additional value of DBT to standard state-of-the-art conventional imaging work-up with respect to detection of additional malignancies. Material and Methods: The study had ethics committee approval. A total of 129 women underwent 2D digital mammography including supplementary cone-down and magnification views and breast ultrasonography if indicated, as well as digital breast tomosynthesis. The indication for conventional imaging in the clinical setting included a palpable lump in 30 (23%), abnormal mammographic screening findings in 54 (42%), and surveillance in 45 (35%) of the women. The women were examined according to present guidelines, including spot-magnification views, ultrasonography, and needle biopsies, if indicated. The DBT examinations were interpreted several weeks after the conventional imaging without knowledge of the conventional imaging findings. In a later session, three radiologists performed a side-by-side feature analysis for cancer conspicuity in a sample of 50 cases. Results: State-of-the-art conventional imaging resulted in needle biopsy of 45 breasts, of which 20 lesions were benign and a total of 25 cancers were diagnosed. The remaining 84 women were dismissed with a normal/definitely benign finding and without indication for needle biopsy. The subsequent DBT interpretation found suspicious findings in four of these 84 women, and these four women had to be called back for repeated work-up with knowledge of the tomosynthesis findings. These delayed work-ups resulted in two cancers (increasing the cancer detection by 8%) and two

  7. Efficacy of digital breast tomosynthesis for breast cancer diagnosis

    Science.gov (United States)

    Alakhras, M.; Mello-Thoms, C.; Rickard, M.; Bourne, R.; Brennan, P. C.

    2014-03-01

    Purpose: To compare the diagnostic performance of digital breast tomosynthesis (DBT) in combination with digital mammography (DM) with that of digital mammography alone. Materials and Methods: Twenty six experienced radiologists who specialized in breast imaging read 50 cases (27 cancers and 23 non-cancer cases) of patients who underwent DM and DBT. Both exams included the craniocaudal (CC) and mediolateral oblique (MLO) views. Histopathologic examination established truth in all lesions. Each case was interpreted in two modes, once with DM alone followed by DM+DBT, and the observers were asked to mark the location of any lesions, if present, and give it a score based on a five-category assessment by the Royal Australian and New Zealand College of Radiologists (RANZCR). The diagnostic performance of DM compared with that of DM+DBT was evaluated in terms of the difference between areas under receiver-operating characteristic curves (AUCs), Jackknife free-response receiver operator characteristics (JAFROC) figure-of-merit, sensitivity, location sensitivity and specificity. Results: Average AUC and JAFROC for DM versus DM+DBT was significantly different (AUCs 0.690 vs 0.781, p=< 0.0001), (JAFROC 0.618 vs. 0.732, p=< 0.0001) respectively. In addition, the use of DM+DBT resulted in an improvement in sensitivity (0.629 vs. 0.701, p=0.0011), location sensitivity (0.548 vs. 0.690, p=< 0.0001) and specificity (0.656 vs. 0.758, p=0.0015) when compared to DM alone. Conclusion: Adding DBT to the standard DM significantly improved radiologists' performance in terms of AUCs, JAFROC figure of merit, sensitivity, location sensitivity and specificity values.

  8. Digital Breast Tomosynthesis: Comparison of Different Methods to Calculate Patient Doses

    International Nuclear Information System (INIS)

    Different methods have been proposed in the literature to calculate the dose to the patient's breast in 3-D mammography. The methods described by Dance et al. and Sechopoulos et al. have been compared in this study using the two tomosynthesis systems available in the authors' hospitals (Siemens and Hologic). There is a small but significant difference of 23% for the first X ray system and 13% for the second system between dose calculations performed with Dance's method and Sechopoulos' method. These differences are mainly due to the fact that the two sets of authors used different breast models for their Monte Carlo calculations. For each system, the calculated breast doses were compared with the dose values indicated on the system console. Good agreement was found when the method of Dance et al. was used for a breast glandularity based on the patient age. For the Siemens system, the calculated doses were 5% lower than the indicated dose and for the Hologic system, the calculated doses were 12% higher. Finally, the 3-D dose values were compared with the doses found in a large 2-D dosimetry study. The dose values for tomosynthesis on the Siemens system were almost double the doses in one view 2-D digital mammography. For a typical breast of thickness 45 mm, the dose of one 2-D view was 0.83 mGy and for one 3-D view 1.79 mGy. (author)

  9. Comparison study of reconstruction algorithms for prototype digital breast tomosynthesis using various breast phantoms.

    Science.gov (United States)

    Kim, Ye-seul; Park, Hye-suk; Lee, Haeng-Hwa; Choi, Young-Wook; Choi, Jae-Gu; Kim, Hak Hee; Kim, Hee-Joung

    2016-02-01

    Digital breast tomosynthesis (DBT) is a recently developed system for three-dimensional imaging that offers the potential to reduce the false positives of mammography by preventing tissue overlap. Many qualitative evaluations of digital breast tomosynthesis were previously performed by using a phantom with an unrealistic model and with heterogeneous background and noise, which is not representative of real breasts. The purpose of the present work was to compare reconstruction algorithms for DBT by using various breast phantoms; validation was also performed by using patient images. DBT was performed by using a prototype unit that was optimized for very low exposures and rapid readout. Three algorithms were compared: a back-projection (BP) algorithm, a filtered BP (FBP) algorithm, and an iterative expectation maximization (EM) algorithm. To compare the algorithms, three types of breast phantoms (homogeneous background phantom, heterogeneous background phantom, and anthropomorphic breast phantom) were evaluated, and clinical images were also reconstructed by using the different reconstruction algorithms. The in-plane image quality was evaluated based on the line profile and the contrast-to-noise ratio (CNR), and out-of-plane artifacts were evaluated by means of the artifact spread function (ASF). Parenchymal texture features of contrast and homogeneity were computed based on reconstructed images of an anthropomorphic breast phantom. The clinical images were studied to validate the effect of reconstruction algorithms. The results showed that the CNRs of masses reconstructed by using the EM algorithm were slightly higher than those obtained by using the BP algorithm, whereas the FBP algorithm yielded much lower CNR due to its high fluctuations of background noise. The FBP algorithm provides the best conspicuity for larger calcifications by enhancing their contrast and sharpness more than the other algorithms; however, in the case of small-size and low

  10. A review of breast tomosynthesis. Part II. Image reconstruction, processing and analysis, and advanced applications.

    Science.gov (United States)

    Sechopoulos, Ioannis

    2013-01-01

    Many important post-acquisition aspects of breast tomosynthesis imaging can impact its clinical performance. Chief among them is the reconstruction algorithm that generates the representation of the three-dimensional breast volume from the acquired projections. But even after reconstruction, additional processes, such as artifact reduction algorithms, computer aided detection and diagnosis, among others, can also impact the performance of breast tomosynthesis in the clinical realm. In this two part paper, a review of breast tomosynthesis research is performed, with an emphasis on its medical physics aspects. In the companion paper, the first part of this review, the research performed relevant to the image acquisition process is examined. This second part will review the research on the post-acquisition aspects, including reconstruction, image processing, and analysis, as well as the advanced applications being investigated for breast tomosynthesis. PMID:23298127

  11. Issues to consider before implementing digital breast tomosynthesis into a breast imaging practice.

    Science.gov (United States)

    Hardesty, Lara A

    2015-03-01

    OBJECTIVE. The purpose of this article is to discuss issues surrounding the implementation of digital breast tomosynthesis (DBT) into a clinical breast imaging practice and assist radiologists, technologists, and administrators who are considering the addition of this new technology to their practices. CONCLUSION. When appropriate attention is given to image acquisition, interpretation, storage, technologist and radiologist training, patient selection, billing, radiation dose, and marketing, implementation of DBT into a breast imaging practice can be successful.

  12. Comparison of digital breast tomosynthesis and 2D digital mammography using a hybrid performance test

    Science.gov (United States)

    Cockmartin, Lesley; Marshall, Nicholas W.; Van Ongeval, Chantal; Aerts, Gwen; Stalmans, Davina; Zanca, Federica; Shaheen, Eman; De Keyzer, Frederik; Dance, David R.; Young, Kenneth C.; Bosmans, Hilde

    2015-05-01

    This paper introduces a hybrid method for performing detection studies in projection image based modalities, based on image acquisitions of target objects and patients. The method was used to compare 2D mammography and digital breast tomosynthesis (DBT) in terms of the detection performance of spherical densities and microcalcifications. The method starts with the acquisition of spheres of different glandular equivalent densities and microcalcifications of different sizes immersed in a homogeneous breast tissue simulating medium. These target objects are then segmented and the subsequent templates are fused in projection images of patients and processed or reconstructed. This results in hybrid images with true mammographic anatomy and clinically relevant target objects, ready for use in observer studies. The detection study of spherical densities used 108 normal and 178 hybrid 2D and DBT images; 156 normal and 321 hybrid images were used for the microcalcifications. Seven observers scored the presence/absence of the spheres/microcalcifications in a square region via a 5-point confidence rating scale. Detection performance in 2D and DBT was compared via ROC analysis with sub-analyses for the density of the spheres, microcalcification size, breast thickness and z-position. The study was performed on a Siemens Inspiration tomosynthesis system using patient acquisitions with an average age of 58 years and an average breast thickness of 53 mm providing mean glandular doses of 1.06 mGy (2D) and 2.39 mGy (DBT). Study results showed that breast tomosynthesis (AUC = 0.973) outperformed 2D (AUC = 0.831) for the detection of spheres (p  breast thicknesses. By way of contrast, DBT was worse than 2D for microcalcification detection (AUC2D = 0.974, AUCDBT = 0.838, p  breast thicknesses above 40 mm and for heights above the detector of 20 mm and above. In conclusion, the hybrid method was successfully used to produce images for a detection study; results

  13. Breast MRI, digital mammography and breast tomosynthesis: Comparison of three methods for early detection of breast cancer

    OpenAIRE

    Dragana Roganovic; Dragana Djilas; Sasa Vujnovic; Dag Pavic; Dragan Stojanov

    2015-01-01

    Breast cancer is the most common malignancy in women and early detection is important for its successful treatment. The aim of this study was to investigate the sensitivity and specificity of three methods for early detection of breast cancer: breast magnetic resonance imaging (MRI), digital mammography, and breast tomosynthesis in comparison to histopathology, as well as to investigate the intraindividual variability between these modalities.  We included 57 breast lesions, each detected by ...

  14. Potential impact of tomosynthesis on the detection and diagnosis of breast lesi

    Directory of Open Access Journals (Sweden)

    Tamer F. Taha Ali

    2016-03-01

    Conclusion: Breast tomosynthesis is a promising technology that offers improved diagnostic and screening accuracy, fewer recalls as well as 3D lesion localization. Lesion conspicuity is improved using DBT compared with FFDM with a more confidence in making clinical decisions.

  15. Generalized filtered back-projection for digital breast tomosynthesis reconstruction

    Science.gov (United States)

    Erhard, Klaus; Grass, Michael; Hitziger, Sebastian; Iske, Armin; Nielsen, Tim

    2012-03-01

    Filtered backprojection (FBP) has been commonly used as an efficient and robust reconstruction technique in tomographic X-ray imaging during the last decades. For standard geometries like circle or helix it is known how to efficiently filter the data. However, for geometries with only few projection views or with a limited angular range, the application of FBP algorithms generally provides poor results. In digital breast tomosynthesis (DBT) these limitations give rise to image artifacts due to the limited angular range and the coarse angular sampling. In this work, a generalized FBP algorithm is presented, which uses the filtered projection data of all acquired views for backprojection along one direction. The proposed method yields a computationally efficient generalized FBP algorithm for DBT, which provides similar image quality as iterative reconstruction techniques while preserving the ability for region of interest reconstructions. To demonstrate the excellent performance of this method, examples are given with a simulated breast phantom and the hardware BR3D phantom.

  16. Added value of one-view breast tomosynthesis combined with digital mammography according to reader experience

    Energy Technology Data Exchange (ETDEWEB)

    Thomassin-Naggara, Isabelle, E-mail: isabelle.thomassin@tnn.aphp.fr [Sorbonne Universités, UPMC Univ Paris 06, IUC, 75005 Paris (France); INSERM, UMR970, Equipe 2, Imagerie de l’angiogenèse, 75005 Paris (France); AP-HP, Hôpital Tenon, Department of Radiology, 4 rue de la Chine, 75020 Paris (France); Perrot, Nicolas [AP-HP, Hôpital Tenon, Department of Radiology, 4 rue de la Chine, 75020 Paris (France); Centre Pyramides, Paris (France); Dechoux, Sophie [Sorbonne Universités, UPMC Univ Paris 06, IUC, 75005 Paris (France); AP-HP, Hôpital Tenon, Department of Radiology, 4 rue de la Chine, 75020 Paris (France); Ribeiro, Carine [Centre Pyramides, Paris (France); Chopier, Jocelyne [AP-HP, Hôpital Tenon, Department of Radiology, 4 rue de la Chine, 75020 Paris (France); Bazelaire, Cedric de [APHP, Department of Radiology, Hôpital Saint Louis, 75010 Paris (France)

    2015-02-15

    Highlights: • Breast tomosynthesis improves diagnostic performance especially for radiologists with lower experience in mammography. • Adding only one-view digital breast tomosynthesis to mammography improves the cancer detection rate. • Breast tomosynthesis is mainly useful for helping radiologists to detect architectural distortion. - Abstract: Purpose: To retrospectively evaluate the added value of one-view breast tomosynthesis in adjunct with mammography to characterize breast lesions. Materials and methods: Our institutional ethics committees approved the study and granted a waiver of informed consent. One hundred fifty-five women (mean age, 51.3 years, range: 24–92 years) who systematically underwent mammography and breast tomosynthesis with subsequent percutaneous biopsy were analyzed. Four radiologists (two seniors, R1 and R2, and two juniors, R3 and R4 with 30, 10, 3 and 1 years of experience in breast imaging, respectively) independently reviewed exams in two steps: mammography alone and tomosynthesis in adjunct with mammography. The lesions in the cohort included 39.3% (61/155) cancers, 2.5% (4/155) high-risk lesions and 58.1% (90/155) benign lesions. A receiver operating characteristic (ROC) curve analysis was performed to compare the results of the two readings. Results: There was almost perfect agreement irrespective of reader experience for the reading of the mammography in adjunct with tomosynthesis, whereas agreement was poor between junior and senior readers for the reading of mammography alone. Area under the ROC (Az) values for the tomosynthesis in adjunct with mammography were significantly better than Az values for mammography alone for all readers except the most experienced, for whom only a tendency was noted. The proportion of cancers undiagnosed by mammography alone that were well diagnosed by tomosynthesis in adjunct with mammography was 6.5% (4/61), 13.1% (8/61), 27.8% (17/61) and 26.2% (16/61) for Readers 1, 2, 3 and 4

  17. Molecular breast tomosynthesis with scanning focus multi-pinhole cameras

    Science.gov (United States)

    van Roosmalen, Jarno; Goorden, Marlies C.; Beekman, Freek J.

    2016-08-01

    Planar molecular breast imaging (MBI) is rapidly gaining in popularity in diagnostic oncology. To add 3D capabilities, we introduce a novel molecular breast tomosynthesis (MBT) scanner concept based on multi-pinhole collimation. In our design, the patient lies prone with the pendant breast lightly compressed between transparent plates. Integrated webcams view the breast through these plates and allow the operator to designate the scan volume (e.g. a whole breast or a suspected region). The breast is then scanned by translating focusing multi-pinhole plates and NaI(Tl) gamma detectors together in a sequence that optimizes count yield from the volume-of-interest. With simulations, we compared MBT with existing planar MBI. In a breast phantom containing different lesions, MBT improved tumour-to-background contrast-to-noise ratio (CNR) over planar MBI by 12% and 111% for 4.0 and 6.0 mm lesions respectively in case of whole breast scanning. For the same lesions, much larger CNR improvements of 92% and 241% over planar MBI were found in a scan that focused on a breast region containing several lesions. MBT resolved 3.0 mm rods in a Derenzo resolution phantom in the transverse plane compared to 2.5 mm rods distinguished by planar MBI. While planar MBI cannot provide depth information, MBT offered 4.0 mm depth resolution. Our simulations indicate that besides offering 3D localization of increased tracer uptake, multi-pinhole MBT can significantly increase tumour-to-background CNR compared to planar MBI. These properties could be promising for better estimating the position, extend and shape of lesions and distinguishing between single and multiple lesions.

  18. Wiener filter for filtered back projection in digital breast tomosynthesis

    Science.gov (United States)

    Wang, Xinying; Mainprize, James G.; Wu, Gang; Yaffe, Martin J.

    2012-03-01

    Conventional filtered back projection (FBP) reconstruction for digital breast tomosynthesis (DBT) can suffer from a low signal to noise ratio. Because of the strong amplification by the reconstruction filters (ramp, apodization and slice thickness), noise at high spatial frequencies can be greatly increased. Image enhancement by Wiener filtering is investigated as a possible method to improve image quality. A neighborhood wavelet coefficient window technique is used to estimate the noise content of projection images and a Wiener filter is applied to the projection images. The neighborhood wavelet coefficient window is a non-linear technique, which may cause the Wiener filters estimated before and after the application of the reconstruction filters to be different. Image quality of a FBP reconstruction with and without Wiener filtering is investigated using a Fourier-based observer detectability metric ( d' ) for evaluation. Simulations of tomosynthesis are performed in both homogeneous and anatomic textured backgrounds containing lowcontrast masses or small microcalcifications. Initial results suggest that improvements in detectability can be achieved when the Wiener filter is applied, especially when the Wiener filter is estimated for the reconstruction filtered projections.

  19. Digital Breast Tomosynthesis: A New Diagnostic Method for Mass-Like Lesions in Dense Breasts.

    Science.gov (United States)

    Bian, Tiantian; Lin, Qing; Cui, Chunxiao; Li, Lili; Qi, Chunhua; Fei, Jie; Su, Xiaohui

    2016-09-01

    To compare the rates and accuracy of digital breast tomosynthesis (DBT) and 2D digital mammography (DM) for detecting and diagnosing mass-like lesions in dense breasts. Mediolateral and craniocaudal images taken with DBT (affected breast) and DM (both breasts) of the dense breasts of 631 women were assessed independently using Breast Imaging Reporting and Data System (BI-RADS) scores. Images were compared for detection and diagnostic accuracy for masses; sensitivity and specificity of diagnosis; false-negative and recall rates; and clarity of display, particularly of margins and spicules. Histopathology was conducted via surgical biopsies of all patients. The detection and diagnostic accuracy rates of DBT images (84.3% and 82.3%, respectively) were significantly higher than that of DM (77.3% and 73.4%; p < 0.01, both). The sensitivity and specificity of DBT (68.1% and 95.2%) were higher than that of DM (58.8% and 86.7%), whereas the recall rate of DBT was lower (3.6% cf. 9.8%). The number of cases of benign circumscribed masses and malignant spiculated masses detected by DBT (172 and 182) was significantly higher than the number detected through DM (75 and 115; p < 0.01, both). Radiologists assigned higher BI-RADS scores for probability of malignancy to DBT images than DM, to lesions proved malignant (p = 0.025); for benign cases, the methods were comparable (p = 0.065). Compared with DM, DBT yielded significantly higher rates of detection and diagnostic accuracy for benign and malignant masses, with greater sensitivity and specificity and lower recall rates. In addition, DBT images facilitated analysis of margins, and the rate of accuracy for judgments of malignancy probability was higher, as proved on biopsy. PMID:27296324

  20. A software-based x-ray scatter correction method for breast tomosynthesis

    Energy Technology Data Exchange (ETDEWEB)

    Jia Feng, Steve Si; Sechopoulos, Ioannis [Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, and Department of Radiology and Imaging Sciences and Winship Cancer Institute, Emory University, 1701 Uppergate Drive Northeast, Suite 5018, Atlanta, Georgia 30322 (United States); Department of Radiology and Imaging Sciences, Hematology and Medical Oncology and Winship Cancer Institute, Emory University, 1701 Uppergate Drive Northeast, Suite 5018, Atlanta, Georgia 30322 (United States)

    2011-12-15

    Purpose: To develop a software-based scatter correction method for digital breast tomosynthesis (DBT) imaging and investigate its impact on the image quality of tomosynthesis reconstructions of both phantoms and patients. Methods: A Monte Carlo (MC) simulation of x-ray scatter, with geometry matching that of the cranio-caudal (CC) view of a DBT clinical prototype, was developed using the Geant4 toolkit and used to generate maps of the scatter-to-primary ratio (SPR) of a number of homogeneous standard-shaped breasts of varying sizes. Dimension-matched SPR maps were then deformed and registered to DBT acquisition projections, allowing for the estimation of the primary x-ray signal acquired by the imaging system. Noise filtering of the estimated projections was then performed to reduce the impact of the quantum noise of the x-ray scatter. Three dimensional (3D) reconstruction was then performed using the maximum likelihood-expectation maximization (MLEM) method. This process was tested on acquisitions of a heterogeneous 50/50 adipose/glandular tomosynthesis phantom with embedded masses, fibers, and microcalcifications and on acquisitions of patients. The image quality of the reconstructions of the scatter-corrected and uncorrected projections was analyzed by studying the signal-difference-to-noise ratio (SDNR), the integral of the signal in each mass lesion (integrated mass signal, IMS), and the modulation transfer function (MTF). Results: The reconstructions of the scatter-corrected projections demonstrated superior image quality. The SDNR of masses embedded in a 5 cm thick tomosynthesis phantom improved 60%-66%, while the SDNR of the smallest mass in an 8 cm thick phantom improved by 59% (p < 0.01). The IMS of the masses in the 5 cm thick phantom also improved by 15%-29%, while the IMS of the masses in the 8 cm thick phantom improved by 26%-62% (p < 0.01). Some embedded microcalcifications in the tomosynthesis phantoms were visible only in the scatter

  1. A parameterization method and application in breast tomosynthesis dosimetry

    Energy Technology Data Exchange (ETDEWEB)

    Li, Xinhua; Zhang, Da; Liu, Bob [Division of Diagnostic Imaging Physics and Webster Center for Advanced Research and Education in Radiation, Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts 02114 (United States)

    2013-09-15

    Purpose: To present a parameterization method based on singular value decomposition (SVD), and to provide analytical parameterization of the mean glandular dose (MGD) conversion factors from eight references for evaluating breast tomosynthesis dose in the Mammography Quality Standards Act (MQSA) protocol and in the UK, European, and IAEA dosimetry protocols.Methods: MGD conversion factor is usually listed in lookup tables for the factors such as beam quality, breast thickness, breast glandularity, and projection angle. The authors analyzed multiple sets of MGD conversion factors from the Hologic Selenia Dimensions quality control manual and seven previous papers. Each data set was parameterized using a one- to three-dimensional polynomial function of 2–16 terms. Variable substitution was used to improve accuracy. A least-squares fit was conducted using the SVD.Results: The differences between the originally tabulated MGD conversion factors and the results computed using the parameterization algorithms were (a) 0.08%–0.18% on average and 1.31% maximum for the Selenia Dimensions quality control manual, (b) 0.09%–0.66% on average and 2.97% maximum for the published data by Dance et al. [Phys. Med. Biol. 35, 1211–1219 (1990); ibid. 45, 3225–3240 (2000); ibid. 54, 4361–4372 (2009); ibid. 56, 453–471 (2011)], (c) 0.74%–0.99% on average and 3.94% maximum for the published data by Sechopoulos et al. [Med. Phys. 34, 221–232 (2007); J. Appl. Clin. Med. Phys. 9, 161–171 (2008)], and (d) 0.66%–1.33% on average and 2.72% maximum for the published data by Feng and Sechopoulos [Radiology 263, 35–42 (2012)], excluding one sample in (d) that does not follow the trends in the published data table.Conclusions: A flexible parameterization method is presented in this paper, and was applied to breast tomosynthesis dosimetry. The resultant data offer easy and accurate computations of MGD conversion factors for evaluating mean glandular breast dose in the MQSA

  2. A task-based comparison of two reconstruction algorithms for digital breast tomosynthesis

    Science.gov (United States)

    Mahadevan, Ravi; Ikejimba, Lynda C.; Lin, Yuan; Samei, Ehsan; Lo, Joseph Y.

    2014-03-01

    Digital breast tomosynthesis (DBT) generates 3-D reconstructions of the breast by taking X-Ray projections at various angles around the breast. DBT improves cancer detection as it minimizes tissue overlap that is present in traditional 2-D mammography. In this work, two methods of reconstruction, filtered backprojection (FBP) and the Newton-Raphson iterative reconstruction were used to create 3-D reconstructions from phantom images acquired on a breast tomosynthesis system. The task based image analysis method was used to compare the performance of each reconstruction technique. The task simulated a 10mm lesion within the breast containing iodine concentrations between 0.0mg/ml and 8.6mg/ml. The TTF was calculated using the reconstruction of an edge phantom, and the NPS was measured with a structured breast phantom (CIRS 020) over different exposure levels. The detectability index d' was calculated to assess image quality of the reconstructed phantom images. Image quality was assessed for both conventional, single energy and dual energy subtracted reconstructions. Dose allocation between the high and low energy scans was also examined. Over the full range of dose allocations, the iterative reconstruction yielded a higher detectability index than the FBP for single energy reconstructions. For dual energy subtraction, detectability index was maximized when most of the dose was allocated to the high energy image. With that dose allocation, the performance trend for reconstruction algorithms reversed; FBP performed better than the corresponding iterative reconstruction. However, FBP performance varied very erratically with changing dose allocation. Therefore, iterative reconstruction is preferred for both imaging modalities despite underperforming dual energy FBP, as it provides stable results.

  3. A second pass correction method for calcification artifacts in digital breast tomosynthesis

    NARCIS (Netherlands)

    Erhard, K.; Grass, M.; Nielsen, T.

    2011-01-01

    Digital breast tomosynthesis (DBT) aims for improving the diagnosis of breast cancer and reducing the false positive rates by going from 2D projection mammography to 3D volume information. With the acquisition of a series of projection images, taken over a limited angular range, DBT allows for tomog

  4. Quality control in breast tomosynthesis; Controle de qualidade em tomossintese mamaria

    Energy Technology Data Exchange (ETDEWEB)

    Jakubiak, Rosangela Requi; Messias, Pricila Cordeiro; Santos, Marilia Fernanda, E-mail: requi@gmail.com [Universidade Tecnologica Federal do Parana (UTFPR), Curitiba, PR (Brazil); Urban, Linei Augusta B.D., E-mail: ineiurban@hotmail.com [Diagnostico Avancado por Imagem (DAPI), Curitiba, PR (Brazil)

    2014-07-01

    In Brazil breast cancer is the most common and the leading cause of death among women, with estimated 57,000 new cases in 2014. The mammography (2D) plays an important role in the early detection of breast cancer, but in some cases can be difficult to detect malignant lesions due overlap of breast tissues. The Breast Digital Tomosynthesis (BDT: 3D) reduces the effects of overlap, providing improved characterization of mammographic findings. However, the dose may double as compared to the mammography. This study presents results of Contrast Ratio Noise tests (CRN) and quality image on a Siemens mammography equipment Mammomat Inspiration with tomosynthesis. The CRN was determined with plates Polymethylmethacrylate (PMMA) of 20 to 70 mm thickness and an aluminum plate of 10 mm{sup 2} and 0.2 mm thickness. Image quality was assessed with the ACR Breast Simulator. In assessment of image quality, the detectability of fibers and masses was identical in 2D and 3D systems. Were visualized 4.5 fibers and 4 mass in both modes. In 2D mode groups have been identified 3.5 microcalcifications, and 3D were 3 groups. The Mean Glandular Dose for the simulator in 2D mode was 1.17 mGy and 2.35 mGy for the 3D mode. The result reinforces the importance of quality control in the process of obtaining the images and obtained in accordance CRN values, ensuring image quality and dose compatible in 2D and 3D processes.

  5. Task-based strategy for optimized contrast enhanced breast imaging: Analysis of six imaging techniques for mammography and tomosynthesis

    Energy Technology Data Exchange (ETDEWEB)

    Ikejimba, Lynda C., E-mail: lci@duke.edu [Medical Physics Graduate Program, Duke University, Durham, North Carolina 27705 and Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Duke University Medical Center, Durham, North Carolina 27705 (United States); Kiarashi, Nooshin [Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Duke University Medical Center, Durham, North Carolina 27705 and Department of Electrical and Computer Engineering, Duke University, Durham, North Carolina 27705 (United States); Ghate, Sujata V. [Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Duke University Medical Center, Durham, North Carolina 27705 (United States); Samei, Ehsan [Medical Physics Graduate Program, Duke University, Durham, North Carolina 27705 (United States); Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Duke University Medical Center, Durham, North Carolina 27705 (United States); Department of Electrical and Computer Engineering, Duke University, Durham, North Carolina 27705 (United States); Department of Physics, Duke University, Durham, North Carolina 27705 (United States); Department of Biomedical Engineering, Duke University, Durham, North Carolina 27705 (United States); Lo, Joseph Y. [Medical Physics Graduate Program, Duke University, Durham, North Carolina 27705 (United States); Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Duke University Medical Center, Durham, North Carolina 27705 (United States); Department of Electrical and Computer Engineering, Duke University, Durham, North Carolina 27705 (United States); Department of Biomedical Engineering, Duke University, Durham, North Carolina 27705 (United States)

    2014-06-15

    Purpose: The use of contrast agents in breast imaging has the capability of enhancing nodule detectability and providing physiological information. Accordingly, there has been a growing trend toward using iodine as a contrast medium in digital mammography (DM) and digital breast tomosynthesis (DBT). Widespread use raises concerns about the best way to use iodine in DM and DBT, and thus a comparison is necessary to evaluate typical iodine-enhanced imaging methods. This study used a task-based observer model to determine the optimal imaging approach by analyzing six imaging paradigms in terms of their ability to resolve iodine at a given dose: unsubtracted mammography and tomosynthesis, temporal subtraction mammography and tomosynthesis, and dual energy subtraction mammography and tomosynthesis. Methods: Imaging performance was characterized using a detectability index d{sup ′}, derived from the system task transfer function (TTF), an imaging task, iodine signal difference, and the noise power spectrum (NPS). The task modeled a 10 mm diameter lesion containing iodine concentrations between 2.1 mg/cc and 8.6 mg/cc. TTF was obtained using an edge phantom, and the NPS was measured over several exposure levels, energies, and target-filter combinations. Using a structured CIRS phantom, d{sup ′} was generated as a function of dose and iodine concentration. Results: For all iodine concentrations and dose, temporal subtraction techniques for mammography and tomosynthesis yielded the highest d{sup ′}, while dual energy techniques for both modalities demonstrated the next best performance. Unsubtracted imaging resulted in the lowest d{sup ′} values for both modalities, with unsubtracted mammography performing the worst out of all six paradigms. Conclusions: At any dose, temporal subtraction imaging provides the greatest detectability, with temporally subtracted DBT performing the highest. The authors attribute the successful performance to excellent cancellation of

  6. Task-based strategy for optimized contrast enhanced breast imaging: Analysis of six imaging techniques for mammography and tomosynthesis

    International Nuclear Information System (INIS)

    Purpose: The use of contrast agents in breast imaging has the capability of enhancing nodule detectability and providing physiological information. Accordingly, there has been a growing trend toward using iodine as a contrast medium in digital mammography (DM) and digital breast tomosynthesis (DBT). Widespread use raises concerns about the best way to use iodine in DM and DBT, and thus a comparison is necessary to evaluate typical iodine-enhanced imaging methods. This study used a task-based observer model to determine the optimal imaging approach by analyzing six imaging paradigms in terms of their ability to resolve iodine at a given dose: unsubtracted mammography and tomosynthesis, temporal subtraction mammography and tomosynthesis, and dual energy subtraction mammography and tomosynthesis. Methods: Imaging performance was characterized using a detectability index d′, derived from the system task transfer function (TTF), an imaging task, iodine signal difference, and the noise power spectrum (NPS). The task modeled a 10 mm diameter lesion containing iodine concentrations between 2.1 mg/cc and 8.6 mg/cc. TTF was obtained using an edge phantom, and the NPS was measured over several exposure levels, energies, and target-filter combinations. Using a structured CIRS phantom, d′ was generated as a function of dose and iodine concentration. Results: For all iodine concentrations and dose, temporal subtraction techniques for mammography and tomosynthesis yielded the highest d′, while dual energy techniques for both modalities demonstrated the next best performance. Unsubtracted imaging resulted in the lowest d′ values for both modalities, with unsubtracted mammography performing the worst out of all six paradigms. Conclusions: At any dose, temporal subtraction imaging provides the greatest detectability, with temporally subtracted DBT performing the highest. The authors attribute the successful performance to excellent cancellation of inplane structures and

  7. Digital breast tomosynthesis versus mammography and breast ultrasound: a multireader performance study

    Energy Technology Data Exchange (ETDEWEB)

    Thibault, Fabienne; Malhaire, Caroline; Tardivon, Anne [Department of Radiology, Paris Cedex 05 (France); Dromain, Clarisse; Balleyguier, Corinne S. [Institut de cancerologie Gustave-Roussy, Department of Radiology, Villejuif (France); Breucq, Catherine [Universitair Ziekenhuis-VUB, Department of Radiology, Bruxelles (Belgium); Steyaert, Luc [Department of Radiology, Brugge (Belgium); Baldan, Enrica [Veneto Institute of Oncology (IOV)-IRCCS, Department of Radiology, Padua (Italy); Drevon, Harir [Numerus Ltd, Lyon (France)

    2013-09-15

    To compare the diagnostic performance of single-view breast tomosynthesis (BT) with that of dual-view mammography (MX); to assess the benefit of adding the craniocaudal (CC) mammographic view to BT, and of adding BT to MX plus breast ultrasound, considered to be the reference work-up. One hundred and fifty-five consenting patients with unresolved mammographic and/or ultrasound findings or breast symptoms underwent conventional work-up plus mediolateral oblique-view BT of the affected breast. The final study set in 130 patients resulted in 55 malignant and 76 benign and normal cases. Seven breast radiologists rated the cases through five sequential techniques using a BIRADS-based scale: MX, MX + ultrasound, MX + ultrasound + BT, BT, BT + MX(CC). Multireader, multicase receiver operating characteristic (ROC) analysis was performed and performance of the techniques was assessed from the areas under ROC curves. The performance of BT and of BT + MX(CC) was tested versus MX; the performance of MX + ultrasound + BT tested versus MX + ultrasound. Tomosynthesis was found to be non-inferior to mammography. BT + MX(CC) did not appear to be superior to MX, and MX + ultrasound + BT not superior to MX + ultrasound. Overall, none of the five techniques tested outperformed the others. Further clinical studies are needed to clarify the role of BT as a substitute for traditional work-up in the diagnostic environment. (orig.)

  8. Digital breast tomosynthesis reconstruction with an adaptive voxel grid

    Science.gov (United States)

    Claus, Bernhard; Chan, Heang-Ping

    2014-03-01

    In digital breast tomosynthesis (DBT) volume datasets are typically reconstructed with an anisotropic voxel size, where the in-plane voxel size usually reflects the detector pixel size (e.g., 0.1 mm), and the slice separation is generally between 0.5-1.0 mm. Increasing the tomographic angle is expected to give better 3D image quality; however, the slice spacing in the reconstruction should be reduced, otherwise one may risk losing fine-scale image detail (e.g., small microcalcifications). An alternative strategy consists of reconstructing on an adaptive voxel grid, where the voxel height at each location is adapted based on the backprojected data at this location, with the goal to improve image quality for microcalcifications. In this paper we present an approach for generating such an adaptive voxel grid. This approach is based on an initial reconstruction step that is performed at a finer slice-spacing combined with a selection of an "optimal" height for each voxel. This initial step is followed by a (potentially iterative) reconstruction acting now on the adaptive grid only.

  9. Description and validation of a scoring system for tomosynthesis in pulmonary cystic fibrosis.

    OpenAIRE

    Vult von Steyern, Kristina; Björkman-Burtscher, Isabella; Höglund, Peter; Bozovic, Gracijela; Wiklund, Marie; Geijer, Mats

    2012-01-01

    OBJECTIVES: To design and validate a scoring system for tomosynthesis (digital tomography) in pulmonary cystic fibrosis. METHODS: A scoring system dedicated to tomosynthesis in pulmonary cystic fibrosis was designed. Three radiologists independently scored 88 pairs of radiographs and tomosynthesis examinations of the chest in 60 patients with cystic fibrosis and 7 oncology patients. Radiographs were scored according to the Brasfield scoring system and tomosynthesis examination...

  10. Observation of super-resolution in digital breast tomosynthesis

    Energy Technology Data Exchange (ETDEWEB)

    Acciavatti, Raymond J.; Maidment, Andrew D. A. [Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania 19104-4206 (United States)

    2012-12-15

    Purpose: Digital breast tomosynthesis (DBT) is a 3D x-ray imaging modality in which tomographic sections of the breast are generated from a limited range of tube angles. Because oblique x-ray incidence shifts the image of an object in subpixel detector element increments with each increasing projection angle, it is demonstrated that DBT is capable of super-resolution (i.e., subpixel resolution). Methods: By convention, DBT reconstructions are performed on planes parallel to the breast support at various depths of the breast volume. In order for resolution in each reconstructed slice to be comparable to the detector, the pixel size should match that of the detector elements; hence, the highest frequency that can be resolved in the plane of reconstruction is the alias frequency of the detector. This study considers reconstruction grids with much smaller pixelation to visualize higher frequencies. For analytical proof of super-resolution, a theoretical framework is developed in which the reconstruction of a high frequency sinusoidal input is calculated using both simple backprojection (SBP) and filtered backprojection. To study the frequency spectrum of the reconstruction, its Fourier transform is also determined. The experimental feasibility of super-resolution was investigated by acquiring images of a bar pattern phantom with frequencies higher than the detector alias frequency. Results: Using analytical modeling, it is shown that the central projection cannot resolve frequencies exceeding the detector alias frequency. The Fourier transform of the central projection is maximized at a lower frequency than the input as evidence of aliasing. By contrast, SBP reconstruction can resolve the input, and its Fourier transform is correctly maximized at the input frequency. Incorporating filters into the reconstruction smoothens pixelation artifacts in the spatial domain and reduces spectral leakage in the Fourier domain. It is also demonstrated that the existence of super

  11. Digital breast tomosynthesis: computerized detection of microcalcifications in reconstructed breast volume using a 3D approach

    Science.gov (United States)

    Chan, Heang-Ping; Sahiner, Berkman; Wei, Jun; Hadjiiski, Lubomir M.; Zhou, Chuan; Helvie, Mark A.

    2010-03-01

    We are developing a computer-aided detection (CAD) system for clustered microcalcifications in digital breast tomosynthesis (DBT). In this preliminary study, we investigated the approach of detecting microcalcifications in the tomosynthesized volume. The DBT volume is first enhanced by 3D multi-scale filtering and analysis of the eigenvalues of Hessian matrices with a calcification response function and signal-to-noise ratio enhancement filtering. Potential signal sites are identified in the enhanced volume and local analysis is performed to further characterize each object. A 3D dynamic clustering procedure is designed to locate potential clusters using hierarchical criteria. We collected a pilot data set of two-view DBT mammograms of 39 breasts containing microcalcification clusters (17 malignant, 22 benign) with IRB approval. A total of 74 clusters were identified by an experienced radiologist in the 78 DBT views. Our prototype CAD system achieved view-based sensitivity of 90% and 80% at an average FP rate of 7.3 and 2.0 clusters per volume, respectively. At the same levels of case-based sensitivity, the FP rates were 3.6 and 1.3 clusters per volume, respectively. For the subset of malignant clusters, the view-based detection sensitivity was 94% and 82% at an average FP rate of 6.0 and 1.5 FP clusters per volume, respectively. At the same levels of case-based sensitivity, the FP rates were 1.2 and 0.9 clusters per volume, respectively. This study demonstrated that computerized microcalcification detection in 3D is a promising approach to the development of a CAD system for DBT. Study is underway to further improve the computer-vision methods and to optimize the processing parameters using a larger data set.

  12. Effect of the glandular composition on digital breast tomosynthesis image quality and dose optimisation

    International Nuclear Information System (INIS)

    In the image quality assessment for digital breast tomosynthesis (DBT), a breast phantom with an average percentage of 50 % glandular tissue is seldom used, which may not be representative of the breast tissue composition of the women undergoing such examination. This work aims at studying the effect of the glandular composition of the breast on the image quality taking into consideration different sizes of lesions. Monte Carlo simulations were performed using the state-of-the-art computer program PENELOPE to validate the image acquisition system of the DBT equipment as well as to calculate the mean glandular dose for each projection image and for different breast compositions. The integrated PENELOPE imaging tool (PenEasy) was used to calculate, in mammography, for each clinical detection task the X-ray energy that maximises the figure of merit. All the 2D cranial-caudal projections for DBT were simulated and then underwent the reconstruction process applying the Simultaneous Algebraic Reconstruction Technique. Finally, through signal-to-noise ratio analysis, the image quality in DBT was assessed. (authors)

  13. Effect of the glandular composition on digital breast tomosynthesis image quality and dose optimisation.

    Science.gov (United States)

    Marques, T; Ribeiro, A; Di Maria, S; Belchior, A; Cardoso, J; Matela, N; Oliveira, N; Janeiro, L; Almeida, P; Vaz, P

    2015-07-01

    In the image quality assessment for digital breast tomosynthesis (DBT), a breast phantom with an average percentage of 50 % glandular tissue is seldom used, which may not be representative of the breast tissue composition of the women undergoing such examination. This work aims at studying the effect of the glandular composition of the breast on the image quality taking into consideration different sizes of lesions. Monte Carlo simulations were performed using the state-of-the-art computer program PENELOPE to validate the image acquisition system of the DBT equipment as well as to calculate the mean glandular dose for each projection image and for different breast compositions. The integrated PENELOPE imaging tool (PenEasy) was used to calculate, in mammography, for each clinical detection task the X-ray energy that maximises the figure of merit. All the 2D cranial-caudal projections for DBT were simulated and then underwent the reconstruction process applying the Simultaneous Algebraic Reconstruction Technique. Finally, through signal-to-noise ratio analysis, the image quality in DBT was assessed.

  14. Breast Cancer Risk Estimation Using Parenchymal Texture Analysis in Digital Breast Tomosynthesis

    Science.gov (United States)

    Ikejimba, Lynda C.; Kontos, Despina; Maidment, Andrew D. A.

    2010-10-01

    Mammographic parenchymal texture has been shown to correlate with genetic markers of developing breast cancer. Digital breast tomosynthesis (DBT) is a novel x-ray imaging technique in which tomographic images of the breast are reconstructed from multiple source projections acquired at different angles of the x-ray tube. Compared to digital mammography (DM), DBT eliminates breast tissue overlap, offering superior parenchymal tissue visualization. We hypothesize that texture analysis in DBT could potentially provide a better assessment of parenchymal texture and ultimately result in more accurate assessment of breast cancer risk. As a first step towards validating this hypothesis, we investigated the association between DBT parenchymal texture and breast percent density (PD), a known breast cancer risk factor, and compared it to DM. Bilateral DBT and DM images from 71 women participating in a breast cancer screening trial were analyzed. Filtered-backprojection was used to reconstruct DBT tomographic planes in 1 mm increments with 0.22 mm in-plane resolution. Corresponding DM images were acquired at 0.1 mm pixel resolution. Retroareolar regions of interest (ROIs) equivalent to 2.5 cm3 were segmented from the DBT images and corresponding 2.5 cm2 ROIs were segmented from the DM images. Breast PD was mammographically estimated using the Cumulus scale. Overall, DBT texture features demonstrated a stronger correlation than DM to PD. The Pearson correlation coefficients for DBT were r = 0.40 (pbreast cancer risk assessment in the future.

  15. Multiscale regularized reconstruction for enhancing microcalcification in digital breast tomosynthesis

    Science.gov (United States)

    Lu, Yao; Chan, Heang-Ping; Wei, Jun; Hadjiiski, Lubomir; Zhou, Chuan

    2012-03-01

    Digital breast tomosynthesis (DBT) holds strong promise for improving the sensitivity of detecting subtle mass lesions. Detection of microcalcifications is more difficult because of high noise and subtle signals in the large DBT volume. It is important to enhance the contrast-to-noise ratio (CNR) of microcalcifications in DBT reconstruction. A major challenge of implementing microcalcification enhancement or noise regularization in DBT reconstruction is to preserve the image quality of masses, especially those with ill-defined margins and subtle spiculations. We are developing a new multiscale regularization (MSR) method for the simultaneous algebraic reconstruction technique (SART) to improve the CNR of microcalcifications without compromising the quality of masses. Each DBT slice is stratified into different frequency bands via wavelet decomposition and the regularization method applies different degrees of regularization to different frequency bands to preserve features of interest and suppress noise. Regularization is constrained by a characteristic map to avoid smoothing subtle microcalcifications. The characteristic map is generated via image feature analysis to identify potential microcalcification locations in the DBT volume. The MSR method was compared to the non-convex total pvariation (TpV) method and SART with no regularization (NR) in terms of the CNR and the full width at half maximum of the line profiles intersecting calcifications and mass spiculations in DBT of human subjects. The results demonstrated that SART regularized by the MSR method was superior to the TpV method for subtle microcalcifications in terms of CNR enhancement. The MSR method preserved the quality of subtle spiculations better than the TpV method in comparison to NR.

  16. The effect of angular dose distribution on the detection of microcalcifications in digital breast tomosynthesis

    OpenAIRE

    Hu, Yue-Houng; Zhao, Wei

    2011-01-01

    Purpose: Substantial effort has been devoted to the clinical development of digital breast tomosynthesis (DBT). DBT is a three-dimensional (3D) x-ray imaging modality that reconstructs a number of thin image slices parallel to a stationary detector plane. Preliminary clinical studies have shown that the removal of overlapping breast tissue reduces image clutter and increases detectability of large, low contrast lesions. However, some studies, as well as anecdotal evidence, suggested decreased...

  17. Digital breast tomosynthesis and digital mammography: A comparison of figures of merit for various average glandular doses

    Science.gov (United States)

    Kim, Ye-seul; Park, Hye-Suk; Park, SuJin; Kim, Hee-Joung; Choi, Jae-Gu; Choi, Young-Wook; Park, Jun-Ho; Lee, Jae-Jun

    2013-05-01

    Previous studies on the application of tomosynthesis to breast imaging have demonstrated the potential of digital breast tomosynthesis (DBT). DBT can improve the specificity of digital mammography (DM) through improved marginal visibility of lesions and early breast cancer detection for women with dense breasts. To investigate possible improvements in the accuracy of lesion detection with DBT systems as compared to DM, we conducted a quantitative evaluation by using simulated lesions embedded in a breast phantom. A prototype DBT and dedicated DM system were used in this study. For the DBT system, the average glandular dose (AGD) was calculated using a formalism that was a simple extension of mammography dosimetry. The DBT and the DM images were acquired with average glandular doses (AGDs) ranging from 1 to 4 mGy. To analyze the results objectively, we calculated metrics for in-plane lesion visibility in the form of the contrast-to-noise ratio for the in-focus plane from the DBT reconstruction image and from the craniocaudal (CC) image from the DM system. The imaging performance of DBT was quantitatively compared with that of DM in terms of the figure of merit. Although the DM showed better results in terms of the contrast-to-noise ratio (CNR) of the mass due to the reduced overlapping of tissue and lesion, an increase in breast thickness of over 3 cm increased the CNR of the mass with the DBT system. For microcalcification detection, the DBT system showed significantly higher CNR than the DM system and gave better predictions of the microcalcification size. We compared the performances of the DM and the DBT systems for various AGDs and breast thicknesses. In conclusion, the results indicate that the DBT systems can play an important role in the detection of masses or microcalcifications without severe compression.

  18. Image quality evaluation of breast tomosynthesis with synchrotron radiation

    Energy Technology Data Exchange (ETDEWEB)

    Malliori, A.; Bliznakova, K.; Speller, R. D.; Horrocks, J. A.; Rigon, L.; Tromba, G.; Pallikarakis, N. [Department of Medical Physics, Faculty of Medicine, University of Patras, Patras 26500 (Greece); Department of Medical Physics and Bioengineering, University College London, London WVC1E 6BT (United Kingdom); Clinical Physics CAU, St Bartholomew' s Hospital, London EC1A 7BE (United Kingdom); INFN, Sezione di Trieste, Trieste 34127 (Italy); ELETTRA, Basovizza, Trieste 34012 (Italy); Department of Medical Physics, Faculty of Medicine, University of Patras, Patras 26500 (Greece)

    2012-09-15

    Purpose: This study investigates the image quality of tomosynthesis slices obtained from several acquisition sets with synchrotron radiation using a breast phantom incorporating details that mimic various breast lesions, in a heterogeneous background. Methods: A complex Breast phantom (MAMMAX) with a heterogeneous background and thickness that corresponds to 4.5 cm compressed breast with an average composition of 50% adipose and 50% glandular tissue was assembled using two commercial phantoms. Projection images using acquisition arcs of 24 Degree-Sign , 32 Degree-Sign , 40 Degree-Sign , 48 Degree-Sign , and 56 Degree-Sign at incident energy of 17 keV were obtained from the phantom with the synchrotron radiation for medical physics beamline at ELETTRA Synchrotron Light Laboratory. The total mean glandular dose was set equal to 2.5 mGy. Tomograms were reconstructed with simple multiple projection algorithm (MPA) and filtered MPA. In the latter case, a median filter, a sinc filter, and a combination of those two filters were applied on the experimental data prior to MPA reconstruction. Visual inspection, contrast to noise ratio, contrast, and artifact spread function were the figures of merit used in the evaluation of the visualisation and detection of low- and high-contrast breast features, as a function of the reconstruction algorithm and acquisition arc. To study the benefits of using monochromatic beams, single projection images at incident energies ranging from 14 to 27 keV were acquired with the same phantom and weighted to synthesize polychromatic images at a typical incident x-ray spectrum with W target. Results: Filters were optimised to reconstruct features with different attenuation characteristics and dimensions. In the case of 6 mm low-contrast details, improved visual appearance as well as higher contrast to noise ratio and contrast values were observed for the two filtered MPA algorithms that exploit the sinc filter. These features are better visualized

  19. Value analysis of digital breast tomosynthesis for breast cancer screening in a commercially-insured US population

    Directory of Open Access Journals (Sweden)

    Bonafede MM

    2015-01-01

    Full Text Available Machaon M Bonafede,1 Vivek B Kalra,2 Jeffrey D Miller,1 Laurie L Fajardo3 1Truven Health Analytics, Cambridge, MA, 2Yale University School of Medicine, New Haven, CT, 3Department of Radiology, University of Iowa College of Medicine, Iowa City, IA, USA Purpose: The objective of this study was to conduct a value analysis of digital breast tomosynthesis (DBT for breast cancer screening among women enrolled in US commercial health insurance plans to assess the potential budget impact associated with the clinical benefits of DBT. Methods: An economic model was developed to estimate the system-wide financial impact of DBT as a breast cancer screening modality within a hypothetical US managed care plan with one million members. Two scenarios were considered for women in the health plan who undergo annual screening mammography, ie, full field digital mammography (FFDM and combined FFDM + DBT. The model focused on two main drivers of DBT value, ie, the capacity for DBT to reduce the number of women recalled for additional follow-up imaging and diagnostic services and the capacity of DBT to facilitate earlier diagnosis of cancer at less invasive stages where treatment costs are lower. Model inputs were derived from published sources and from analyses of the Truven Health MarketScan® Research Databases (2010–2012. Comparative clinical and economic outcomes were simulated for one year following screening and compared on an incremental basis. Results: Base-case analysis results show that 4,523 women in the hypothetical million member health plan who are screened using DBT avoid the use of follow-up services. The overall benefit of DBT was calculated at $78.53 per woman screened. Adjusting for a hypothetical $50 incremental cost of the DBT examination, this translates to $28.53 savings per woman screened, or $0.20 savings per member per month across the plan population and an overall cost savings to the plan of $2.4 million per year. Conclusion: The

  20. Near-infrared spectral tomography integrated with digital breast tomosynthesis: Effects of tissue scattering on optical data acquisition design

    Energy Technology Data Exchange (ETDEWEB)

    Michaelsen, Kelly; Krishnaswamy, Venkat; Pogue, Brian W.; Poplack, Steven P.; Paulsen, Keith D. [Thayer School of Engineering, Dartmouth College, Hanover, New Hampshire 03755 (United States); Department of Diagnostic Radiology, Dartmouth Medical School, Lebanon, New Hampshire 03756 (United States); Thayer School of Engineering, Dartmouth College, Hanover, New Hampshire 03755 and Department of Diagnostic Radiology, Dartmouth Medical School, Lebanon, New Hampshire 03756 (United States)

    2012-07-15

    Purpose: Design optimization and phantom validation of an integrated digital breast tomosynthesis (DBT) and near-infrared spectral tomography (NIRST) system targeting improvement in sensitivity and specificity of breast cancer detection is presented. Factors affecting instrumentation design include minimization of cost, complexity, and examination time while maintaining high fidelity NIRST measurements with sufficient information to recover accurate optical property maps. Methods: Reconstructed DBT slices from eight patients with abnormal mammograms provided anatomical information for the NIRST simulations. A limited frequency domain (FD) and extensive continuous wave (CW) NIRST system was modeled. The FD components provided tissue scattering estimations used in the reconstruction of the CW data. Scattering estimates were perturbed to study the effects on hemoglobin recovery. Breast mimicking agar phantoms with inclusions were imaged using the combined DBT/NIRST system for comparison with simulation results. Results: Patient simulations derived from DBT images show successful reconstruction of both normal and malignant lesions in the breast. They also demonstrate the importance of accurately quantifying tissue scattering. Specifically, 20% errors in optical scattering resulted in 22.6% or 35.1% error in quantification of total hemoglobin concentrations, depending on whether scattering was over- or underestimated, respectively. Limited frequency-domain optical signal sampling provided two regions scattering estimates (for fat and fibroglandular tissues) that led to hemoglobin concentrations that reduced the error in the tumor region by 31% relative to when a single estimate of optical scattering was used throughout the breast volume of interest. Acquiring frequency-domain data with six wavelengths instead of three did not significantly improve the hemoglobin concentration estimates. Simulation results were confirmed through experiments in two-region breast mimicking

  1. Value analysis of digital breast tomosynthesis for breast cancer screening in a commercially-insured US population

    OpenAIRE

    Bonafede MM; Kalra VB; Miller JD; Fajardo LL

    2015-01-01

    Machaon M Bonafede,1 Vivek B Kalra,2 Jeffrey D Miller,1 Laurie L Fajardo3 1Truven Health Analytics, Cambridge, MA, 2Yale University School of Medicine, New Haven, CT, 3Department of Radiology, University of Iowa College of Medicine, Iowa City, IA, USA Purpose: The objective of this study was to conduct a value analysis of digital breast tomosynthesis (DBT) for breast cancer screening among women enrolled in US commercial health insurance plans to assess the potential budget impact associated...

  2. Average glandular dose in digital mammography and digital breast tomosynthesis: comparison of phantom and patient data

    Science.gov (United States)

    Bouwman, R. W.; van Engen, R. E.; Young, K. C.; den Heeten, G. J.; Broeders, M. J. M.; Schopphoven, S.; Jeukens, C. R. L. P. N.; Veldkamp, W. J. H.; Dance, D. R.

    2015-10-01

    For the evaluation of the average glandular dose (AGD) in digital mammography (DM) and digital breast tomosynthesis (DBT) phantoms simulating standard model breasts are used. These phantoms consist of slabs of polymethyl methacrylate (PMMA) or a combination of PMMA and polyethylene (PE). In the last decades the automatic exposure control (AEC) increased in complexity and became more sensitive to (local) differences in breast composition. The question is how well the AGD estimated using these simple dosimetry phantoms agrees with the average patient AGD. In this study the AGDs for both dosimetry phantoms and for patients have been evaluated for 5 different x-ray systems in DM and DBT modes. It was found that the ratios between patient and phantom AGD did not differ considerably using both dosimetry phantoms. These ratios averaged over all breast thicknesses were 1.14 and 1.15 for the PMMA and PMMA-PE dosimetry phantoms respectively in DM mode and 1.00 and 1.02 in the DBT mode. These ratios were deemed to be sufficiently close to unity to be suitable for dosimetry evaluation in quality control procedures. However care should be taken when comparing systems for DM and DBT since depending on the AEC operation, ratios for particular breast thicknesses may differ substantially (0.83-1.96). Although the predictions of both phantoms are similar we advise the use of PMMA  +  PE slabs for both DM and DBT to harmonize dosimetry protocols and avoid any potential issues with the use of spacers with the PMMA phantoms.

  3. Average glandular dose in digital mammography and digital breast tomosynthesis: comparison of phantom and patient data

    International Nuclear Information System (INIS)

    For the evaluation of the average glandular dose (AGD) in digital mammography (DM) and digital breast tomosynthesis (DBT) phantoms simulating standard model breasts are used. These phantoms consist of slabs of polymethyl methacrylate (PMMA) or a combination of PMMA and polyethylene (PE). In the last decades the automatic exposure control (AEC) increased in complexity and became more sensitive to (local) differences in breast composition. The question is how well the AGD estimated using these simple dosimetry phantoms agrees with the average patient AGD. In this study the AGDs for both dosimetry phantoms and for patients have been evaluated for 5 different x-ray systems in DM and DBT modes. It was found that the ratios between patient and phantom AGD did not differ considerably using both dosimetry phantoms. These ratios averaged over all breast thicknesses were 1.14 and 1.15 for the PMMA and PMMA-PE dosimetry phantoms respectively in DM mode and 1.00 and 1.02 in the DBT mode. These ratios were deemed to be sufficiently close to unity to be suitable for dosimetry evaluation in quality control procedures. However care should be taken when comparing systems for DM and DBT since depending on the AEC operation, ratios for particular breast thicknesses may differ substantially (0.83–1.96). Although the predictions of both phantoms are similar we advise the use of PMMA  +  PE slabs for both DM and DBT to harmonize dosimetry protocols and avoid any potential issues with the use of spacers with the PMMA phantoms. (paper)

  4. Segmentation methods for breast vasculature in dual-energy contrast-enhanced digital breast tomosynthesis

    Science.gov (United States)

    Lau, Kristen C.; Lee, Hyo Min; Singh, Tanushriya; Maidment, Andrew D. A.

    2015-03-01

    Dual-energy contrast-enhanced digital breast tomosynthesis (DE CE-DBT) uses an iodinated contrast agent to image the three-dimensional breast vasculature. The University of Pennsylvania has an ongoing DE CE-DBT clinical study in patients with known breast cancers. The breast is compressed continuously and imaged at four time points (1 pre-contrast; 3 post-contrast). DE images are obtained by a weighted logarithmic subtraction of the high-energy (HE) and low-energy (LE) image pairs. Temporal subtraction of the post-contrast DE images from the pre-contrast DE image is performed to analyze iodine uptake. Our previous work investigated image registration methods to correct for patient motion, enhancing the evaluation of vascular kinetics. In this project we investigate a segmentation algorithm which identifies blood vessels in the breast from our temporal DE subtraction images. Anisotropic diffusion filtering, Gabor filtering, and morphological filtering are used for the enhancement of vessel features. Vessel labeling methods are then used to distinguish vessel and background features successfully. Statistical and clinical evaluations of segmentation accuracy in DE-CBT images are ongoing.

  5. Description and validation of a scoring system for tomosynthesis in pulmonary cystic fibrosis

    Energy Technology Data Exchange (ETDEWEB)

    Vult von Steyern, Kristina; Bjoerkman-Burtscher, Isabella M.; Bozovic, Gracijela; Wiklund, Marie; Geijer, Mats [Skaane University Hospital, Lund University, Centre for Medical Imaging and Physiology, Lund (Sweden); Hoeglund, Peter [Skaane University Hospital, Competence Centre for Clinical Research, Lund (Sweden)

    2012-12-15

    To design and validate a scoring system for tomosynthesis (digital tomography) in pulmonary cystic fibrosis. A scoring system dedicated to tomosynthesis in pulmonary cystic fibrosis was designed. Three radiologists independently scored 88 pairs of radiographs and tomosynthesis examinations of the chest in 60 patients with cystic fibrosis and 7 oncology patients. Radiographs were scored according to the Brasfield scoring system and tomosynthesis examinations were scored using the new scoring system. Observer agreements for the tomosynthesis score were almost perfect for the total score with square-weighted kappa >0.90, and generally substantial to almost perfect for subscores. Correlation between the tomosynthesis score and the Brasfield score was good for the three observers (Kendall's rank correlation tau 0.68, 0.77 and 0.78). Tomosynthesis was generally scored higher as a percentage of the maximum score. Observer agreements for the total score for Brasfield score were almost perfect (square-weighted kappa 0.80, 0.81 and 0.85). The tomosynthesis scoring system seems robust and correlates well with the Brasfield score. Compared with radiography, tomosynthesis is more sensitive to cystic fibrosis changes, especially bronchiectasis and mucus plugging, and the new tomosynthesis scoring system offers the possibility of more detailed and accurate scoring of disease severity. (orig.)

  6. Description and validation of a scoring system for tomosynthesis in pulmonary cystic fibrosis

    International Nuclear Information System (INIS)

    To design and validate a scoring system for tomosynthesis (digital tomography) in pulmonary cystic fibrosis. A scoring system dedicated to tomosynthesis in pulmonary cystic fibrosis was designed. Three radiologists independently scored 88 pairs of radiographs and tomosynthesis examinations of the chest in 60 patients with cystic fibrosis and 7 oncology patients. Radiographs were scored according to the Brasfield scoring system and tomosynthesis examinations were scored using the new scoring system. Observer agreements for the tomosynthesis score were almost perfect for the total score with square-weighted kappa >0.90, and generally substantial to almost perfect for subscores. Correlation between the tomosynthesis score and the Brasfield score was good for the three observers (Kendall's rank correlation tau 0.68, 0.77 and 0.78). Tomosynthesis was generally scored higher as a percentage of the maximum score. Observer agreements for the total score for Brasfield score were almost perfect (square-weighted kappa 0.80, 0.81 and 0.85). The tomosynthesis scoring system seems robust and correlates well with the Brasfield score. Compared with radiography, tomosynthesis is more sensitive to cystic fibrosis changes, especially bronchiectasis and mucus plugging, and the new tomosynthesis scoring system offers the possibility of more detailed and accurate scoring of disease severity. (orig.)

  7. Estimates of Average Glandular Dose with Auto-modes of X-ray Exposures in Digital Breast Tomosynthesis

    Directory of Open Access Journals (Sweden)

    Izdihar Kamal

    2015-05-01

    Full Text Available Objectives: The aim of this research was to examine the average glandular dose (AGD of radiation among different breast compositions of glandular and adipose tissue with auto-modes of exposure factor selection in digital breast tomosynthesis. Methods: This experimental study was carried out in the National Cancer Society, Kuala Lumpur, Malaysia, between February 2012 and February 2013 using a tomosynthesis digital mammography X-ray machine. The entrance surface air kerma and the half-value layer were determined using a 100H thermoluminescent dosimeter on 50% glandular and 50% adipose tissue (50/50 and 20% glandular and 80% adipose tissue (20/80 commercially available breast phantoms (Computerized Imaging Reference Systems, Inc., Norfolk, Virginia, USA with auto-time, auto-filter and auto-kilovolt modes. Results: The lowest AGD for the 20/80 phantom with auto-time was 2.28 milliGray (mGy for two dimension (2D and 2.48 mGy for three dimensional (3D images. The lowest AGD for the 50/50 phantom with auto-time was 0.97 mGy for 2D and 1.0 mGy for 3D. Conclusion: The AGD values for both phantoms were lower against a high kilovolt peak and the use of auto-filter mode was more practical for quick acquisition while limiting the probability of operator error.

  8. Mammographic density estimation: one-to-one comparison of digital mammography and digital breast tomosynthesis using fully automated software

    Energy Technology Data Exchange (ETDEWEB)

    Tagliafico, Alberto [University of Genoa, Institute of Anatomy, Department of Experimental Medicine, Genoa (Italy); Tagliafico, Giulio [University of Genoa, Dipartimento di Chimica e Chimica Industriale (DCCI), Genoa (Italy); Astengo, Davide [University of Genoa, Radiology Department, Genoa, Genova (Italy); Cavagnetto, Francesca; Rosasco, Raffaella [IRCCS Azienda Ospedaliera Universitaria San Martino, Department of Medical Physics, Ist Istituto Nazionale per la Ricerca sul Cancro, Genoa, Genova (Italy); Rescinito, Giuseppe; Monetti, Francesco; Calabrese, Massimo [IRCCS Azienda Ospedaliera Universitaria San Martino, Department of Diagnostic Senology, Ist Istituto Nazionale per la Ricerca sul Cancro, Genoa (Italy)

    2012-06-15

    To compare breast density on digital mammography and digital breast tomosynthesis using fully automated software. Following institutional approval and written informed consent from all participating women, both digital breast tomosynthesis (DBT) and full-field digital mammography (FFDM) were obtained. Breast percentage density was calculated with software on DBT and FFDM. Fifty consecutive patients (mean age, 51 years; range, 35-83 years) underwent both FFDM and DBT. Using a method based on the integral curve, breast density showed higher results on FFDM (68.1 {+-} 12.1 for FFDM and 51.9 {+-} 6.5 for DBT). FFDM overestimated breast density in 16.2% (P < 0.0001). Using a method based on maximum entropy thresholding, breast density showed higher results on FFDM (68.1 {+-} 12.1 for FFDM and 51.9 {+-} 6.5 for DBT). FFDM overestimated breast density in 11.4% (P < 0.0001). There was a good correlation among BI-RADS categories on a four-grade scale and the density evaluated with DBT and FFDM (r = 0.54, P < 0.01 and r = 0.44, P < 0.01). Breast density appeared to be significantly underestimated on digital breast tomosynthesis. Breast density is considered to be an independent risk factor for cancer Density can be assessed on full-field digital mammography and digital breast tomosynthesis Objective automated estimation of breast density eliminates subjectivity Automated estimation is more accurate than BI-RADS quantitative evaluation Breast density may be significantly underestimated on digital breast tomosynthesis. (orig.)

  9. Investigation of the effect of tube motion in breast tomosynthesis: continuous or step and shoot?

    Science.gov (United States)

    Shaheen, Eman; Marshall, Nicholas; Bosmans, Hilde

    2011-03-01

    Digital breast tomosynthesis (DBT) is a 3D modality that may have the potential to complement or replace 2D mammography. One major design aspect of DBT systems is the choice of tube motion: continuous tube motion during x-ray exposure or the step and shoot method where the tube is held fixed while x-rays are released. Systems with continuous tube motion experience focal spot motion blurring but a reduced patient motion blurring due to potentially faster total acquisition times when compared to the step and shoot approach. In order to examine the influence of focus motion on lesion detectability, a simulation environment was developed where lesions such as microcalcifications and masses are inserted into different thicknesses of theoretical materials. A version of the power law noise method was employed to approximate realistic anatomical breast volumes. The simulated projection images were reconstructed and appropriate metrics (peak contrast, contrast and signal-difference-to-noise ratio) of the lesions in the two different modes were compared. Results suggest an increase of the peak contrasts in the microcalcification data sets by 8 - 9 % for the step-and-shoot method when compared to the continuous mode (p <0.05). While the contrast and signal-difference-to-noise- ratio calculated for the same two modes almost overlapped for the mass datasets showing a difference of only 1-2%.

  10. Design and evaluation of a grid reciprocation scheme for use in digital breast tomosynthesis

    Science.gov (United States)

    Patel, Tushita; Sporkin, Helen; Peppard, Heather; Williams, Mark B.

    2016-03-01

    This work describes a methodology for efficient removal of scatter radiation during digital breast tomosynthesis (DBT). The goal of this approach is to enable grid image obscuration without a large increase in radiation dose by minimizing misalignment of the grid focal point (GFP) and x-ray focal spot (XFS) during grid reciprocation. Hardware for the motion scheme was built and tested on the dual modality breast tomosynthesis (DMT) scanner, which combines DBT and molecular breast tomosynthesis (MBT) on a single gantry. The DMT scanner uses fully isocentric rotation of tube and x-ray detector for maintaining a fixed tube-detector alignment during DBT imaging. A cellular focused copper prototype grid with 80 cm focal length, 3.85 mm height, 0.1 mm thick lamellae, and 1.1 mm hole pitch was tested. Primary transmission of the grid at 28 kV tube voltage was on average 74% with the grid stationary and aligned for maximum transmission. It fell to 72% during grid reciprocation by the proposed method. Residual grid line artifacts (GLAs) in projection views and reconstructed DBT images are characterized and methods for reducing the visibility of GLAs in the reconstructed volume through projection image flat-field correction and spatial frequency-based filtering of the DBT slices are described and evaluated. The software correction methods reduce the visibility of these artifacts in the reconstructed volume, making them imperceptible both in the reconstructed DBT images and their Fourier transforms.

  11. Comparison of computer-aided detection of clustered microcalcifications in digital mammography and digital breast tomosynthesis

    Science.gov (United States)

    Samala, Ravi K.; Chan, Heang-Ping; Lu, Yao; Hadjiiski, Lubomir; Wei, Jun; Helvie, Mark

    2015-03-01

    Digital breast tomosynthesis (DBT) has the potential to replace digital mammography (DM) for breast cancer screening. An effective computer-aided detection (CAD) system for microcalcification clusters (MCs) on DBT will facilitate the transition. In this study, we collected a data set with corresponding DBT and DM for the same breasts. DBT was acquired with IRB approval and informed consent using a GE GEN2 DBT prototype system. The DM acquired with a GE Essential system for the patient's clinical care was collected retrospectively from patient files. DM-based CAD (CADDM) and DBT-based CAD (CADDBT) were previously developed by our group. The major differences between the CAD systems include: (a) CADDBT uses two parallel processes whereas CADDM uses a single process for enhancing MCs and removing the structured background, (b) CADDBT has additional processing steps to reduce the false positives (FPs), including ranking of candidates of cluster seeds and cluster members and the use of adaptive CNR and size thresholds at clustering and FP reduction, (c) CADDM uses convolution neural network (CNN) and linear discriminant analysis (LDA) to differentiate true microcalcifications from FPs based on their morphological and CNN features. The performance difference is assessed by FROC analysis using test set (100 views with MCs and 74 views without MCs) independent of their respective training sets. At sensitivities of 70% and 80%, CADDBT achieved FP rates of 0.78 and 1.57 per view compared to 0.66 and 2.10 per image for the CADDM. JAFROC showed no significant difference between MC detection on DM and DBT by the two CAD systems.

  12. Factors affecting recall rate and false positive fraction in breast cancer screening with breast tomosynthesis - A statistical approach.

    Science.gov (United States)

    Rosso, Aldana; Lång, Kristina; Petersson, Ingemar F; Zackrisson, Sophia

    2015-10-01

    In this study, we investigate which factors affect the false positive fraction (FPF) for digital breast tomosynthesis (DBT) compared to digital mammography (DM) in a screening population by using classification and regression trees (C&RT) and binary marginal generalized linear models. The data was obtained from the Malmö Breast Tomosynthesis Screening Trial, which aimed to compare the performance of DBT to DM in breast cancer screening. By using data from the first half of the study population (7500 women), a tree with the recall probability for different groups was calculated. The effect of age and breast density on the FPF was estimated using a binary marginal generalized linear model. Our results show that breast density and breast cancer were the main factors influencing recall. The FPF is mainly affected by breast density and increases with breast density for DBT and DM. In conclusion, the results obtained with C&RT are easy to interpret and similar to those obtained using binary marginal generalized linear models. The FPF is approximately 40% higher for DBT compared to DM for all breast density categories.

  13. Digital Breast Tomosynthesis Changes Management in Patients Seen at a Tertiary Care Breast Center

    International Nuclear Information System (INIS)

    Objectives. To study factors that predict changes in management with digital breast tomosynthesis (DBT). Methods. The Institutional Review Board approved this HIPAA compliant study. 996 patients had DBT with full field digital mammography (FFDM). Univariate analysis evaluated predictors of management change and cancer detection. Results. DBT changed management in 109 of 996 (11%); 77 (71%) required less imaging. Recalled patients after abnormal FFDM screen were most likely to have management change—25% (24 of 97 patients) compared to 8% (13/163) of symptomatic patients and 10% (72/736) of screening patients (P < 0.001). Dense breasted patients had a higher likelihood of having DBT change management: 13% (68/526) compared to 9% (41/470) (P = 0.03). Of the 996 patients, 19 (2%) were diagnosed with breast cancer. 15 cancers (83%) were seen on FFDM and DBT; 3 (17%) were diagnosed after DBT (0.3%, 95%CI: 0.1–0.9%). One recurrence was in the skin and was not seen on DBT nor was it seen on FFDM. The increase in cancer detection rate was 17% for asymptomatic patients, 0% for symptomatic patients, and 100% for recalled patients. Conclusions. DBT increased cancer detection rate by 20% and decreased the recall rate in 8–25%. Advances in Knowledge. DBT led to a doubling of the cancer detection rate in recalled patients

  14. SU-E-P-31: Quantifying the Amount of Missing Tissue in a Digital Breast Tomosynthesis

    Energy Technology Data Exchange (ETDEWEB)

    Goodenough, D [George Washington University, Washington, DC (United States); Olafsdottir, H; Olafsson, I; Fredriksson, J; Kristinsson, S; Oskarsdottir, G; Kristbjornsson, A [Raforninn Ehf., Reykjavik, Gullbringusysla (Iceland); Mallozzi, R; Healy, A; Levy, J [The Phantom Laboratory, Salem, NY (United States)

    2015-06-15

    Purpose: To automatically quantify the amount of missing tissue in a digital breast tomosynthesis system using four stair-stepped chest wall missing tissue gauges in the Tomophan™ from the Phantom Laboratory and image processing from Image Owl. Methods: The Tomophan™ phantom incorporates four stair-stepped missing tissue gauges by the chest wall, allowing measurement of missing chest wall in two different locations along the chest wall at two different heights. Each of the four gauges has 12 steps in 0.5 mm increments rising from the chest wall. An image processing algorithm was developed by Image Owl that first finds the two slices containing the steps then finds the signal through the highest step in all four gauges. Using the signal drop at the beginning of each gauge the distance to the end of the image gives the length of the missing tissue gauge in millimeters. Results: The Tomophan™ was imaged in digital breast tomosynthesis (DBT) systems from various vendors resulting in 46 cases used for testing. The results showed that on average 1.9 mm of 6 mm of the gauges are visible. A small focus group was asked to count the number of visible steps for each case which resulted in a good agreement between observer counts and computed data. Conclusion: First, the results indicate that the amount of missing chest wall can differ between vendors. Secondly it was shown that an automated method to estimate the amount of missing chest wall gauges agreed well with observer assessments. This finding indicates that consistency testing may be simplified using the Tomophan™ phantom and analysis by an automated image processing named Tomo QA. In general the reason for missing chest wall may be due to a function of the beam profile at the chest wall as DBT projects through the angular sampling. Research supported by Image Owl, Inc., The Phantom Laboratory, Inc. and Raforninn ehf; Mallozzi and Healy employed by The Phantom Laboratory, Inc.; Goodenough is a consultant to The

  15. SU-E-P-31: Quantifying the Amount of Missing Tissue in a Digital Breast Tomosynthesis

    International Nuclear Information System (INIS)

    Purpose: To automatically quantify the amount of missing tissue in a digital breast tomosynthesis system using four stair-stepped chest wall missing tissue gauges in the Tomophan™ from the Phantom Laboratory and image processing from Image Owl. Methods: The Tomophan™ phantom incorporates four stair-stepped missing tissue gauges by the chest wall, allowing measurement of missing chest wall in two different locations along the chest wall at two different heights. Each of the four gauges has 12 steps in 0.5 mm increments rising from the chest wall. An image processing algorithm was developed by Image Owl that first finds the two slices containing the steps then finds the signal through the highest step in all four gauges. Using the signal drop at the beginning of each gauge the distance to the end of the image gives the length of the missing tissue gauge in millimeters. Results: The Tomophan™ was imaged in digital breast tomosynthesis (DBT) systems from various vendors resulting in 46 cases used for testing. The results showed that on average 1.9 mm of 6 mm of the gauges are visible. A small focus group was asked to count the number of visible steps for each case which resulted in a good agreement between observer counts and computed data. Conclusion: First, the results indicate that the amount of missing chest wall can differ between vendors. Secondly it was shown that an automated method to estimate the amount of missing chest wall gauges agreed well with observer assessments. This finding indicates that consistency testing may be simplified using the Tomophan™ phantom and analysis by an automated image processing named Tomo QA. In general the reason for missing chest wall may be due to a function of the beam profile at the chest wall as DBT projects through the angular sampling. Research supported by Image Owl, Inc., The Phantom Laboratory, Inc. and Raforninn ehf; Mallozzi and Healy employed by The Phantom Laboratory, Inc.; Goodenough is a consultant to The

  16. Effect of acquisition parameters on digital breast tomosynthesis: Total angular range and number of projection views

    Science.gov (United States)

    Choi, Young-Wook; Park, Hye-Suk; Kim, Ye-seul; Kim, Hee-Joung; Choi, Jae-Gu

    2012-12-01

    The purpose of this study was to investigate the effect of different acquisition parameters and to determine the optimal set of acquisition parameters of projection views (PVs) for the new developed digital breast tomosynthesis (DBT) system. The DBT imaging parameters were optimized using 32 different acquisition sets with six angular ranges (±5°, ±10°, ±13°, ±17°, ±21°, and ±25°) and eight projection views (5, 11, 15, 21, 25, 31, 41, and 51 prjections). In addition to the contrastto-noise ratio (CNR), the artifact spread function (ASF) was used to quantify the in-focus plane artifacts along the z-direction in order to explore the relationship between the acquisition parameters and the image quality. A commercially, available breast-mimicking phantom was imaged to qualitatively verify our results. Our results show that a wide angular range improved the reconstructed image quality in the z-direction. If a large number of projections are acquired, then the electronic noise may dominate the CNR due to reduce the radiation dose per projection. Although increasing angular range was found to improve the vertical resolution, due to greater effective breast thickness, the image quality of microcalcifications in the in-focus plane was also found not to be improved by increasing the noise. Therefore, potential trade-offs of these physical imaging properties must be considered to optimize the acquisition configuration of a DBT system. Our results suggest possible directions for further improvements in DBT systems for high quality imaging.

  17. Breast tomosynthesis with monochromatic beams: a feasibility study using Monte Carlo simulations

    OpenAIRE

    Malliori, A; Bliznakova, K.; Sechopoulos, I; Kamarianakis, Z; Fei, B; Pallikarakis, N

    2014-01-01

    The aim of the study is to investigate the impact on image quality of using monochromatic beams for lower dose breast tomosynthesis (BT). For this purpose, modeling and simulation of BT and mammography imaging processes have been performed using two x-ray beams: one at 28kVp and a monochromatic at 19keV at different entrance surface air kerma ranging between 0.16 and 5.5 mGy. Two 4cm thick computational breast models in a compressed state were used: one simple homogeneous and one heterogeneou...

  18. False positive reduction of microcalcification cluster detection in digital breast tomosynthesis

    Science.gov (United States)

    Xu, Ning; Yi, Sheng; Mendonca, Paulo; Tian, Tai-peng; Samala, Ravi; Chan, Heang-Ping

    2014-03-01

    Digital breast tomosynthesis (DBT) is a new modality that has strong potential in improving the sensitivity and specificity of breast mass detection. However, the detection of microcalcifications (MCs) in DBT is challenging because radiologists have to search for the often subtle signals in many slices. We are developing a computer-aided detection (CAD) system to assist radiologists in reading DBT. The system consists of four major steps, namely: image enhancement; pre-screening of MC candidates; false-positive (FP) reduction, and detection of MC cluster candidates of clinical interest. We propose an algorithm for reducing FPs by using 3D characteristics of MC clusters in DBT. The proposed method takes the MC candidates from the pre-screening step described in [14] as input, which are then iteratively clustered to provide training samples to a random-forest classifier and a rule-based classifier. The random forest classifier is used to learn a discriminative model of MC clusters using 3D texture features, whereas the rule-based classifier revisits the initial training samples and enhances them by combining median filtering and graph-cut-based segmentation followed by thresholding on the final number of MCs belonging to the candidate cluster. The outputs of these two classifiers are combined according to the prediction confidence of the random-forest classifier. We evaluate the proposed FP-reduction algorithm on a data set of two-view DBT from 40 breasts with biopsy-proven MC clusters. The experimental results demonstrate a significant reduction in FP detections, with a final sensitivity of 92.2% for an FP rate of 50%.

  19. The effect of angular dose distribution on the detection of microcalcifications in digital breast tomosynthesis

    Science.gov (United States)

    Hu, Yue-Houng; Zhao, Wei

    2011-01-01

    Purpose: Substantial effort has been devoted to the clinical development of digital breast tomosynthesis (DBT). DBT is a three-dimensional (3D) x-ray imaging modality that reconstructs a number of thin image slices parallel to a stationary detector plane. Preliminary clinical studies have shown that the removal of overlapping breast tissue reduces image clutter and increases detectability of large, low contrast lesions. However, some studies, as well as anecdotal evidence, suggested decreased conspicuity of small, high contrast objects such as microcalcifications. Several investigators have proposed alternative imaging methods for improving microcalcification detection by delivering half of the total dose to the central view in addition to a separate DBT scan. Preliminary observer studies found possible improvement by either viewing the central projection alone or combining all views with a reconstruction algorithm.Methods: In this paper, we developed a generalized imaging theory based on a cascaded linear-system model for DBT to calculate the effect of variable angular dose distribution on the 3D modulation transfer function (MTF) and noise power spectrum (NPS). Using the ideal observer signal-to-noise ratio (SNR), d′, as a figure-of-merit (FOM) for a signal embedded in a uniform background, we compared the detectability of objects with different sizes under different imaging conditions (e.g., angular dose distribution and reconstruction filters). Experimental investigation was conducted for three different angular dose schemes (ADS) using a Siemens NovationTOMO prototype unit.Results: Our results show excellent agreement between modeled and experimental measurements of 3D NPS with different angular dose distribution. The ideal observer detectability index for the detection of Gaussian objects with different angular dose distributions depends strongly on the applied reconstruction filter as well as the imaging task. For detection tasks of small calcifications

  20. Adaptive diffusion regularization for enhancement of microcalcifications in digital breast tomosynthesis (DBT) reconstruction

    Science.gov (United States)

    Lu, Yao; Chan, Heang-Ping; Fessler, Jeffrey A.; Hadjiiski, Lubomir; Wei, Jun; Goodsitt, Mitchell M.

    2011-03-01

    Digital breast tomosynthesis (DBT) has been shown to increase mass detection. Detection of microcalcifications in DBT is challenging because of the small, subtle signals to be searched in the large breast volume and the noise in the reconstructed volume. We developed an adaptive diffusion (AD) regularization method that can differentially regularize noise and potential signal regions during reconstruction based on local contrast-to-noise ratio (CNR) information. This method adaptively applies different degrees of regularity to signal and noise regions, as guided by a CNR map for each DBT slice within the image volume, such that potential signals will be preserved while noise is suppressed. DBT scans of an American College of Radiology phantom and the breast of a subject with biopsy-proven calcifications were acquired with a GE prototype DBT system at 21 angles in 3° increments over a +/-30° range. Simultaneous algebraic reconstruction technique (SART) was used for DBT reconstruction. The AD regularization method was compared to the non-convex total p-variation (TpV) method and SART with no regularization (NR) in terms of the CNR and the full width at half maximum (FWHM) of the central gray-level line profile in the focal plane of a calcification. The results demonstrated that the SART regularized by the AD method enhanced the CNR and preserved the sharpness of microcalcifications compared to reconstruction without regularization. The AD regularization was superior to the TpV method for subtle microcalcifications in terms of the CNR while the FWHM was comparable. The AD regularized reconstruction has the potential to improve the CNR of microcalcifications in DBT for human or machine detection.

  1. Enhanced imaging of microcalcifications in digital breast tomosynthesis through improved image-reconstruction algorithms

    Energy Technology Data Exchange (ETDEWEB)

    Sidky, Emil Y.; Pan Xiaochuan; Reiser, Ingrid S.; Nishikawa, Robert M.; Moore, Richard H.; Kopans, Daniel B. [Department of Radiology, University of Chicago, 5841 S. Maryland Avenue Chicago, Illinois 60637 (United States); Massachusetts General Hospital, Boston, Massachusetts 02114 (United States)

    2009-11-15

    Purpose: The authors develop a practical, iterative algorithm for image-reconstruction in undersampled tomographic systems, such as digital breast tomosynthesis (DBT). Methods: The algorithm controls image regularity by minimizing the image total p variation (TpV), a function that reduces to the total variation when p=1.0 or the image roughness when p=2.0. Constraints on the image, such as image positivity and estimated projection-data tolerance, are enforced by projection onto convex sets. The fact that the tomographic system is undersampled translates to the mathematical property that many widely varied resultant volumes may correspond to a given data tolerance. Thus the application of image regularity serves two purposes: (1) Reduction in the number of resultant volumes out of those allowed by fixing the data tolerance, finding the minimum image TpV for fixed data tolerance, and (2) traditional regularization, sacrificing data fidelity for higher image regularity. The present algorithm allows for this dual role of image regularity in undersampled tomography. Results: The proposed image-reconstruction algorithm is applied to three clinical DBT data sets. The DBT cases include one with microcalcifications and two with masses. Conclusions: Results indicate that there may be a substantial advantage in using the present image-reconstruction algorithm for microcalcification imaging.

  2. Enhanced imaging of microcalcifications in digital breast tomosynthesis through improved image-reconstruction algorithms

    CERN Document Server

    Sidky, Emil Y; Reiser, Ingrid S; Nishikawa, Robert M; Moore, Richard H; Kopans, Daniel B

    2009-01-01

    PURPOSE: We develop a practical, iterative algorithm for image-reconstruction in under-sampled tomographic systems, such as digital breast tomosynthesis (DBT). METHOD: The algorithm controls image regularity by minimizing the image total $p$-variation (TpV), a function that reduces to the total variation when $p=1.0$ or the image roughness when $p=2.0$. Constraints on the image, such as image positivity and estimated projection-data tolerance, are enforced by projection onto convex sets (POCS). The fact that the tomographic system is under-sampled translates to the mathematical property that many widely varied resultant volumes may correspond to a given data tolerance. Thus the application of image regularity serves two purposes: (1) reduction of the number of resultant volumes out of those allowed by fixing the data tolerance, finding the minimum image TpV for fixed data tolerance, and (2) traditional regularization, sacrificing data fidelity for higher image regularity. The present algorithm allows for this...

  3. Enhanced imaging of microcalcifications in digital breast tomosynthesis through improved image-reconstruction algorithms

    Science.gov (United States)

    Sidky, Emil Y.; Pan, Xiaochuan; Reiser, Ingrid S.; Nishikawa, Robert M.; Moore, Richard H.; Kopans, Daniel B.

    2009-01-01

    Purpose: The authors develop a practical, iterative algorithm for image-reconstruction in undersampled tomographic systems, such as digital breast tomosynthesis (DBT). Methods: The algorithm controls image regularity by minimizing the image total p variation (TpV), a function that reduces to the total variation when p=1.0 or the image roughness whenp=2.0. Constraints on the image, such as image positivity and estimated projection-data tolerance, are enforced by projection onto convex sets. The fact that the tomographic system is undersampled translates to the mathematical property that many widely varied resultant volumes may correspond to a given data tolerance. Thus the application of image regularity serves two purposes: (1) Reduction in the number of resultant volumes out of those allowed by fixing the data tolerance, finding the minimum image TpV for fixed data tolerance, and (2) traditional regularization, sacrificing data fidelity for higher image regularity. The present algorithm allows for this dual role of image regularity in undersampled tomography. Results: The proposed image-reconstruction algorithm is applied to three clinical DBT data sets. The DBT cases include one with microcalcifications and two with masses. Conclusions: Results indicate that there may be a substantial advantage in using the present image-reconstruction algorithm for microcalcification imaging. PMID:19994501

  4. Monte Carlo simulation of breast tomosynthesis: visibility of microcalcifications at different acquisition schemes

    Science.gov (United States)

    Petersson, Hannie; Dustler, Magnus; Tingberg, Anders; Timberg, Pontus

    2015-03-01

    Microcalcifications are one feature of interest in mammography and breast tomosynthesis (BT). To achieve optimal conditions for detection of microcalcifications in BT imaging, different acquisition geometries should be evaluated. The purpose of this work was to investigate the influence of acquisition schemes with different angular ranges, projection distributions and dose distributions on the visibility of microcalcifications in reconstructed BT volumes. Microcalcifications were inserted randomly in a high resolution software phantom and a simulation procedure was used to model a MAMMOMAT Inspiration BT system. The simulation procedure was based on analytical ray tracing to produce primary images, Monte Carlo to simulate scatter contributions and flatfield image acquisitions to model system characteristics. Image volumes were reconstructed using the novel method super-resolution reconstruction with statistical artifact reduction (SRSAR). For comparison purposes, the volume of the standard acquisition scheme (50° angular range and uniform projection and dose distribution) was also reconstructed using standard filtered backprojection (FBP). To compare the visibility and depth resolution of the microcalcifications, signal difference to noise ratio (SDNR) and artifact spread function width (ASFW) were calculated. The acquisition schemes with very high central dose yielded significantly lower SDNR than the schemes with more uniform dose distributions. The ASFW was found to decrease (meaning an increase in depth resolution) with wider angular range. In conclusion, none of the evaluated acquisition schemes were found to yield higher SDNR or depth resolution for the simulated microcalcifications than the standard acquisition scheme.

  5. Indirect-detection single-photon-counting x-ray detector for breast tomosynthesis

    Science.gov (United States)

    Jiang, Hao; Kaercher, Joerg; Durst, Roger

    2016-03-01

    X-ray mammography is a crucial screening tool for early identification of breast cancer. However, the overlap of anatomical features present in projection images often complicates the task of correctly identifying suspicious masses. As a result, there has been increasing interest in acquisition of volumetric information through digital breast tomosynthesis (DBT) which, compared to mammography, offers the advantage of depth information. Since DBT requires acquisition of many projection images, it is desirable that the noise in each projection image be dominated by the statistical noise of the incident x-ray quanta and not by the additive noise of the imaging system (referred to as quantum-limited imaging) and that the cumulative dose be as low as possible (e.g., no more than for a mammogram). Unfortunately, the electronic noise (~2000 electrons) present in current DBT systems based on active matrix, flat-panel imagers (AMFPIs) is still relatively high compared with modest x-ray gain of the a-Se and CsI:Tl x-ray converters often used. To overcome the modest signal-to-noise ratio (SNR) limitations of current DBT systems, we have developed a large-area x-ray imaging detector with the combination of an extremely low noise (~20 electrons) active-pixel CMOS and a specially designed high resolution scintillator. The high sensitivity and low noise of such system provides better SNR by at least an order of magnitude than current state-of-art AMFPI systems and enables x-ray indirect-detection single photon counting (SPC) at mammographic energies with the potential of dose reduction.

  6. Detection of microcalcifications in breast tomosynthesis reconstructed with multiscale bilateral filtering regularization

    Science.gov (United States)

    Samala, Ravi K.; Chan, Heang-Ping; Lu, Yao; Hadjiyski, Lubomir; Wei, Jun; Sahiner, Berkman; Helvie, Mark

    2013-03-01

    We are developing a CAD system to assist radiologists in detecting microcalcification clusters (MCs) in digital breast tomosynthesis (DBT). In this study, we investigated the feasibility of using as input to the CAD system an enhanced DBT volume that was reconstructed with the iterative simultaneous algebraic reconstruction technique (SART) regularized by a new multiscale bilateral filtering (MBiF) method. The MBiF method utilizes the multiscale structures of the breast to selectively enhance MCs and preserve mass spiculations while smoothing noise in the DBT images. The CAD system first extracted the enhancement-modulated calcification response (EMCR) in the DBT volume. Detection of the seed points for MCs and individual calcifications were guided by the EMCR. MC candidates were formed by dynamic clustering. FPs were further reduced by analysis of the feature characteristics of the MCs. With IRB approval, two-view DBT of 91 subjects with biopsy-proven MCs were collected. Seventy-eight views from 39 subjects with MCs were used for training and the remaining 52 cases were used for independent testing. For view-based detection, a sensitivity of 85% was achieved at 3.23 FPs/volume. For case-based detection, the same sensitivity was obtained at 1.63 FPs/volume. The results indicate that the new MBiF method is useful in improving the detection accuracy of clustered microcalcifications. An effective CAD system for microcalcification detection in DBT has the potential to eliminate the need for additional mammograms, thereby reducing patient dose and reading time.

  7. Numerical Methods for Coupled Reconstruction and Registration in Digital Breast Tomosynthesis

    CERN Document Server

    Yang, Guang; Hawkes, David J; Arridge, Simon R

    2013-01-01

    Digital Breast Tomosynthesis (DBT) provides an insight into the fine details of normal fibroglandular tissues and abnormal lesions by reconstructing a pseudo-3D image of the breast. In this respect, DBT overcomes a major limitation of conventional X-ray mammography by reducing the confounding effects caused by the superposition of breast tissue. In a breast cancer screening or diagnostic context, a radiologist is interested in detecting change, which might be indicative of malignant disease. To help automate this task image registration is required to establish spatial correspondence between time points. Typically, images, such as MRI or CT, are first reconstructed and then registered. This approach can be effective if reconstructing using a complete set of data. However, for ill-posed, limited-angle problems such as DBT, estimating the deformation is complicated by the significant artefacts associated with the reconstruction, leading to severe inaccuracies in the registration. This paper presents a mathemati...

  8. Radiation dose differences between digital mammography and digital breast tomosynthesis are dependent on breast thickness

    Science.gov (United States)

    Alakhras, Maram M.; Mello-Thoms, Claudia; Bourne, Roger; Rickard, Mary; Diffey, Jennifer; Brennan, Patrick C.

    2016-03-01

    Purpose To evaluate the radiation dose derived from digital mammography (DM) and digital breast tomosynthesis (DBT) at different tube current-exposure time product (mAs) and at 6 phantom thicknesses from 10 to 60 mm. Materials and Methods A total of 240 DM and DBT cranio-caudal (CC) phantom images were acquired at each thickness and at four exposure levels (the baseline mAs, 50%, 25% and 12.5% the baseline mAs). The incident Air Kerma (K) at the surface of the phantoms was measured using a solid state dosimeter. Mean Glandular Doses (MGD) were calculated for both modalities (DM and DBT). Results DBT dose was greater than that of DM for all mAs at each phantom thickness. For a breast thickness of 50 mm (close to average sized breast), the dose for DBT (2.32 mGy) was 13% higher than that for DM (2.05 mGy). The results also show that the difference in MGD between DM and DBT was less for the thicker compared with the thinner phantom, this difference being approximately a factor of 2.58 at 10 mm compared with a factor of 1.08 at 60 mm. While the MGD increased with increasing phantom thickness for both modalities, the dose increase with DBT was less than for DM, with the difference between 10 and 60 mm being a factor of 7 for DM and 3 for DBT. Conclusion The radiation dose from DBT was higher than that of DM and the difference in dose between DM and DBT decreases as phantom thickness increases.

  9. Digital breast tomosynthesis: computer-aided detection of clustered microcalcifications on planar projection images

    Science.gov (United States)

    Samala, Ravi K.; Chan, Heang-Ping; Lu, Yao; Hadjiiski, Lubomir M.; Wei, Jun; Helvie, Mark A.

    2014-12-01

    This paper describes a new approach to detect microcalcification clusters (MCs) in digital breast tomosynthesis (DBT) via its planar projection (PPJ) image. With IRB approval, two-view (cranio-caudal and mediolateral oblique views) DBTs of human subject breasts were obtained with a GE GEN2 prototype DBT system that acquires 21 projection angles spanning 60° in 3° increments. A data set of 307 volumes (154 human subjects) was divided by case into independent training (127 with MCs) and test sets (104 with MCs and 76 free of MCs). A simultaneous algebraic reconstruction technique with multiscale bilateral filtering (MSBF) regularization was used to enhance microcalcifications and suppress noise. During the MSBF regularized reconstruction, the DBT volume was separated into high frequency (HF) and low frequency components representing microcalcifications and larger structures. At the final iteration, maximum intensity projection was applied to the regularized HF volume to generate a PPJ image that contained MCs with increased contrast-to-noise ratio (CNR) and reduced search space. High CNR objects in the PPJ image were extracted and labeled as microcalcification candidates. Convolution neural network trained to recognize the image pattern of microcalcifications was used to classify the candidates into true calcifications and tissue structures and artifacts. The remaining microcalcification candidates were grouped into MCs by dynamic conditional clustering based on adaptive CNR threshold and radial distance criteria. False positive (FP) clusters were further reduced using the number of candidates in a cluster, CNR and size of microcalcification candidates. At 85% sensitivity an FP rate of 0.71 and 0.54 was achieved for view- and case-based sensitivity, respectively, compared to 2.16 and 0.85 achieved in DBT. The improvement was significant (p-value = 0.003) by JAFROC analysis.

  10. Preliminary Clinical Experience with Digital Breast Tomosynthesis in the Visualization of Breast Microcalcifications

    Directory of Open Access Journals (Sweden)

    Stamatia V Destounis

    2013-01-01

    Full Text Available Objectives: To compare the visualization and image quality of microcalcifications imaged with digital breast tomosynthesis (DBT versus conventional digital mammography. Materials and Methods: Patients with microcalcifications detected on full field digital mammography (FFDM recommended for needle core biopsy were enrolled in the study after obtaining patient′s consent and institutional review board approval (n = 177 patients, 179 lesions. All had a bilateral combination DBT exam, after undergoing routine digital mammography, prior to biopsy. The study radiologist reviewed the FFDM and DBT images in a non-blinded comparison and assessed the visibility of the microcalcifications with both methods, including image quality and clarity with which the calcifications were seen. Data recorded included patient demographics, lesion size on FFDM, DBT, and surgical excision (when applicable, biopsy, and surgical pathology, if any. Results: Average lesion size on DBT was 1.5 cm; average lesion size on FFDM was 1.4 cm. The image quality of DBT was assessed as equivalent or superior in 92.2% of cases. In 7.8% of the cases, the FFDM image quality was assessed as equivalent or superior. Conclusion: In our review, DBT image quality appears to be comparable to or better than conventional FFDM in terms of demonstrating microcalcifications, as shown in 92.2% of cases.

  11. Preliminary Clinical Experience with Digital Breast Tomosynthesis in the Visualization of Breast Microcalcifications

    Science.gov (United States)

    Destounis, Stamatia V.; Arieno, Andrea L.; Morgan, Renee C.

    2013-01-01

    Objectives: To compare the visualization and image quality of microcalcifications imaged with digital breast tomosynthesis (DBT) versus conventional digital mammography. Materials and Methods: Patients with microcalcifications detected on full field digital mammography (FFDM) recommended for needle core biopsy were enrolled in the study after obtaining patient's consent and institutional review board approval (n = 177 patients, 179 lesions). All had a bilateral combination DBT exam, after undergoing routine digital mammography, prior to biopsy. The study radiologist reviewed the FFDM and DBT images in a non-blinded comparison and assessed the visibility of the microcalcifications with both methods, including image quality and clarity with which the calcifications were seen. Data recorded included patient demographics, lesion size on FFDM, DBT, and surgical excision (when applicable), biopsy, and surgical pathology, if any. Results: Average lesion size on DBT was 1.5 cm; average lesion size on FFDM was 1.4 cm. The image quality of DBT was assessed as equivalent or superior in 92.2% of cases. In 7.8% of the cases, the FFDM image quality was assessed as equivalent or superior. Conclusion: In our review, DBT image quality appears to be comparable to or better than conventional FFDM in terms of demonstrating microcalcifications, as shown in 92.2% of cases. PMID:24605260

  12. In-line phase-contrast breast tomosynthesis: a phantom feasibility study at a synchrotron radiation facility

    Science.gov (United States)

    Bliznakova, K.; Russo, P.; Kamarianakis, Z.; Mettivier, G.; Requardt, H.; Bravin, A.; Buliev, I.

    2016-08-01

    The major objective is to adopt, apply and test developed in-house algorithms for volumetric breast reconstructions from projection images, obtained in in-line phase-contrast mode. Four angular sets, each consisting of 17 projection images obtained from four physical phantoms, were acquired at beamline ID17, European Synchroton Radiation Facility, Grenoble, France. The tomosynthesis arc was  ±32°. The physical phantoms differed in complexity of texture and introduced features of interest. Three of the used phantoms were in-house developed, and made of epoxy resin, polymethyl-methacrylate and paraffin wax, while the fourth phantom was the CIRS BR3D. The projection images had a pixel size of 47 µm  ×  47 µm. Tomosynthesis images were reconstructed with standard shift-and-add (SAA) and filtered backprojection (FBP) algorithms. It was found that the edge enhancement observed in planar x-ray images is preserved in tomosynthesis images from both phantoms with homogeneous and highly heterogeneous backgrounds. In case of BR3D, it was found that features not visible in the planar case were well outlined in the tomosynthesis slices. In addition, the edge enhancement index calculated for features of interest was found to be much higher in tomosynthesis images reconstructed with FBP than in planar images and tomosynthesis images reconstructed with SAA. The comparison between images reconstructed by the two reconstruction algorithms shows an advantage for the FBP method in terms of better edge enhancement. Phase-contrast breast tomosynthesis realized in in-line mode benefits the detection of suspicious areas in mammography images by adding the edge enhancement effect to the reconstructed slices.

  13. Use of the Hotelling observer to optimize image reconstruction in digital breast tomosynthesis.

    Science.gov (United States)

    Sánchez, Adrian A; Sidky, Emil Y; Pan, Xiaochuan

    2016-01-01

    We propose an implementation of the Hotelling observer that can be applied to the optimization of linear image reconstruction algorithms in digital breast tomosynthesis. The method is based on considering information within a specific region of interest, and it is applied to the optimization of algorithms for detectability of microcalcifications. Several linear algorithms are considered: simple back-projection, filtered back-projection, back-projection filtration, and [Formula: see text]-tomography. The optimized algorithms are then evaluated through the reconstruction of phantom data. The method appears robust across algorithms and parameters and leads to the generation of algorithm implementations which subjectively appear optimized for the task of interest. PMID:26702408

  14. Digital breast tomosynthesis reconstruction using spatially weighted non-convex regularization

    Science.gov (United States)

    Zheng, Jiabei; Fessler, Jeffrey A.; Chan, Heang-Ping

    2016-03-01

    Regularization is an effective strategy for reducing noise in tomographic reconstruction. This paper proposes a spatially weighted non-convex (SWNC) regularization method for digital breast tomosynthesis (DBT) image reconstruction. With a non-convex cost function, this method can suppress noise without blurring microcalcifications (MC) and spiculations of masses. To minimize the non-convex cost function, we apply a majorize-minimize separable quadratic surrogate algorithm (MM-SQS) that is further accelerated by ordered subsets (OS). We applied the new method to a heterogeneous breast phantom and to human subject DBT data, and observed improved image quality in both situations. A quantitative study also showed that the SWNC method can significantly enhance the contrast-to-noise ratio of MCs. By properly selecting its parameters, the SWNC regularizer can preserve the appearance of the mass margins and breast parenchyma.

  15. A second pass correction method for calcification artifacts in digital breast tomosynthesis

    Science.gov (United States)

    Erhard, Klaus; Grass, Michael; Nielsen, Tim

    2011-03-01

    Digital breast tomosynthesis (DBT) allows a quasi-3D reconstruction of the breast with high in-plane and poor depth resolution by the principles of limited angle tomography. The limited angular range and the coarse angular sampling result in prominent streak artifacts arising from high-contrast structures such as calcifications. These artifacts do not only degrade the image quality but also hold the risk of overlaying suspicious tissue structure in neighbouring slices, which might therefore be overlooked. This work presents a second pass method for correcting these kinds of high-contrast streak artifacts. In a first pass reconstruction the candidate highcontrast calcifications are segmented and subtracted from the original projection data to generate a subsequent artifact-free second pass reconstruction. The method is demonstrated in a simulation study using software breast phantoms, which have been derived from segmented MRI data.

  16. Additional findings at preoperative breast MRI: the value of second-look digital breast tomosynthesis

    Energy Technology Data Exchange (ETDEWEB)

    Clauser, Paola; Pancot, Martina; Girometti, Rossano; Bazzocchi, Massimo; Zuiani, Chiara [University of Udine, Azienda Ospedaliero-Universitaria, ' ' S.Maria della Misericordia' ' , Institute of Diagnostic Radiology, Department of Medical and Biological Sciences, Udine (Italy); Carbonaro, Luca A. [IRCCS Policlinico San Donato, Unit of Radiology, Milan (Italy); Sardanelli, Francesco [IRCCS Policlinico San Donato, Unit of Radiology, Milan (Italy); Universita degli Studi di Milano, Department of Biomedical Sciences of Health, Milan (Italy)

    2015-10-15

    To evaluate second-look digital breast tomosynthesis (SL-DBT) for additional findings (AFs) at preoperative MRI compared with second-look ultrasound (SL-US). We included 135 patients with breast cancer who underwent digital mammography (DM), DBT, US, and MRI at two centres. MR images were retrospectively evaluated to find AFs, described as focus, mass, or non-mass; ≤10 mm or >10 mm in size; BI-RADS 3, 4, or 5. DM and DBT exams were reviewed looking for MRI AFs; data on SL-US were collected. Reference standard was histopathology or ≥12-month negative follow-up. Fisher exact test and McNemar test were used. Eighty-four AFs were detected in 53/135 patients (39 %, 95 %CI 31-48 %). A correlate was found for 44/84 (52 %, 95 %CI 41-63 %) at SL-US, for 20/84 (24 %, 95 %CI 11-28 %) at SL-DM, for 42/84 (50 %, 95 %CI 39-61 %) at SL-DBT, for 63/84 (75 %, 95 %CI 64-84 %) at SL-DBT, and/or SL-US, the last rate being higher than for SL-US only, overall (p < 0.001), for mass or non-mass, ≤ or >10 mm, BI-RADS 4 or 5, or malignant lesions (p < 0.031). Of 21 AFs occult at both SLs, 17 were malignant (81 %, 95 %CI 58-94 %). When adding SL-DBT to SL-US, AFs detection increased from 52 % to 75 %. MR-guided biopsy is needed for the remaining 25 %. (orig.)

  17. One-to-one comparison between digital spot compression view and digital breast tomosynthesis

    Energy Technology Data Exchange (ETDEWEB)

    Tagliafico, Alberto [University of Genoa, Institute of Anatomy, Department of Experimental Medicine, Genoa (Italy); Astengo, Davide [University of Genoa, Radiology Department, Genoa (Italy); Cavagnetto, Francesca; Rosasco, Raffaella [IRCCS Azienda Ospedaliera Universitaria San Martino - IST-Istituto Nazionale per la Ricerca sul Cancro, Department of Medical Physics, Genova (Italy); Rescinito, Giuseppe; Monetti, Francesco; Calabrese, Massimo [IRCCS Azienda Ospedaliera Universitaria San Martino - IST-Istituto Nazionale per la Ricerca sul Cancro, UOC Senologia Diagnostica, Genova (Italy)

    2012-03-15

    To assess if digital breast tomosynthesis (DBT) is at least equal to digital spot compression view (DSCV). Following institutional approval and written informed consent, both DBT and DSCV were obtained in women with a screening abnormality. The diagnostic accuracy of DBT and DSCV was evaluated by two radiologists of varying experience (Reader1 and Reader2). 52 consecutive recalled women without calcification (mean age: 51 {+-} 12 years) underwent DSCV and DBT. Overall sensitivity was equal for both techniques (100% [95% CI, 91-100%] for DBT and 100% [95% CI, 91-100%] for DSCV). Overall specificity was higher for DBT (100% [95%CI, 91-100%]) than for DSCV (94% [95% CI, 91-100%]). Specificity for DSCV was higher for Reader1 (95% [95% CI, 91-100%]). Reader2 had lower values of specificity (92% [95% CI, 90-92%]). On DSCV, three and two false positives were recorded by Reader2 and Reader1, respectively. Overall, the area under the curve (AUC) was greater for DBT (AUC = 1) than for DSCV (AUC = 0.963). The mean difference between the two techniques was not significantly different (P = 0.43). In this dataset, diagnostic accuracy of digital breast tomosynthesis is at least equal to that of digital spot compression. (orig.)

  18. Computer-aided detection of clustered microcalcifications in digital breast tomosynthesis: A 3D approach

    Science.gov (United States)

    Sahiner, Berkman; Chan, Heang-Ping; Hadjiiski, Lubomir M.; Helvie, Mark A.; Wei, Jun; Zhou, Chuan; Lu, Yao

    2012-01-01

    Purpose: To design a computer-aided detection (CADe) system for clustered microcalcifications in reconstructed digital breast tomosynthesis (DBT) volumes and to perform a preliminary evaluation of the CADe system. Methods: IRB approval and informed consent were obtained in this study. A data set of two-view DBT of 72 breasts containing microcalcification clusters was collected from 72 subjects who were scheduled to undergo breast biopsy. Based on tissue sampling results, 17 cases had breast cancer and 55 were benign. A separate data set of two-view DBT of 38 breasts free of clustered microcalcifications from 38 subjects was collected to independently estimate the number of false-positives (FPs) generated by the CADe system. A radiologist experienced in breast imaging marked the biopsied cluster of microcalcifications with a 3D bounding box using all available clinical and imaging information. A CADe system was designed to detect microcalcification clusters in the reconstructed volume. The system consisted of prescreening, clustering, and false-positive reduction stages. In the prescreening stage, the conspicuity of microcalcification-like objects was increased by an enhancement-modulated 3D calcification response function. An iterative thresholding and 3D object growing method was used to detect cluster seed objects, which were used as potential centers of microcalcification clusters. In the cluster detection stage, microcalcification candidates were identified using a second iterative thresholding procedure, which was applied to the signal-to-noise ratio (SNR) enhanced image voxels with a positive calcification response. Starting with each cluster seed object as the initial cluster center, a dynamic clustering algorithm formed a cluster candidate by including microcalcification candidates within a 3D neighborhood of the cluster seed object that satisfied the clustering criteria. The number, size, and SNR of the microcalcifications in a cluster candidate and the

  19. A virtual trial framework for quantifying the detectability of masses in breast tomosynthesis projection data

    Energy Technology Data Exchange (ETDEWEB)

    Young, Stefano [College of Optical Sciences, University of Arizona, Tucson, Arizona 85721 (United States); Bakic, Predrag R. [Radiology Department, University of Pennsylvania, Philadelphia, Pennsylvania 19104 (United States); Myers, Kyle J.; Jennings, Robert J.; Park, Subok [Division of Imaging and Applied Mathematics, Center for Devices and Radiological Health, FDA, Silver Spring, Maryland 20993 (United States)

    2013-05-15

    Purpose: Digital breast tomosynthesis (DBT) is a promising breast cancer screening tool that has already begun making inroads into clinical practice. However, there is ongoing debate over how to quantitatively evaluate and optimize these systems, because different definitions of image quality can lead to different optimal design strategies. Powerful and accurate tools are desired to extend our understanding of DBT system optimization and validate published design principles. Methods: The authors developed a virtual trial framework for task-specific DBT assessment that uses digital phantoms, open-source x-ray transport codes, and a projection-space, spatial-domain observer model for quantitative system evaluation. The authors considered evaluation of reconstruction algorithms as a separate problem and focused on the information content in the raw, unfiltered projection images. Specifically, the authors investigated the effects of scan angle and number of angular projections on detectability of a small (3 mm diameter) signal embedded in randomly-varying anatomical backgrounds. Detectability was measured by the area under the receiver-operating characteristic curve (AUC). Experiments were repeated for three test cases where the detectability-limiting factor was anatomical variability, quantum noise, or electronic noise. The authors also juxtaposed the virtual trial framework with other published studies to illustrate its advantages and disadvantages. Results: The large number of variables in a virtual DBT study make it difficult to directly compare different authors' results, so each result must be interpreted within the context of the specific virtual trial framework. The following results apply to 25% density phantoms with 5.15 cm compressed thickness and 500 {mu}m{sup 3} voxels (larger 500 {mu}m{sup 2} detector pixels were used to avoid voxel-edge artifacts): 1. For raw, unfiltered projection images in the anatomical-variability-limited regime, AUC appeared to

  20. Overview of the evidence on digital breast tomosynthesis in breast cancer detection.

    Science.gov (United States)

    Houssami, Nehmat; Skaane, Per

    2013-04-01

    Digital breast tomosynthesis (DBT, or 3D-mammography), a three-dimensional derivative of digital mammography (DM), reduces the effect of tissue superimposition and may improve mammographic interpretation. In this review, we examined the evidence on the accuracy of DBT in clinical studies. Published studies of DBT were relatively small studies, mostly test-set observer (reader) studies or clinical series that included symptomatic and screen-recalled cases, and were generally enriched with cancers. With these limitations in mind, the evidence showed some consistent findings, summarized as follows: two-view DBT has at least equal or better accuracy than standard two-view DM, whereas one-view DBT does not have better accuracy than standard DM; the addition of DBT to standard mammography (for mammographic interpretation or for assessment or triage of screen-recalled abnormalities) increases accuracy; improved accuracy from using DBT (relative to, or added to, DM) may be due to increased cancer detection or due to reduced false positive recalls, or both; and subjective interpretation of cancer conspicuity consistently found that cancers were equally or more conspicuous on DBT relative to DM. Preliminary data from population screening trials suggest that the integration of DBT with conventional DM (screen-reading using combined 2D + 3D mammography) may substantially improve breast cancer detection, although final results are not yet available, and many logistical issues need further evaluation to determine the potential implications and cost of combined 2D + 3D mammographic screening. At present, there is insufficient evidence to justify a change from standard DM to DBT however the available data strongly support investment in new large-scale population screening trials. These trials need to avoid the 'double' acquisitions required for 2D + 3D mammograms, and should therefore focus on evaluating integrated 2Dsynthetic + 3D mammography (where 2D-images are

  1. Image quality of microcalcifications in digital breast tomosynthesis: Effects of projection-view distributions

    Science.gov (United States)

    Lu, Yao; Chan, Heang-Ping; Wei, Jun; Goodsitt, Mitch; Carson, Paul L.; Hadjiiski, Lubomir; Schmitz, Andrea; Eberhard, Jeffrey W.; Claus, Bernhard E. H.

    2011-01-01

    Purpose: To analyze the effects of projection-view (PV) distribution on the contrast and spatial blurring of microcalcifications on the tomosynthesized slices (X-Y plane) and along the depth (Z) direction for the same radiation dose in digital breast tomosynthesis (DBT).Methods: A GE GEN2 prototype DBT system was used for acquisition of DBT scans. The system acquires PV images from 21 angles in 3° increments over a ±30° range. From these acquired PV images, the authors selected six subsets of PV images to simulate DBT of different angular ranges and angular increments. The number of PV images in each subset was fixed at 11 to simulate a constant total dose. These different PV distributions were subjectively divided into three categories: uniform group, nonuniform central group, and nonuniform extreme group with different angular ranges and angular increments. The simultaneous algebraic reconstruction technique (SART) was applied to each subset to reconstruct the DBT slices. A selective diffusion regularization method was employed to suppress noise. The image quality of microcalcifications in the reconstructed DBTs with different PV distributions was compared using the DBT scans of an American College of Radiology phantom and three human subjects. The contrast-to-noise ratio (CNR) and the full width at half maximum (FWHM) of the line profiles of microcalcifications within their in-focus DBT slices (parallel to detector plane) and the FWHMs of the interplane artifact spread function (ASF) in the Z-direction (perpendicular to detector plane) were used as image quality measures.Results: The results indicate that DBT acquired with a large angular range or, for an equal angular range,with a large fraction of PVs at large angles yielded superior ASF with smaller FWHM in the Z-direction. PV distributions with a narrow angular range or a large fraction of PVs at small angles had stronger interplane artifacts. In the X-Y focal planes, the effect of PV distributions on

  2. Image quality of microcalcifications in digital breast tomosynthesis: Effects of projection-view distributions

    Energy Technology Data Exchange (ETDEWEB)

    Lu, Yao; Chan, Heang-Ping; Wei, Jun; Goodsitt, Mitch; Carson, Paul L.; Hadjiiski, Lubomir; Schmitz, Andrea; Eberhard, Jeffrey W.; Claus, Bernhard E. H. [Department of Radiology, University of Michigan, Ann Arbor, Michigan 48109-5842 (United States); GE Global Research, Niskayuna, New York 12309 (United States)

    2011-10-15

    Purpose: To analyze the effects of projection-view (PV) distribution on the contrast and spatial blurring of microcalcifications on the tomosynthesized slices (X-Y plane) and along the depth (Z) direction for the same radiation dose in digital breast tomosynthesis (DBT). Methods: A GE GEN2 prototype DBT system was used for acquisition of DBT scans. The system acquires PV images from 21 angles in 3 deg. increments over a {+-}30 deg. range. From these acquired PV images, the authors selected six subsets of PV images to simulate DBT of different angular ranges and angular increments. The number of PV images in each subset was fixed at 11 to simulate a constant total dose. These different PV distributions were subjectively divided into three categories: uniform group, nonuniform central group, and nonuniform extreme group with different angular ranges and angular increments. The simultaneous algebraic reconstruction technique (SART) was applied to each subset to reconstruct the DBT slices. A selective diffusion regularization method was employed to suppress noise. The image quality of microcalcifications in the reconstructed DBTs with different PV distributions was compared using the DBT scans of an American College of Radiology phantom and three human subjects. The contrast-to-noise ratio (CNR) and the full width at half maximum (FWHM) of the line profiles of microcalcifications within their in-focus DBT slices (parallel to detector plane) and the FWHMs of the interplane artifact spread function (ASF) in the Z-direction (perpendicular to detector plane) were used as image quality measures. Results: The results indicate that DBT acquired with a large angular range or, for an equal angular range,with a large fraction of PVs at large angles yielded superior ASF with smaller FWHM in the Z-direction. PV distributions with a narrow angular range or a large fraction of PVs at small angles had stronger interplane artifacts. In the X-Y focal planes, the effect of PV

  3. The role of digital tomosynthesis in reducing the number of equivocal breast reportings

    Science.gov (United States)

    Alakhras, Maram; Mello-Thoms, Claudia; Rickard, Mary; Bourne, Roger; Brennan, Patrick C.

    2015-03-01

    Purpose To compare radiologists' confidence in assessing breast cancer using combined digital mammography (DM) and digital breast tomosynthesis (DBT) compared with DM alone as a function of previous experience with DBT. Materials and Methods Institutional ethics approval was obtained. Twenty-three experienced breast radiologists reviewed 50 cases in two modes, DM alone and DM+DBT. Twenty-seven cases presented with breast cancer. Each radiologist was asked to detect breast lesions and give a confidence score of 1-5 (1- Normal, 2- Benign, 3- Equivocal, 4- Suspicious, 5- Malignant). Radiologists were divided into three sub-groups according to their prior experience with DBT (none, workshop experience, and clinical experience). Confidence scores using DM+DBT were compared with DM alone for all readers combined and for each DBT experience subgroup. Statistical analyses, using GraphPad Prism 5, were carried out using the Wilcoxon signed-rank test with statistical significance set at pResults Confidence scores were higher for true positive cancer cases using DM+DBT compared with DM alone for all readers (p cancer diagnosis) with DM+DBT compared with DM alone for all readers (p= 0.018) and readers with no prior DBT experience (p= 0.035). Conclusion Addition of DBT to DM increases the confidence level of radiologists in scoring cancer and normal/benign cases. This finding appears to apply across radiologists with varying levels of DBT experience, however further work involving greater numbers of radiologists is required.

  4. Evaluation of the possibility to use thick slabs of reconstructed outer breast tomosynthesis slice images

    Science.gov (United States)

    Petersson, Hannie; Dustler, Magnus; Tingberg, Anders; Timberg, Pontus

    2016-03-01

    The large image volumes in breast tomosynthesis (BT) have led to large amounts of data and a heavy workload for breast radiologists. The number of slice images can be decreased by combining adjacent image planes (slabbing) but the decrease in depth resolution can considerably affect the detection of lesions. The aim of this work was to assess if thicker slabbing of the outer slice images (where lesions seldom are present) could be a viable alternative in order to reduce the number of slice images in BT image volumes. The suggested slabbing (an image volume with thick outer slabs and thin slices between) were evaluated in two steps. Firstly, a survey of the depth of 65 cancer lesions within the breast was performed to estimate how many lesions would be affected by outer slabs of different thicknesses. Secondly, a selection of 24 lesions was reconstructed with 2, 6 and 10 mm slab thickness to evaluate how the appearance of lesions located in the thicker slabs would be affected. The results show that few malignant breast lesions are located at a depth less than 10 mm from the surface (especially for breast thicknesses of 50 mm and above). Reconstruction of BT volumes with 6 mm slab thickness yields an image quality that is sufficient for lesion detection for a majority of the investigated cases. Together, this indicates that thicker slabbing of the outer slice images is a promising option in order to reduce the number of slice images in BT image volumes.

  5. Selective-diffusion regularization for enhancement of microcalcifications in digital breast tomosynthesis reconstruction

    Energy Technology Data Exchange (ETDEWEB)

    Lu Yao; Chan, Heang-Ping; Wei Jun; Hadjiiski, Lubomir M. [Department of Radiology, University of Michigan, Ann Arbor, Michigan 48109 (United States)

    2010-11-15

    Purpose: Digital breast tomosynthesis (DBT) has been shown to improve mass detection. Detection of microcalcifications is more challenging because of the large breast volume to be searched for subtle signals. The simultaneous algebraic reconstruction technique (SART) was found to provide good image quality for DBT, but the image noise is amplified with an increasing number of iterations. In this study, the authors developed a selective-diffusion (SD) method for noise regularization with SART to improve the contrast-to-noise ratio (CNR) of microcalcifications in the DBT slices for human or machine detection. Methods: The SD method regularizes SART reconstruction during updating with each projection view. Potential microcalcifications are differentiated from the noisy background by estimating the local gradient information. Different degrees of regularization are applied to the signal or noise classes, such that the microcalcifications will be enhanced while the noise is suppressed. The new SD method was compared to several current methods, including the quadratic Laplacian (QL) method, the total variation (TV) method, and the nonconvex total p-variation (TpV) method for noise regularization with SART. A GE GEN2 prototype DBT system with a stationary digital detector was used for the acquisition of DBT scans at 21 angles in 3 deg. increments over a {+-}30 deg. range. The reconstruction image quality without regularization and that with the different regularization methods were compared using the DBT scans of an American College of Radiology phantom and a human subject. The CNR and the full width at half maximum (FWHM) of the line profiles of microcalcifications within the in-focus DBT slices were used as image quality measures. Results: For the comparison of large microcalcifications in the DBT data of the subject, the SD method resulted in comparable CNR to the nonconvex TpV method. Both of them performed better than the other two methods. For subtle

  6. Selective-diffusion regularization for enhancement of microcalcifications in digital breast tomosynthesis reconstruction

    Science.gov (United States)

    Lu, Yao; Chan, Heang-Ping; Wei, Jun; Hadjiiski, Lubomir M.

    2010-01-01

    Purpose: Digital breast tomosynthesis (DBT) has been shown to improve mass detection. Detection of microcalcifications is more challenging because of the large breast volume to be searched for subtle signals. The simultaneous algebraic reconstruction technique (SART) was found to provide good image quality for DBT, but the image noise is amplified with an increasing number of iterations. In this study, the authors developed a selective-diffusion (SD) method for noise regularization with SART to improve the contrast-to-noise ratio (CNR) of microcalcifications in the DBT slices for human or machine detection. Methods: The SD method regularizes SART reconstruction during updating with each projection view. Potential microcalcifications are differentiated from the noisy background by estimating the local gradient information. Different degrees of regularization are applied to the signal or noise classes, such that the microcalcifications will be enhanced while the noise is suppressed. The new SD method was compared to several current methods, including the quadratic Laplacian (QL) method, the total variation (TV) method, and the nonconvex total p-variation (TpV) method for noise regularization with SART. A GE GEN2 prototype DBT system with a stationary digital detector was used for the acquisition of DBT scans at 21 angles in 3° increments over a ±30° range. The reconstruction image quality without regularization and that with the different regularization methods were compared using the DBT scans of an American College of Radiology phantom and a human subject. The CNR and the full width at half maximum (FWHM) of the line profiles of microcalcifications within the in-focus DBT slices were used as image quality measures. Results: For the comparison of large microcalcifications in the DBT data of the subject, the SD method resulted in comparable CNR to the nonconvex TpV method. Both of them performed better than the other two methods. For subtle microcalcifications

  7. Development and validation of a modelling framework for simulating 2D-mammography and breast tomosynthesis images

    International Nuclear Information System (INIS)

    Planar 2D x-ray mammography is generally accepted as the preferred screening technique used for breast cancer detection. Recently, digital breast tomosynthesis (DBT) has been introduced to overcome some of the inherent limitations of conventional planar imaging, and future technological enhancements are expected to result in the introduction of further innovative modalities. However, it is crucial to understand the impact of any new imaging technology or methodology on cancer detection rates and patient recall. Any such assessment conventionally requires large scale clinical trials demanding significant investment in time and resources. The concept of virtual clinical trials and virtual performance assessment may offer a viable alternative to this approach. However, virtual approaches require a collection of specialized modelling tools which can be used to emulate the image acquisition process and simulate images of a quality indistinguishable from their real clinical counterparts. In this paper, we present two image simulation chains constructed using modelling tools that can be used for the evaluation of 2D-mammography and DBT systems. We validate both approaches by comparing simulated images with real images acquired using the system being simulated. A comparison of the contrast-to-noise ratios and image blurring for real and simulated images of test objects shows good agreement ( < 9% error). This suggests that our simulation approach is a promising alternative to conventional physical performance assessment followed by large scale clinical trials. (paper)

  8. Cancer risk estimation in Digital Breast Tomosynthesis using GEANT4 Monte Carlo simulations and voxel phantoms.

    Science.gov (United States)

    Ferreira, P; Baptista, M; Di Maria, S; Vaz, P

    2016-05-01

    The aim of this work was to estimate the risk of radiation induced cancer following the Portuguese breast screening recommendations for Digital Mammography (DM) when applied to Digital Breast Tomosynthesis (DBT) and to evaluate how the risk to induce cancer could influence the energy used in breast diagnostic exams. The organ doses were calculated by Monte Carlo simulations using a female voxel phantom and considering the acquisition of 25 projection images. Single organ cancer incidence risks were calculated in order to assess the total effective radiation induced cancer risk. The screening strategy techniques considered were: DBT in Cranio-Caudal (CC) view and two-view DM (CC and Mediolateral Oblique (MLO)). The risk of cancer incidence following the Portuguese screening guidelines (screening every two years in the age range of 50-80years) was calculated by assuming a single CC DBT acquisition view as standalone screening strategy and compared with two-view DM. The difference in the total effective risk between DBT and DM is quite low. Nevertheless in DBT an increase of risk for the lung is observed with respect to DM. The lung is also the organ that is mainly affected when non-optimal beam energy (in terms of image quality and absorbed dose) is used instead of an optimal one. The use of non-optimal energies could increase the risk of lung cancer incidence by a factor of about 2. PMID:27133140

  9. Workflow improvements for digital breast tomosynthesis: computerized generation of enhanced synthetic images

    Science.gov (United States)

    Fotin, Sergei V.; Yin, Yin; Haldankar, Hrishikesh; Hoffmeister, Jeffrey W.; Periaswamy, Senthil

    2016-03-01

    In a typical 2D mammography workflow scenario, a computer-aided detection (CAD) algorithm is used as a second reader producing marks for a radiologist to review. In the case of 3D digital breast tomosynthesis (DBT), the display of CAD detections at multiple reconstruction heights would lead to an increased image browsing and interpretation time. We propose an alternative approach in which an algorithm automatically identifies suspicious regions of interest from 3D reconstructed DBT slices and then merges the findings with the corresponding 2D synthetic projection image which is then reviewed. The resultant enhanced synthetic 2D image combines the benefits of a familiar 2D breast view with superior appearance of suspicious locations from 3D slices. Moreover, clicking on 2D suspicious locations brings up the display of the corresponding 3D regions in a DBT volume allowing navigation between 2D and 3D images. We explored the use of these enhanced synthetic images in a concurrent read paradigm by conducting a study with 5 readers and 30 breast exams. We observed that the introduction of the enhanced synthetic view reduced radiologist's average interpretation time by 5.4%, increased sensitivity by 6.7% and increased specificity by 15.6%.

  10. Fusion of digital breast tomosynthesis images via wavelet synthesis for improved lesion conspicuity

    Science.gov (United States)

    Hariharan, Harishwaran; Pomponiu, Victor; Zheng, Bin; Whiting, Bruce; Gur, David

    2014-03-01

    Full-field digital mammography (FFDM) is the most common screening procedure for detecting early breast cancer. However, due to complications such as overlapping breast tissue in projection images, the efficacy of FFDM reading is reduced. Recent studies have shown that digital breast tomosynthesis (DBT), in combination with FFDM, increases detection sensitivity considerably while decreasing false-positive, recall rates. There is a huge interest in creating diagnostically accurate 2-D interpretations from the DBT slices. Most of the 2-D syntheses rely on visualizing the maximum intensities (brightness) from each slice through different methods. We propose a wavelet based fusion method, where we focus on preserving holistic information from larger structures such as masses while adding high frequency information that is relevant and helpful for diagnosis. This method enables the spatial generation of a 2D image from a series of DBT images, each of which contains both smooth and coarse structures distributed in the wavelet domain. We believe that the wavelet-synthesized images, generated from their DBT image datasets, provide radiologists with improved lesion and micro-calcification conspicuity as compared with FFDM images. The potential impact of this fusion method is (1) Conception of a device-independent, data-driven modality that increases the conspicuity of lesions, thereby facilitating early detection and potentially reducing recall rates; (2) Reduction of the accompanying radiation dose to the patient.

  11. Real time radial and tangential tomosynthesis system dedicated to on line x-ray examination of moving objects

    International Nuclear Information System (INIS)

    This presentation describes a system able to compute and display in real time a reconstructed image of a moving object using tomosynthesis methods. The object being moved on a known trajectory between the x-ray source and a detector, the tomosynthesis is focused on a given surface of the object and allows to reconstruct a sharp image of the structure on the surface superimposed to a blurred image of the surrounding plane. The developed tomosynthesis algorithm is based on a set of look up tables which provide for each position of the object on the trajectory, the projection of a given point of the imaged surface of the object on the detector. Several hundreds of frames can be combined to compute the tomosynthesis image. The signal-to-noise ratio obtained on processed images is equivalent to the one obtained by averaging images with a static object. In order to speed up the tomosynthesis reconstruction and to reach the video frame rate, we integrated a DSP based hardware in a PC host. The geometric calibration parameters and the look up tables are pre-computed on the PC. The on-line tomosynthesis calculation is carried out by the multi DSP architecture which manages in real time, frame acquisition, parallel tomosynthesis calculation and output image display. On this particular implementation of tomosynthesis, up to hundred video frames can be combined. We illustrate the potential of this system on an application of the tomosynthesis to solid rocket motor examination

  12. Tomo-synthesis. Bibliographic study report

    International Nuclear Information System (INIS)

    Tomo-synthesis is a recent technique for breast imaging. This technique, qualified as 'pseudo-3D', draws the attention of health professionals. Indeed, this technique could offer a gain in sensibility and in specificity in the detection of breast cancers compared to 2D mammography, thanks to the reduction of the tissues' overlapping in particular. Although its place and its clinical indication are not still clearly defined, tomo-synthesis is already used in France. The introduction of this technique within the national breast cancer screening program, seems to be foreseen by the authorities in the coming years. IRSN, in the scope of its mission of evaluation of the dose impact of innovative techniques, is closely interested in this technique and has proceeded in 2015 to a bibliographical review of the state of the art in tomo-synthesis. This review paid specific attention to the following points: conception of the installations, dose, image quality and quality control. it has highlighted several points of attention, which incite IRSN to formulate certain recommendations to accompany the spreading of this new technique in France. Most of the clinical trials validating the use of tomo-synthesis were realized on systems of a single manufacturer. However, manufacturers' strategies of design are heterogeneous. There is no unique technique of tomo-synthesis but several, of which equivalence in terms of technical and clinical performances is not demonstrated. Due to the heterogeneity of the different models available on the French market, IRSN recommends not to extrapolate the results of clinical studies obtained on a specific system but to consolidate them for all the available systems. In many imaging departments, tomo-synthesis is already implemented in addition or in substitution of 2D mammography without any regulatory quality control and periodic technical checks. The European reference standard for quality control of these devices is not yet

  13. Breast tomosynthesis with monochromatic beams: a feasibility study using Monte Carlo simulations

    Science.gov (United States)

    Malliori, A.; Bliznakova, K.; Sechopoulos, I.; Kamarianakis, Z.; Fei, B.; Pallikarakis, N.

    2014-08-01

    The aim of this study is to investigate the impact on image quality of using monochromatic beams for lower dose breast tomosynthesis (BT). For this purpose, modeling and simulation of BT and mammography imaging processes have been performed using two x-ray beams: one at 28 kVp and a monochromatic one at 19 keV at different entrance surface air kerma ranging between 0.16 and 5.5 mGy. Two 4 cm thick computational breast models, in a compressed state, were used: one simple homogeneous and one heterogeneous based on CT breast images, with compositions of 50% glandular-50% adipose and 40% glandular-60% adipose tissues by weight, respectively. Modeled lesions, representing masses and calcifications, were inserted within these breast phantoms. X-ray transport in the breast models was simulated with previously developed and validated Monte Carlo application. Results showed that, for the same incident photon fluence, the use of the monochromatic beam in BT resulted in higher image quality compared to the one using polychromatic acquisition, especially in terms of contrast. For the homogenous phantom, the improvement ranged between 15% and 22% for calcifications and masses, respectively, while for the heterogeneous one this improvement was in the order of 33% for the masses and 17% for the calcifications. For different exposures, comparable image quality in terms of signal-difference-to-noise ratio and higher contrast for all features was obtained when using a monochromatic 19 keV beam at a lower mean glandular dose, compared to the polychromatic one. Monochromatic images also provide better detail and, in combination with BT, can lead to substantial improvement in visualization of features, and particularly better edge detection of low-contrast masses.

  14. The effect of reduced breast compression in breast tomo-synthesis: Human observer study using clinical cases

    International Nuclear Information System (INIS)

    The aim of this study was to investigate whether the compression force used with conventional mammography can be reduced with breast tomo-synthesis (BT), without adversely affecting the visualisation of normal and pathological structures. Forty-five women were examined with BT using full (same as for 2D mammography) and half compression force. Both examinations were performed with the same acquisition parameters. A total of 103 paired structure images were evaluated according to specified image quality criteria. Three experienced radiologists participated in the study. They had to make a forced choice, i.e. choose the image they felt best fulfilled the image quality criteria. The results showed no evident difference in the image quality, indicating that BT may be performed with substantially less compression force compared with 2D mammography. A majority of the examined women felt that half compression was more comfortable than full compression. (authors)

  15. Comparison of the diagnostic performance of digital breast tomosynthesis and magnetic resonance imaging added to digital mammography in women with known breast cancers

    International Nuclear Information System (INIS)

    To compare the diagnostic performance of digital breast tomosynthesis (DBT) and magnetic resonance imaging (MRI) added to mammography in women with known breast cancers. Three radiologists independently reviewed image sets of 172 patients with 184 cancers; mammography alone, DBT plus mammography and MRI plus mammography, and scored for cancer probability using the Breast Imaging Reporting and Data System (BI-RADS). Jack-knife alternative free-response receiver-operating characteristic (JAFROC), which allows diagnostic performance estimation using single lesion as a statistical unit in a cancer-only population, was used. Sensitivity and positive predictive value (PPV) were compared using the McNemar and Fisher-exact tests. The JAFROC figures of merit (FOMs) was lower in DBT plus mammography (0.937) than MRI plus mammography (0.978, P = 0.0006) but higher than mammography alone (0.900, P = 0.0013). The sensitivity was lower in DBT plus mammography (88.2 %) than MRI plus mammography (97.8 %) but higher than mammography alone (78.3 %, both P < 0.0001). The PPV was significantly higher in DBT plus mammography (93.3 %) than MRI plus mammography (89.6 %, P = 0.0282). DBT provided lower diagnostic performance than MRI as an adjunctive imaging to mammography. However, DBT had higher diagnostic performance than mammography and higher PPV than MRI. (orig.)

  16. Comparison of the diagnostic performance of digital breast tomosynthesis and magnetic resonance imaging added to digital mammography in women with known breast cancers

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Won Hwa; Chang, Jung Min; Moon, Woo Kyung [Seoul National University Hospital, Department of Radiology, 101 Daehangno, Jongno-gu, Seoul (Korea, Republic of); Moon, Hyeong-Gon [Seoul National University Hospital, Department of Surgery, Seoul (Korea, Republic of); Yi, Ann [Seoul National University Hospital, Department of Radiology, Gangnan Healthcare Center, Seoul (Korea, Republic of); Koo, Hye Ryoung [Hanyang University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Gweon, Hye Mi [Yonsei University College of Medicine, Department of Radiology, Gangnam Severance Hospital, Seoul (Korea, Republic of)

    2016-06-15

    To compare the diagnostic performance of digital breast tomosynthesis (DBT) and magnetic resonance imaging (MRI) added to mammography in women with known breast cancers. Three radiologists independently reviewed image sets of 172 patients with 184 cancers; mammography alone, DBT plus mammography and MRI plus mammography, and scored for cancer probability using the Breast Imaging Reporting and Data System (BI-RADS). Jack-knife alternative free-response receiver-operating characteristic (JAFROC), which allows diagnostic performance estimation using single lesion as a statistical unit in a cancer-only population, was used. Sensitivity and positive predictive value (PPV) were compared using the McNemar and Fisher-exact tests. The JAFROC figures of merit (FOMs) was lower in DBT plus mammography (0.937) than MRI plus mammography (0.978, P = 0.0006) but higher than mammography alone (0.900, P = 0.0013). The sensitivity was lower in DBT plus mammography (88.2 %) than MRI plus mammography (97.8 %) but higher than mammography alone (78.3 %, both P < 0.0001). The PPV was significantly higher in DBT plus mammography (93.3 %) than MRI plus mammography (89.6 %, P = 0.0282). DBT provided lower diagnostic performance than MRI as an adjunctive imaging to mammography. However, DBT had higher diagnostic performance than mammography and higher PPV than MRI. (orig.)

  17. Analysis of computer-aided detection techniques and signal characteristics for clustered microcalcifications on digital mammography and digital breast tomosynthesis

    Science.gov (United States)

    Samala, Ravi K.; Chan, Heang-Ping; Hadjiiski, Lubomir M.; Helvie, Mark A.

    2016-10-01

    With IRB approval, digital breast tomosynthesis (DBT) images of human subjects were collected using a GE GEN2 DBT prototype system. Corresponding digital mammograms (DMs) of the same subjects were collected retrospectively from patient files. The data set contained a total of 237 views of DBT and equal number of DM views from 120 human subjects, each included 163 views with microcalcification clusters (MCs) and 74 views without MCs. The data set was separated into training and independent test sets. The pre-processing, object prescreening and segmentation, false positive reduction and clustering strategies for MC detection by three computer-aided detection (CADe) systems designed for DM, DBT, and a planar projection image generated from DBT were analyzed. Receiver operating characteristic (ROC) curves based on features extracted from microcalcifications and free-response ROC (FROC) curves based on scores from MCs were used to quantify the performance of the systems. Jackknife FROC (JAFROC) and non-parametric analysis methods were used to determine the statistical difference between the FROC curves. The difference between the CADDM and CADDBT systems when the false positive rate was estimated from cases without MCs did not reach statistical significance. The study indicates that the large search space in DBT may not be a limiting factor for CADe to achieve similar performance as that observed in DM.

  18. Investigation on location-dependent detectability of a small mass for digital breast tomosynthesis evaluation

    Science.gov (United States)

    Lee, Changwoo; Baek, Jongduk; Park, Subok

    2016-03-01

    Digital breast tomosynthesis (DBT) is an emerging imaging modality for improved breast cancer detection and diagnosis [1-5]. Numerous efforts have been made to find quantitative metrics associated with mammographic image quality assessment, such as the exponent β of anatomical noise power spectrum, glandularity, contrast noise ratio, etc. [6-8]. In addition, with the use of Fourier-domain detectability for a task-based assessment of DBT, a stationarity assumption on reconstructed image statistics was often made [9-11], resulting in the use of multiple regions-of-interest (ROIs) from different locations in order to increase sample size. While all these metrics provide some information on mammographic image characteristics and signal detection, the relationship between these metrics and detectability in DBT evaluation has not been fully understood. In this work, we investigated spatial-domain detectability trends and levels as a function of the number of slices Ns at three different ROI locations on the same image slice, where background statistics differ in terms of the aforementioned metrics. Detectabilities for the three ROI locations were calculated using multi-slice channelized Hotelling observers with 2D/3D Laguerre-Gauss channels. Our simulation results show that detectability levels and trends as a function of Ns vary across these three ROI locations. They also show that the exponent β, mean glandularity, and mean attenuation coefficient vary across the three ROI locations but they do not necessarily predict the ranking of detectability levels and trends across these ROI locations.

  19. Simplified false-positive reduction in computer-aided detection scheme of clustered microcalcifications in digital breast tomosynthesis

    Science.gov (United States)

    Jeong, Ji-Wook; Chae, Seung-Hoon; Lee, Sooyeul; Chae, Eun Young; Kim, Hak Hee; Choi, Young-Wook

    2015-03-01

    A computer-aided detection (CADe) system for clustered microcalcifications (MCs) in reconstructed digital breast tomosynthesis (DBT) volumes was suggested. The system consisted of prescreening, MC detecting, clustering, and falsepositive reduction steps. In the prescreening stage, the MC-like objects were enhanced by a multiscale-based 3D calcification response function. A connected component segmentation method was used to detect cluster seed objects, which were considered as potential clustering centers of MCs. Starting with each cluster seed object as the initial cluster center, a cluster candidate was formed by including nearby MC candidates within a 3D neighborhood of the cluster seed object satisfying the clustering criteria during the clustering step. The size and number of the clustered MCs in a cluster seed candidate were used to reduce the number of FPs. A bounding cube for each MCC was generated for each accepted seed candidates. Then, the overlapping cubes were combined and examined according to the FP reduction criteria. After FP reduction step, we obtained the average number of FPs of 2.47 per DBT volume with sensitivity of 83.3%. Our study indicates the simplified false-positive reduction approach applied to the detection of clustered MCs in DBT is promising as an efficient CADe system.

  20. Deep-learning convolution neural network for computer-aided detection of microcalcifications in digital breast tomosynthesis

    Science.gov (United States)

    Samala, Ravi K.; Chan, Heang-Ping; Hadjiiski, Lubomir M.; Cha, Kenny; Helvie, Mark A.

    2016-03-01

    A deep learning convolution neural network (DLCNN) was designed to differentiate microcalcification candidates detected during the prescreening stage as true calcifications or false positives in a computer-aided detection (CAD) system for clustered microcalcifications. The microcalcification candidates were extracted from the planar projection image generated from the digital breast tomosynthesis volume reconstructed by a multiscale bilateral filtering regularized simultaneous algebraic reconstruction technique. For training and testing of the DLCNN, true microcalcifications are manually labeled for the data sets and false positives were obtained from the candidate objects identified by the CAD system at prescreening after exclusion of the true microcalcifications. The DLCNN architecture was selected by varying the number of filters, filter kernel sizes and gradient computation parameter in the convolution layers, resulting in a parameter space of 216 combinations. The exhaustive grid search method was used to select an optimal architecture within the parameter space studied, guided by the area under the receiver operating characteristic curve (AUC) as a figure-of-merit. The effects of varying different categories of the parameter space were analyzed. The selected DLCNN was compared with our previously designed CNN architecture for the test set. The AUCs of the CNN and DLCNN was 0.89 and 0.93, respectively. The improvement was statistically significant (p < 0.05).

  1. A comparison of image interpretation times in full field digital mammography and digital breast tomosynthesis

    Science.gov (United States)

    Astley, Susan; Connor, Sophie; Lim, Yit; Tate, Catriona; Entwistle, Helen; Morris, Julie; Whiteside, Sigrid; Sergeant, Jamie; Wilson, Mary; Beetles, Ursula; Boggis, Caroline; Gilbert, Fiona

    2013-03-01

    Digital Breast Tomosynthesis (DBT) provides three-dimensional images of the breast that enable radiologists to discern whether densities are due to overlapping structures or lesions. To aid assessment of the cost-effectiveness of DBT for screening, we have compared the time taken to interpret DBT images and the corresponding two-dimensional Full Field Digital Mammography (FFDM) images. Four Consultant Radiologists experienced in reading FFDM images (4 years 8 months to 8 years) with training in DBT interpretation but more limited experience (137-407 cases in the past 6 months) were timed reading between 24 and 32 two view FFDM and DBT cases. The images were of women recalled from screening for further assessment and women under surveillance because of a family history of breast cancer. FFDM images were read before DBT, according to local practice. The median time for readers to interpret FFDM images was 17.0 seconds, with an interquartile range of 12.3-23.6 seconds. For DBT, the median time was 66.0 seconds, and the interquartile range was 51.1-80.5 seconds. The difference was statistically significant (p<0.001). Reading times were significantly longer in family history clinics (p<0.01). Although it took approximately four times as long to interpret DBT than FFDM images, the cases were more complex than would be expected for routine screening, and with higher mammographic density. The readers were relatively inexperienced in DBT interpretation and may increase their speed over time. The difference in times between clinics may be due to increased throughput at assessment, or decreased density.

  2. Detection of soft tissue densities from digital breast tomosynthesis: comparison of conventional and deep learning approaches

    Science.gov (United States)

    Fotin, Sergei V.; Yin, Yin; Haldankar, Hrishikesh; Hoffmeister, Jeffrey W.; Periaswamy, Senthil

    2016-03-01

    Computer-aided detection (CAD) has been used in screening mammography for many years and is likely to be utilized for digital breast tomosynthesis (DBT). Higher detection performance is desirable as it may have an impact on radiologist's decisions and clinical outcomes. Recently the algorithms based on deep convolutional architectures have been shown to achieve state of the art performance in object classification and detection. Similarly, we trained a deep convolutional neural network directly on patches sampled from two-dimensional mammography and reconstructed DBT volumes and compared its performance to a conventional CAD algorithm that is based on computation and classification of hand-engineered features. The detection performance was evaluated on the independent test set of 344 DBT reconstructions (GE SenoClaire 3D, iterative reconstruction algorithm) containing 328 suspicious and 115 malignant soft tissue densities including masses and architectural distortions. Detection sensitivity was measured on a region of interest (ROI) basis at the rate of five detection marks per volume. Moving from conventional to deep learning approach resulted in increase of ROI sensitivity from 0:832 +/- 0:040 to 0:893 +/- 0:033 for suspicious ROIs; and from 0:852 +/- 0:065 to 0:930 +/- 0:046 for malignant ROIs. These results indicate the high utility of deep feature learning in the analysis of DBT data and high potential of the method for broader medical image analysis tasks.

  3. Utilizing digital breast tomosynthesis projection views correlation for microcalcification enhancement for detection purposes

    Science.gov (United States)

    Baddar, Wissam J.; Kim, Eun Joon; Kim, Dae Hoe; Ro, Yong Man

    2015-03-01

    This paper presents a novel method for enhancing the contrast of microcalcifications in digital breast tomosynthesis projection views for detection purposes. The proposed method relies on the correlation between the projection views in order to reduce the effect of noise, due to the low-dose exposure, and increase the contrast of the microcalcification particles for microcalcification cluster detection purposes. The method performs a series of multi-shift operations to capture the microcalcification particle movement information and compensate it in order to enhance microcalcification particles contrast. Furthermore, the proposed approach utilizes the projection view correlation in order to reduce the falsely detected regions of interest, and improve the classification of the detected regions into false positives or actual microcalcification clusters. Comparative experiments have been performed to quantitatively measure the contrast enhancement of microcalcification particles and its effect on the MC cluster detection. To that end, the contrast to noise ratio have been calculated and compared with some with previous methods. Furthermore, the free response receiver operating characteristic (FROC) curve have been used to measure the effect of the proposed enhancement on the microcalcification cluster detectability.

  4. Three-Dimensional Computer-Aided Detection of Microcalcification Clusters in Digital Breast Tomosynthesis

    Science.gov (United States)

    Jeong, Ji-wook; Chae, Seung-Hoon; Chae, Eun Young; Kim, Hak Hee; Choi, Young-Wook; Lee, Sooyeul

    2016-01-01

    We propose computer-aided detection (CADe) algorithm for microcalcification (MC) clusters in reconstructed digital breast tomosynthesis (DBT) images. The algorithm consists of prescreening, MC detection, clustering, and false-positive (FP) reduction steps. The DBT images containing the MC-like objects were enhanced by a multiscale Hessian-based three-dimensional (3D) objectness response function and a connected-component segmentation method was applied to extract the cluster seed objects as potential clustering centers of MCs. Secondly, a signal-to-noise ratio (SNR) enhanced image was also generated to detect the individual MC candidates and prescreen the MC-like objects. Each cluster seed candidate was prescreened by counting neighboring individual MC candidates nearby the cluster seed object according to several microcalcification clustering criteria. As a second step, we introduced bounding boxes for the accepted seed candidate, clustered all the overlapping cubes, and examined. After the FP reduction step, the average number of FPs per case was estimated to be 2.47 per DBT volume with a sensitivity of 83.3%. PMID:27274993

  5. Three-Dimensional Computer-Aided Detection of Microcalcification Clusters in Digital Breast Tomosynthesis.

    Science.gov (United States)

    Jeong, Ji-Wook; Chae, Seung-Hoon; Chae, Eun Young; Kim, Hak Hee; Choi, Young-Wook; Lee, Sooyeul

    2016-01-01

    We propose computer-aided detection (CADe) algorithm for microcalcification (MC) clusters in reconstructed digital breast tomosynthesis (DBT) images. The algorithm consists of prescreening, MC detection, clustering, and false-positive (FP) reduction steps. The DBT images containing the MC-like objects were enhanced by a multiscale Hessian-based three-dimensional (3D) objectness response function and a connected-component segmentation method was applied to extract the cluster seed objects as potential clustering centers of MCs. Secondly, a signal-to-noise ratio (SNR) enhanced image was also generated to detect the individual MC candidates and prescreen the MC-like objects. Each cluster seed candidate was prescreened by counting neighboring individual MC candidates nearby the cluster seed object according to several microcalcification clustering criteria. As a second step, we introduced bounding boxes for the accepted seed candidate, clustered all the overlapping cubes, and examined. After the FP reduction step, the average number of FPs per case was estimated to be 2.47 per DBT volume with a sensitivity of 83.3%. PMID:27274993

  6. Feasibility of Amorphous Selenium Based Photon Counting Detectors for Digital Breast Tomosynthesis

    Energy Technology Data Exchange (ETDEWEB)

    Chen, J.; O' Connor, P.; Lehnert, J., De Geronimo, G., Dolazza, E., Tousignant, O., Laperriere, L., Greenspan, J., Zhao, W.

    2009-02-27

    Amorphous selenium (a-Se) has been incorporated successfully in direct conversion flat panel x-ray detectors, and has demonstrated superior image quality in screening mammography and digital breast tomosynthesis (DBT) under energy integration mode. The present work explores the potential of a-Se for photon counting detectors in DBT. We investigated major factors contributing to the variation in the charge collected by a pixel upon absorption of each x-ray photon. These factors included x-ray photon interaction, detector geometry, charge transport, and the pulse shaping and noise properties of the photon counting readout circuit. Experimental measurements were performed on a linear array test structure constructed by evaporating an a-Se layer onto an array of 100 {mu}m pitch strip electrodes, which are connected to a 32 channel low noise photon counting integrated circuit. The measured pulse height spectrum (PHS) under polychromatic xray exposure was interpreted quantitatively using the factors identified. Based on the understanding of a-Se photon counting performance, design parameters were proposed for a 2D detector with high quantum efficiency and count rate that could meet the requirements of photon counting detector for DBT.

  7. Three-Dimensional Computer-Aided Detection of Microcalcification Clusters in Digital Breast Tomosynthesis

    Directory of Open Access Journals (Sweden)

    Ji-wook Jeong

    2016-01-01

    Full Text Available We propose computer-aided detection (CADe algorithm for microcalcification (MC clusters in reconstructed digital breast tomosynthesis (DBT images. The algorithm consists of prescreening, MC detection, clustering, and false-positive (FP reduction steps. The DBT images containing the MC-like objects were enhanced by a multiscale Hessian-based three-dimensional (3D objectness response function and a connected-component segmentation method was applied to extract the cluster seed objects as potential clustering centers of MCs. Secondly, a signal-to-noise ratio (SNR enhanced image was also generated to detect the individual MC candidates and prescreen the MC-like objects. Each cluster seed candidate was prescreened by counting neighboring individual MC candidates nearby the cluster seed object according to several microcalcification clustering criteria. As a second step, we introduced bounding boxes for the accepted seed candidate, clustered all the overlapping cubes, and examined. After the FP reduction step, the average number of FPs per case was estimated to be 2.47 per DBT volume with a sensitivity of 83.3%.

  8. Development of model observers applied to 3D breast tomosynthesis microcalcifications and masses

    Science.gov (United States)

    Diaz, Ivan; Timberg, Pontus; Zhang, Sheng; Abbey, Craig; Verdun, Francis; Bochud, François O.

    2011-03-01

    The development of model observers for mimicking human detection strategies has followed from symmetric signals in simple noise to increasingly complex backgrounds. In this study we implement different model observers for the complex task of detecting a signal in a 3D image stack. The backgrounds come from real breast tomosynthesis acquisitions and the signals were simulated and reconstructed within the volume. Two different tasks relevant to the early detection of breast cancer were considered: detecting an 8 mm mass and detecting a cluster of microcalcifications. The model observers were calculated using a channelized Hotelling observer (CHO) with dense difference-of-Gaussian channels, and a modified (Partial prewhitening [PPW]) observer which was adapted to realistic signals which are not circularly symmetric. The sustained temporal sensitivity function was used to filter the images before applying the spatial templates. For a frame rate of five frames per second, the only CHO that we calculated performed worse than the humans in a 4-AFC experiment. The other observers were variations of PPW and outperformed human observers in every single case. This initial frame rate was a rather low speed and the temporal filtering did not affect the results compared to a data set with no human temporal effects taken into account. We subsequently investigated two higher speeds at 5, 15 and 30 frames per second. We observed that for large masses, the two types of model observers investigated outperformed the human observers and would be suitable with the appropriate addition of internal noise. However, for microcalcifications both only the PPW observer consistently outperformed the humans. The study demonstrated the possibility of using a model observer which takes into account the temporal effects of scrolling through an image stack while being able to effectively detect a range of mass sizes and distributions.

  9. Digital breast tomosynthesis: application of 2D digital mammography CAD to detection of microcalcification clusters on planar projection image

    Science.gov (United States)

    Samala, Ravi K.; Chan, Heang-Ping; Lu, Yao; Hadjiiski, Lubomir; Wei, Jun; Helvie, Mark

    2015-03-01

    Computer-aided detection (CAD) has the potential to aid radiologists in detection of microcalcification clusters (MCs). CAD for digital breast tomosynthesis (DBT) can be developed by using the reconstructed volume, the projection views or other derivatives as input. We have developed a novel method of generating a single planar projection (PPJ) image from a regularized DBT volume to emphasize the high contrast objects such as microcalcifications while removing the anatomical background and noise. In this work, we adapted a CAD system developed for digital mammography (CADDM) to the PPJ image and compared its performance with our CAD system developed for DBT volumes (CADDBT) in the same set of cases. For microcalcification detection in the PPJ image using the CADDM system, the background removal preprocessing step designed for DM was not needed. The other methods and processing steps in the CADDM system were kept without modification while the parameters were optimized with a training set. The linear discriminant analysis classifier using cluster based features was retrained to generate a discriminant score to be used as decision variable. For view-based FROC analysis, at 80% sensitivity, an FP rate of 1.95/volume and 1.54/image were achieved, respectively, for CADDBT and CADDM in an independent test set. At a threshold of 1.2 FPs per image or per DBT volume, the nonparametric analysis of the area under the FROC curve shows that the optimized CADDM for PPJ is significantly better than CADDBT. However, the performance of CADDM drops at higher sensitivity or FP rate, resulting in similar overall performance between the two CAD systems. The higher sensitivity of the CADDM in the low FP rate region and vice versa for the CADDBT indicate that a joint CAD system combining detection in the DBT volume and the PPJ image has the potential to increase the sensitivity and reduce the FP rate.

  10. Computer-aided detection of clustered microcalcifications in multiscale bilateral filtering regularized reconstructed digital breast tomosynthesis volume

    Energy Technology Data Exchange (ETDEWEB)

    Samala, Ravi K., E-mail: rsamala@umich.edu; Chan, Heang-Ping; Lu, Yao; Hadjiiski, Lubomir; Wei, Jun; Helvie, Mark A. [Department of Radiology, University of Michigan, Ann Arbor, Michigan 48109-5842 (United States); Sahiner, Berkman [Center for Devices and Radiological Health, U.S. Food and Drug Administration, Maryland 20993 (United States)

    2014-02-15

    Purpose: Develop a computer-aided detection (CADe) system for clustered microcalcifications in digital breast tomosynthesis (DBT) volume enhanced with multiscale bilateral filtering (MSBF) regularization. Methods: With Institutional Review Board approval and written informed consent, two-view DBT of 154 breasts, of which 116 had biopsy-proven microcalcification (MC) clusters and 38 were free of MCs, was imaged with a General Electric GEN2 prototype DBT system. The DBT volumes were reconstructed with MSBF-regularized simultaneous algebraic reconstruction technique (SART) that was designed to enhance MCs and reduce background noise while preserving the quality of other tissue structures. The contrast-to-noise ratio (CNR) of MCs was further improved with enhancement-modulated calcification response (EMCR) preprocessing, which combined multiscale Hessian response to enhance MCs by shape and bandpass filtering to remove the low-frequency structured background. MC candidates were then located in the EMCR volume using iterative thresholding and segmented by adaptive region growing. Two sets of potential MC objects, cluster centroid objects and MC seed objects, were generated and the CNR of each object was calculated. The number of candidates in each set was controlled based on the breast volume. Dynamic clustering around the centroid objects grouped the MC candidates to form clusters. Adaptive criteria were designed to reduce false positive (FP) clusters based on the size, CNR values and the number of MCs in the cluster, cluster shape, and cluster based maximum intensity projection. Free-response receiver operating characteristic (FROC) and jackknife alternative FROC (JAFROC) analyses were used to assess the performance and compare with that of a previous study. Results: Unpaired two-tailedt-test showed a significant increase (p < 0.0001) in the ratio of CNRs for MCs with and without MSBF regularization compared to similar ratios for FPs. For view-based detection, a

  11. Computer-aided detection of clustered microcalcifications in multiscale bilateral filtering regularized reconstructed digital breast tomosynthesis volume

    International Nuclear Information System (INIS)

    Purpose: Develop a computer-aided detection (CADe) system for clustered microcalcifications in digital breast tomosynthesis (DBT) volume enhanced with multiscale bilateral filtering (MSBF) regularization. Methods: With Institutional Review Board approval and written informed consent, two-view DBT of 154 breasts, of which 116 had biopsy-proven microcalcification (MC) clusters and 38 were free of MCs, was imaged with a General Electric GEN2 prototype DBT system. The DBT volumes were reconstructed with MSBF-regularized simultaneous algebraic reconstruction technique (SART) that was designed to enhance MCs and reduce background noise while preserving the quality of other tissue structures. The contrast-to-noise ratio (CNR) of MCs was further improved with enhancement-modulated calcification response (EMCR) preprocessing, which combined multiscale Hessian response to enhance MCs by shape and bandpass filtering to remove the low-frequency structured background. MC candidates were then located in the EMCR volume using iterative thresholding and segmented by adaptive region growing. Two sets of potential MC objects, cluster centroid objects and MC seed objects, were generated and the CNR of each object was calculated. The number of candidates in each set was controlled based on the breast volume. Dynamic clustering around the centroid objects grouped the MC candidates to form clusters. Adaptive criteria were designed to reduce false positive (FP) clusters based on the size, CNR values and the number of MCs in the cluster, cluster shape, and cluster based maximum intensity projection. Free-response receiver operating characteristic (FROC) and jackknife alternative FROC (JAFROC) analyses were used to assess the performance and compare with that of a previous study. Results: Unpaired two-tailedt-test showed a significant increase (p < 0.0001) in the ratio of CNRs for MCs with and without MSBF regularization compared to similar ratios for FPs. For view-based detection, a

  12. Dosimetric characterization and organ dose assessment in digital breast tomosynthesis: Measurements and Monte Carlo simulations using voxel phantoms

    Energy Technology Data Exchange (ETDEWEB)

    Baptista, Mariana, E-mail: marianabaptista@ctn.ist.utl.pt; Di Maria, Salvatore; Barros, Sílvia; Vaz, Pedro [Centro de Ciências e Tecnologias Nucleares, Instituto Superior Técnico, Universidade de Lisboa, Estrada Nacional 10, km 139,7, Bobadela LRS 2695-066 (Portugal); Figueira, Catarina [Centre for Plasma Physics, School of Mathematics and Physics, Queen’s University, Belfast BT7 1NN (United Kingdom); Sarmento, Marta; Orvalho, Lurdes [Serviço de Imagiologia, Hospital da Luz, Avenida Lusíada, 100, Lisboa 1500-650 (Portugal)

    2015-07-15

    Purpose: Due to its capability to more accurately detect deep lesions inside the breast by removing the effect of overlying anatomy, digital breast tomosynthesis (DBT) has the potential to replace the standard mammography technique in clinical screening exams. However, the European Guidelines for DBT dosimetry are still a work in progress and there are little data available on organ doses other than to the breast. It is, therefore, of great importance to assess the dosimetric performance of DBT with respect to the one obtained with standard digital mammography (DM) systems. The aim of this work is twofold: (i) to study the dosimetric properties of a combined DBT/DM system (MAMMOMAT Inspiration Siemens{sup ®}) for a tungsten/rhodium (W/Rh) anode/filter combination and (ii) to evaluate organs doses during a DBT examination. Methods: For the first task, measurements were performed in manual and automatic exposure control (AEC) modes, using two homogeneous breast phantoms: a PMMA slab phantom and a 4 cm thick breast-shaped rigid phantom, with 50% of glandular tissue in its composition. Monte Carlo (MC) simulations were performed using Monte Carlo N-Particle eXtended v.2.7.0. A MC model was implemented to mimic DM and DBT acquisitions for a wide range of x-ray spectra (24 –34 kV). This was used to calculate mean glandular dose (MGD) and to compute series of backscatter factors (BSFs) that could be inserted into the DBT dosimetric formalism proposed by Dance et al. Regarding the second aim of the study, the implemented MC model of the clinical equipment, together with a female voxel phantom (“Laura”), was used to calculate organ doses considering a typical DBT acquisition. Results were compared with a standard two-view mammography craniocaudal (CC) acquisition. Results: Considering the AEC mode, the acquisition of a single CC view results in a MGD ranging from 0.53 ± 0.07 mGy to 2.41 ± 0.31 mGy in DM mode and from 0.77 ± 0.11 mGy to 2.28 ± 0.32 mGy in DBT mode

  13. Evaluation of digital breast tomosynthesis reconstruction algorithms using synchrotron radiation in standard geometry

    Energy Technology Data Exchange (ETDEWEB)

    Bliznakova, K.; Kolitsi, Z.; Speller, R. D.; Horrocks, J. A.; Tromba, G.; Pallikarakis, N. [Department of Medical Physics, School of Medicine, University of Patras, Rio, Patras GR-26500 (Greece); Department of Medical Physics and Bioengineering, University College London, London WC1E 6BT (United Kingdom); Clinical Physics Group, St. Bartholomew' s Hospital, Barts and the London NHS Trust, London EC1A 7BE (United Kingdom); ELETTRA, Basovizza, Trieste I-34012 (Italy); Department of Medical Physics, School of Medicine, University of Patras, Rio, Patras GR-26500 (Greece)

    2010-04-15

    Purpose: In this article, the image quality of reconstructed volumes by four algorithms for digital tomosynthesis, applied in the case of breast, is investigated using synchrotron radiation. Methods: An angular data set of 21 images of a complex phantom with heterogeneous tissue-mimicking background was obtained using the SYRMEP beamline at ELETTRA Synchrotron Light Laboratory, Trieste, Italy. The irradiated part was reconstructed using the multiple projection algorithm (MPA) and the filtered backprojection with ramp followed by hamming windows (FBR-RH) and filtered backprojection with ramp (FBP-R). Additionally, an algorithm for reducing the noise in reconstructed planes based on noise mask subtraction from the planes of the originally reconstructed volume using MPA (MPA-NM) has been further developed. The reconstruction techniques were evaluated in terms of calculations and comparison of the contrast-to-noise ratio (CNR) and artifact spread function. Results: It was found that the MPA-NM resulted in higher CNR, comparable with the CNR of FBP-RH for high contrast details. Low contrast objects are well visualized and characterized by high CNR using the simple MPA and the MPA-NM. In addition, the image quality of the reconstructed features in terms of CNR and visual appearance as a function of the initial number of projection images and the reconstruction arc was carried out. Slices reconstructed with more input projection images result in less reconstruction artifacts and higher detail CNR, while those reconstructed from projection images acquired in reduced angular range causes pronounced streak artifacts. Conclusions: Of the reconstruction algorithms implemented, the MPA-NM and MPA are a good choice for detecting low contrast objects, while the FBP-RH, FBP-R, and MPA-NM provide high CNR and well outlined edges in case of microcalcifications.

  14. Two complementary model observers to evaluate reconstructions of simulated micro-calcifications in digital breast tomosynthesis

    Science.gov (United States)

    Michielsen, Koen; Zanca, Federica; Marshall, Nicholas; Bosmans, Hilde; Nuyts, Johan

    2013-03-01

    New imaging modalities need to be properly evaluated before being introduced in clinical practice. The gold standard is to perform clinical trials or dedicated clinical performance related observer experiments with experienced readers. Unfortunately this is not feasible during development or optimization of new reconstruction algorithms due to their many degrees of freedom. Our goal is to design a set of model observers to evaluate the performance of newly developed reconstruction methods on the assessment of micro-calcifications in digital breast tomosynthesis. In order to do so, the model observers need to evaluate both detection and classification of micro-calcifications. A channelized Hotelling observer was created for the detection task and a Hotelling observer working on an extracted feature vector was implemented for the classification task. These observers were evaluated on their ability to predict the results of human observers. Results from a previous observer study were used as reference to compare performance between human and model observers. This study evaluated detection of small micro-calcifications (100 { 200 _m) by a free search task in a power law filtered noise background and classification of two types of larger micro-calcifications (200 {600 _m) in the same background. Scores from the free search study were evaluated using the weighted JAFROC method and the classification scores were analyzed using the DBM MRMC method. The same analysis methods were applied to the model observer scores. Results of the detection model observer were related linearly with the human observer results with a correlation coefficient of 0.962. The correlation coefficient for the classification task was 0.959 with a power law non-linear regression.

  15. Detection of microcalcification clusters by 2D-mammography and narrow and wide angle digital breast tomosynthesis

    Science.gov (United States)

    Hadjipanteli, Andria; Elangovan, Premkumar; Looney, Padraig T.; Mackenzie, Alistair; Wells, Kevin; Dance, David R.; Young, Kenneth C.

    2016-03-01

    The aim of this study was to compare the detection of microcalcification clusters by human observers in breast images using 2D-mammography and narrow (15°/15 projections) and wide (50°/25 projections) angle digital breast tomosynthesis (DBT). Simulated microcalcification clusters with a range of microcalcification diameters (125 μm-275 μm) were inserted into 6 cm thick simulated compressed breasts. Breast images were produced with and without inserted microcalcification clusters using a set of image modelling tools, which were developed to represent clinical imaging by mammography and tomosynthesis. Commercially available software was used for image processing and image reconstruction. The images were then used in a series of 4-alternative forced choice (4AFC) human observer experiments conducted for signal detection with the microcalcification clusters as targets. The minimum detectable calcification diameter was found for each imaging modality: (i) 2D-mammography: 164+/-5 μm (ii) narrow angle DBT: 210+/-5 μm, (iii) wide angle DBT: 255+/-4 μm. A statistically significant difference was found between the minimum detectable calcification diameters that can be detected by the three imaging modalities. Furthermore, it was found that there was not a statistically significant difference between the results of the five observers that participated in this study. In conclusion, this study presents a method that quantifies the threshold diameter required for microcalcification detection, using high resolution, realistic images with observers, for the comparison of DBT geometries with 2D-mammography. 2Dmammography can visualise smaller detail diameter than both DBT imaging modalities and narrow-angle DBT can visualise a smaller detail diameter than wide-angle DBT.

  16. Digital breast tomosynthesis (DBT) to characterize MRI-detected additional lesions unidentified at targeted ultrasound in newly diagnosed breast cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Mariscotti, Giovanna; Durando, Manuela; Regini, Elisa; Fornari, Alberto; Fonio, Paolo; Gandini, Giovanni [Breast Imaging Service, Radiology - University of Turin, Department of Diagnostic Imaging and Radiotherapy, A.O.U. Citta della Salute e della Scienza, Torino (Italy); Houssami, Nehmat [University of Sydney, Screening and Test Evaluation Program, School of Public Health, Sydney Medical School, Sydney, NSW (Australia); Campanino, Pier Paolo [Ospedale Koelliker, Breast Imaging Service, Torino (Italy); Bussone, Riccardo [A.O.U. Citta della Salute e della Scienza of Turin, SSCVD Breast Surgery. Department of Surgery, Torino (Italy); Castellano, Isabella; Sapino, Anna [University of Turin, Department of Biomedical Sciences and Human Oncology, A.O.U. Citta della Salute e della Scienza, Torino (Italy)

    2015-09-15

    Preoperative breast magnetic resonance (MR) often generates additional suspicious findings needing further investigations. Targeted breast ultrasound (US) is the standard tool to characterize MR additional lesions. The purpose of this study is to evaluate the potential role of digital breast tomosynthesis (DBT) to characterize MR detected additional findings, unidentified at targeted breast US. This prospective study included women who a) had biopsy-proven, newly diagnosed breast cancers detected at conventional 2D mammography and/or US, referred to breast MR for tumour staging; and b) had DBT if additional MR findings were not detected at targeted ('second look') US. In 520 patients, MR identified 164 (in 114 women, 22 %) additional enhancing lesions. Targeted US identified 114/164 (69.5 %) of these, whereas 50/164 (30.5 %) remained unidentified. DBT identified 32/50 of these cases, increasing the overall characterization of MR detected additional findings to 89.0 % (146/164). Using DBT the identified lesions were significantly more likely to be malignant than benign MR-detected additional lesions (p = 0.04). DBT improves the characterization of additional MR findings not identified at targeted breast US in preoperative breast cancer staging. (orig.)

  17. Digital breast tomosynthesis: studies of the effects of acquisition geometry on contrast-to-noise ratio and observer preference of low-contrast objects in breast phantom images

    International Nuclear Information System (INIS)

    The effect of acquisition geometry in digital breast tomosynthesis was evaluated with studies of contrast-to-noise ratios (CNRs) and observer preference. Contrast-detail (CD) test objects in 5 cm thick phantoms with breast-like backgrounds were imaged. Twelve different angular acquisitions (average glandular dose for each ∼1.1 mGy) were performed ranging from narrow angle 16° with 17 projection views (16d17p) to wide angle 64d17p. Focal slices of SART-reconstructed images of the CD arrays were selected for CNR computations and the reader preference study. For the latter, pairs of images obtained with different acquisition geometries were randomized and scored by 7 trained readers. The total scores for all images and readings for each acquisition geometry were compared as were the CNRs. In general, readers preferred images acquired with wide angle as opposed to narrow angle geometries. The mean percent preferred was highly correlated with tomosynthesis angle (R = 0.91). The highest scoring geometries were 60d21p (95%), 64d17p (80%), and 48d17p (72%); the lowest scoring were 16d17p (4%), 24d9p (17%) and 24d13p (33%). The measured CNRs for the various acquisitions showed much overlap but were overall highest for wide-angle acquisitions. Finally, the mean reader scores were well correlated with the mean CNRs (R = 0.83). (paper)

  18. The accuracy of digital breast tomosynthesis compared with coned compression magnification mammography in the assessment of abnormalities found on mammography

    International Nuclear Information System (INIS)

    Aim: To compare the diagnostic accuracy of the digital breast tomosynthesis (DBT) with coned compression magnification mammography (CCMM). Materials and methods: The study design included two reading sessions completed by seven experienced radiologists. In the first session, all readers read bilateral standard two-view mammograms and a CCMM view of the lesion before giving a combined score for assessment. In the second session, readers read bilateral standard two-view mammograms plus one-view DBT. The two reading sessions of the experiment were separated by at least 2 weeks to reduce the chance of reader memory of the images read in the previous session from influencing the performance in the subsequent session. Results: Three hundred and fifty-four lesions were assessed and receiver-operative characteristic (ROC) analysis was used to evaluate the difference between the two modes. For standard two-view mammography plus CCMM, the area under the curve (AUC) was 0.87 [95% confidence interval (CI): 0.83–0.91] and for standard two-view mammography plus DBT the AUC was 0.93 (95% CI: 0.91–0.95). The difference between the AUCs was 0.06 with p-value of 0.0014. Conclusion: Two-view mammography with one-view DBT showed significantly improved accuracy compared to two-view mammography and CCMM in the assessment of mammographic abnormalities. These results show that DBT can be used effectively in the further evaluation of mammographic abnormalities found at screening and in symptomatic diagnostic practice. - Highlights: • Diagnostic accuracy of magnification mammography and digital breast tomosynthesis. • There is statistical difference between CCMM and DBT. • DBT has a role in evaluating mammographic abnormalities

  19. 50 μm pixel pitch wafer-scale CMOS active pixel sensor x-ray detector for digital breast tomosynthesis

    Science.gov (United States)

    Zhao, C.; Konstantinidis, A. C.; Zheng, Y.; Anaxagoras, T.; Speller, R. D.; Kanicki, J.

    2015-12-01

    Wafer-scale CMOS active pixel sensors (APSs) have been developed recently for x-ray imaging applications. The small pixel pitch and low noise are very promising properties for medical imaging applications such as digital breast tomosynthesis (DBT). In this work, we evaluated experimentally and through modeling the imaging properties of a 50 μm pixel pitch CMOS APS x-ray detector named DynAMITe (Dynamic Range Adjustable for Medical Imaging Technology). A modified cascaded system model was developed for CMOS APS x-ray detectors by taking into account the device nonlinear signal and noise properties. The imaging properties such as modulation transfer function (MTF), noise power spectrum (NPS), and detective quantum efficiency (DQE) were extracted from both measurements and the nonlinear cascaded system analysis. The results show that the DynAMITe x-ray detector achieves a high spatial resolution of 10 mm-1 and a DQE of around 0.5 at spatial frequencies  microcalcifications at various mean glandular dose (MGD). For an average breast (5 cm thickness, 50% glandular fraction), 165 μm microcalcifications can be distinguished at a MGD of 27% lower than the clinical value (~1.3 mGy). To detect 100 μm microcalcifications, further optimizations of the CMOS APS x-ray detector, image aquisition geometry and image reconstruction techniques should be considered.

  20. Visibility of microcalcification clusters and masses in breast tomosynthesis image volumes and digital mammography: A 4AFC human observer study

    Energy Technology Data Exchange (ETDEWEB)

    Timberg, P.; Baath, M.; Andersson, I.; Mattsson, S.; Tingberg, A.; Ruschin, M. [Medical Radiation Physics, Department of Clinical Sciences Malmoe, Lund University, Skaane University Hospital, SE-205 02 Malmoe (Sweden); Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, SE-413 45 Gothenburg (Sweden) and Department of Radiation Physics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, SE-413 45 Gothenburg (Sweden); Department of Clinical Sciences Malmoe, Lund University, Skaane University Hospital, SE-205 02 Malmoe (Sweden); Medical Radiation Physics, Department of Clinical Sciences Malmoe, Lund University, Skaane University Hospital, SE-205 02 Malmoe (Sweden); Medical Radiation Physics, Department of Clinical Sciences Malmoe, Lund University, Skaane University Hospital, SE-205 02 Malmoe (Sweden) and Department of Radiation Physics, Skaane University Hospital, Malmoe, SE-205 02 Malmoe (Sweden); Radiation Medicine Program, Princess Margaret Hospital, University Health Network, Toronto, Ontario M5G 2M9 (Canada)

    2012-05-15

    Purpose: To investigate the visibility of simulated lesions in digital breast tomosynthesis (BT) image volumes compared with 2D digital mammography (DM). Methods: Simulated lesions (masses and microcalcifications) were added to images of the same women acquired on a DM system (Mammomat Novation, Siemens) and a BT prototype. The same beam quality was used for the DM and BT acquisitions. The total absorbed dose resulting from a 25-projection BT acquisition and reconstruction (BT{sub 25}) was approximately twice that of a single DM view. By excluding every other projection image from the reconstruction (BT{sub 13}), approximately the same dose as in DM was effected. Simulated microcalcifications were digitally added with varying contrast to the DM and BT images. Simulated masses with 8 mm diameter were also added to BT images. A series of 4-alternative forced choice (4AFC) human observer experiments were conducted. Four medical physicists participated in all experiments, each consisting of 60 trials per experimental condition. The observers interpreted the BT image volumes in cine-mode at a fixed image sequence speed. The required threshold contrast (S{sub t}) to achieve a detectability index (d') of 2.5 (i.e., 92.5% correct decisions) was determined. Results: The S{sub t} for mass detection in DM was approximately a factor of 2 higher than required in BT indicating that the detection of masses was improved under BT conditions compared to DM. S{sub t} for microcalcification detection was higher for BT than for DM at both BT dose levels (BT{sub 25} and BT{sub 13}), with a statistically significant difference in S{sub t} between DM and BT{sub 13}. These results indicate a dose-dependent decrease in detection performance in BT for detection of microcalcifications. Conclusions: In agreement with previous investigations, masses of size 8 mm can be detected with less contrast in BT than in DM indicating improved detection performance for BT. However, for the

  1. An experimental study of the scatter correction by using a beam-stop-array algorithm with digital breast tomosynthesis

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ye-Seul; Park, Hye-Suk; Kim, Hee-Joung [Yonsei University, Wonju (Korea, Republic of); Choi, Young-Wook; Choi, Jae-Gu [Korea Electrotechnology Research Institute, Ansan (Korea, Republic of)

    2014-12-15

    Digital breast tomosynthesis (DBT) is a technique that was developed to overcome the limitations of conventional digital mammography by reconstructing slices through the breast from projections acquired at different angles. In developing and optimizing DBT, The x-ray scatter reduction technique remains a significant challenge due to projection geometry and radiation dose limitations. The most common approach to scatter reduction is a beam-stop-array (BSA) algorithm; however, this method raises concerns regarding the additional exposure involved in acquiring the scatter distribution. The compressed breast is roughly symmetric, and the scatter profiles from projections acquired at axially opposite angles are similar to mirror images. The purpose of this study was to apply the BSA algorithm with only two scans with a beam stop array, which estimates the scatter distribution with minimum additional exposure. The results of the scatter correction with angular interpolation were comparable to those of the scatter correction with all scatter distributions at each angle. The exposure increase was less than 13%. This study demonstrated the influence of the scatter correction obtained by using the BSA algorithm with minimum exposure, which indicates its potential for practical applications.

  2. Changes in frequency of recall recommendations of examinations depicting cancer with the availability of either priors or digital breast tomosynthesis

    Science.gov (United States)

    Hakim, Christiane M.; Bandos, Andriy I.; Ganott, Marie A.; Catullo, Victor J.; Chough, Denise M.; Kelly, Amy E.; Shinde, Dilip D.; Sumkin, Jules H.; Wallace, Luisa P.; Nishikawa, Robert M.; Gur, David

    2016-03-01

    Performance changes in a binary environment when using additional information is affected only when changes in recommendations are made due to the additional information in question. In a recent study, we have shown that, contrary to general expectation, introducing prior examinations improved recall rates, but not sensitivity. In this study, we assessed cancer detection differences when prior examinations and/or digital breast tomosynthesis (DBT) were made available to the radiologist. We identified a subset of 21 cancer cases with differences in the number of radiologists who recalled these cases after reviewing either a prior examination or DBT. For the cases with differences in recommendations after viewing either priors or DBT, separately, we evaluated the total number of readers that changed their recommendations, regardless of the specific radiologist in question. Confidence intervals for the number of readers and a test for the hypothesis of no difference was performed using the non-parameteric bootstrap approach addressing both case and reader-related sources of variability by resampling cases and readers. With the addition of priors, there were 14 cancer cases (out of 15) where the number of "recalling radiologists" decreased. With the addition of DBT, the number of "recalling radiologists" decreased in only five cases (out of 15) while increasing in the remaining 9 cases. Unlike most new approaches to breast imaging DBT seems to improve both recall rates and cancer detection rates. Changes in recommendations were noted by all radiologists for all cancers by type, size, and breast density.

  3. Identification of error making patterns in lesion detection on digital breast tomosynthesis using computer-extracted image features

    Science.gov (United States)

    Wang, Mengyu; Zhang, Jing; Grimm, Lars J.; Ghate, Sujata V.; Walsh, Ruth; Johnson, Karen S.; Lo, Joseph Y.; Mazurowski, Maciej A.

    2016-03-01

    Digital breast tomosynthesis (DBT) can improve lesion visibility by eliminating the issue of overlapping breast tissue present in mammography. However, this new modality likely requires new approaches to training. The issue of training in DBT is not well explored. We propose a computer-aided educational approach for DBT training. Our hypothesis is that the trainees' educational outcomes will improve if they are presented with cases individually selected to address their weaknesses. In this study, we focus on the question of how to select such cases. Specifically, we propose an algorithm that based on previously acquired reading data predicts which lesions will be missed by the trainee for future cases (i.e., we focus on false negative error). A logistic regression classifier was used to predict the likelihood of trainee error and computer-extracted features were used as the predictors. Reader data from 3 expert breast imagers was used to establish the ground truth and reader data from 5 radiology trainees was used to evaluate the algorithm performance with repeated holdout cross validation. Receiver operating characteristic (ROC) analysis was applied to measure the performance of the proposed individual trainee models. The preliminary experimental results for 5 trainees showed the individual trainee models were able to distinguish the lesions that would be detected from those that would be missed with the average area under the ROC curve of 0.639 (95% CI, 0.580-0.698). The proposed algorithm can be used to identify difficult cases for individual trainees.

  4. Combination of one-view digital breast tomosynthesis with one-view digital mammography versus standard two-view digital mammography: per lesion analysis

    Energy Technology Data Exchange (ETDEWEB)

    Gennaro, Gisella; Bezzon, Elisabetta; Pescarini, Luigi; Polico, Ilaria; Proietti, Alessandro; Baldan, Enrica; Pomerri, Fabio; Muzzio, Pier Carlo [Veneto Institute of Oncology (IRCCS), Padua (Italy); Hendrick, R.E. [University of Colorado-Denver, Department of Radiology, School of Medicine, Aurora, CO (United States); Toledano, Alicia [Biostatistics Consulting, LLC, Kensington, MD (United States); Paquelet, Jean R. [Advanced Medical Imaging Consultants, Fort Collins, CO (United States); Breast Imaging, McKee Medical Center, Loveland, CO (United States); Chersevani, Roberta [Private Medical Practice, Gorizia (Italy); Di Maggio, Cosimo [Private Medical Practice, Padua (Italy); La Grassa, Manuela [Department of Radiology, Oncological Reference Center (IRCCS), Aviano (Italy)

    2013-08-15

    To evaluate the clinical value of combining one-view mammography (cranio-caudal, CC) with the complementary view tomosynthesis (mediolateral-oblique, MLO) in comparison to standard two-view mammography (MX) in terms of both lesion detection and characterization. A free-response receiver operating characteristic (FROC) experiment was conducted independently by six breast radiologists, obtaining data from 463 breasts of 250 patients. Differences in mean lesion detection fraction (LDF) and mean lesion characterization fraction (LCF) were analysed by analysis of variance (ANOVA) to compare clinical performance of the combination of techniques to standard two-view digital mammography. The 463 cases (breasts) reviewed included 258 with one to three lesions each, and 205 with no lesions. The 258 cases with lesions included 77 cancers in 68 breasts and 271 benign lesions to give a total of 348 proven lesions. The combination, DBT{sub (MLO)}+MX{sub (CC)}, was superior to MX (CC+MLO) in both lesion detection (LDF) and lesion characterization (LCF) overall and for benign lesions. DBT{sub (MLO)}+MX{sub (CC)} was non-inferior to two-view MX for malignant lesions. This study shows that readers' capabilities in detecting and characterizing breast lesions are improved by combining single-view digital breast tomosynthesis and single-view mammography compared to two-view digital mammography. (orig.)

  5. Combination of one-view digital breast tomosynthesis with one-view digital mammography versus standard two-view digital mammography: per lesion analysis

    International Nuclear Information System (INIS)

    To evaluate the clinical value of combining one-view mammography (cranio-caudal, CC) with the complementary view tomosynthesis (mediolateral-oblique, MLO) in comparison to standard two-view mammography (MX) in terms of both lesion detection and characterization. A free-response receiver operating characteristic (FROC) experiment was conducted independently by six breast radiologists, obtaining data from 463 breasts of 250 patients. Differences in mean lesion detection fraction (LDF) and mean lesion characterization fraction (LCF) were analysed by analysis of variance (ANOVA) to compare clinical performance of the combination of techniques to standard two-view digital mammography. The 463 cases (breasts) reviewed included 258 with one to three lesions each, and 205 with no lesions. The 258 cases with lesions included 77 cancers in 68 breasts and 271 benign lesions to give a total of 348 proven lesions. The combination, DBT(MLO)+MX(CC), was superior to MX (CC+MLO) in both lesion detection (LDF) and lesion characterization (LCF) overall and for benign lesions. DBT(MLO)+MX(CC) was non-inferior to two-view MX for malignant lesions. This study shows that readers' capabilities in detecting and characterizing breast lesions are improved by combining single-view digital breast tomosynthesis and single-view mammography compared to two-view digital mammography. (orig.)

  6. Amorphous In–Ga–Zn–O thin-film transistor active pixel sensor x-ray imager for digital breast tomosynthesis

    Energy Technology Data Exchange (ETDEWEB)

    Zhao, Chumin; Kanicki, Jerzy, E-mail: kanicki@eecs.umich.edu [Solid-State Electronic Laboratory, Department of Electrical Engineering and Computer Science, University of Michigan, Ann Arbor, Michigan 48109 (United States)

    2014-09-15

    Purpose: The breast cancer detection rate for digital breast tomosynthesis (DBT) is limited by the x-ray image quality. The limiting Nyquist frequency for current DBT systems is around 5 lp/mm, while the fine image details contained in the high spatial frequency region (>5 lp/mm) are lost. Also today the tomosynthesis patient dose is high (0.67–3.52 mGy). To address current issues, in this paper, for the first time, a high-resolution low-dose organic photodetector/amorphous In–Ga–Zn–O thin-film transistor (a-IGZO TFT) active pixel sensor (APS) x-ray imager is proposed for next generation DBT systems. Methods: The indirect x-ray detector is based on a combination of a novel low-cost organic photodiode (OPD) and a cesium iodide-based (CsI:Tl) scintillator. The proposed APS x-ray imager overcomes the difficulty of weak signal detection, when small pixel size and low exposure conditions are used, by an on-pixel signal amplification with a significant charge gain. The electrical performance of a-IGZO TFT APS pixel circuit is investigated by SPICE simulation using modified Rensselaer Polytechnic Institute amorphous silicon (a-Si:H) TFT model. Finally, the noise, detective quantum efficiency (DQE), and resolvability of the complete system are modeled using the cascaded system formalism. Results: The result demonstrates that a large charge gain of 31–122 is achieved for the proposed high-mobility (5–20 cm{sup 2}/V s) amorphous metal-oxide TFT APS. The charge gain is sufficient to eliminate the TFT thermal noise, flicker noise as well as the external readout circuit noise. Moreover, the low TFT (<10{sup −13} A) and OPD (<10{sup −8} A/cm{sup 2}) leakage currents can further reduce the APS noise. Cascaded system analysis shows that the proposed APS imager with a 75 μm pixel pitch can effectively resolve the Nyquist frequency of 6.67 lp/mm, which can be further improved to ∼10 lp/mm if the pixel pitch is reduced to 50 μm. Moreover, the

  7. Improvement of image performance in digital breast tomosynthesis (DBT) by incorporating a compressed-sensing (CS)-based deblurring scheme

    Science.gov (United States)

    Kim, Kyuseok; Park, Yeonok; Cho, Heemoon; Cho, Hyosung; Je, Uikyu; Park, Chulkyu; Lim, Hyunwoo; Park, Soyoung; Woo, Taeho; Choi, Sungil

    2016-10-01

    In this work, we investigated a compressed-sensing (CS)-based deblurring scheme incorporated with the total-variation (TV) regularization penalty for image deblurring of high accuracy and adopted it into the image reconstruction in conventional digital breast tomosynthesis (DBT). We implemented the proposed algorithm and performed a systematic simulation to demonstrate its viability for improving the image performance in DBT as well as two-dimensional (2D) mammography. In the simulation, blurred noisy projection images of a 3D numerical breast phantom were generated by convolving their original (or exact) version by a designed 2D Gaussian filter kernel (standard deviation=2 in pixel unit, kernel size=11×11), followed by adding Gaussian noise (mean=0, variance=0.05), and deblurred by using the algorithm before performing the DBT reconstruction procedure. Here the projection images were taken with a half tomographic angle of θ=20° and an angle step of Δθ=2°. We investigated the image performance of the reconstructed DBT images quantitatively in terms of the modulation and the slice-sensitive profile (SSP).

  8. Characterization of masses in digital breast tomosynthesis: Comparison of machine learning in projection views and reconstructed slices

    International Nuclear Information System (INIS)

    Purpose: In digital breast tomosynthesis (DBT), quasi-three-dimensional (3D) structural information is reconstructed from a small number of 2D projection view (PV) mammograms acquired over a limited angular range. The authors developed preliminary computer-aided diagnosis (CADx) methods for classification of malignant and benign masses and compared the effectiveness of analyzing lesion characteristics in the reconstructed DBT slices and in the PVs. Methods: A data set of MLO view DBT of 99 patients containing 107 masses (56 malignant and 51 benign) was collected at the Massachusetts General Hospital with IRB approval. The DBTs were obtained with a GE prototype system which acquired 11 PVs over a 50 deg. arc. The authors reconstructed the DBTs at 1 mm slice interval using a simultaneous algebraic reconstruction technique. The region of interest (ROI) containing the mass was marked by a radiologist in the DBT volume and the corresponding ROIs on the PVs were derived based on the imaging geometry. The subsequent processes were fully automated. For classification of masses using the DBT-slice approach, the mass on each slice was segmented by an active contour model initialized with adaptive k-means clustering. A spiculation likelihood map was generated by analysis of the gradient directions around the mass margin and spiculation features were extracted from the map. The rubber band straightening transform (RBST) was applied to a band of pixels around the segmented mass boundary. The RBST image was enhanced by Sobel filtering in the horizontal and vertical directions, from which run-length statistics texture features were extracted. Morphological features including those from the normalized radial length were designed to describe the mass shape. A feature space composed of the spiculation features, texture features, and morphological features extracted from the central slice alone and seven feature spaces obtained by averaging the corresponding features from three to 19

  9. Large area CMOS active pixel sensor x-ray imager for digital breast tomosynthesis: Analysis, modeling, and characterization

    Energy Technology Data Exchange (ETDEWEB)

    Zhao, Chumin; Kanicki, Jerzy, E-mail: kanicki@eecs.umich.edu [Solid-State Electronics Laboratory, Department of Electrical Engineering and Computer Science, University of Michigan, Ann Arbor, Michigan 48109 (United States); Konstantinidis, Anastasios C. [Department of Medical Physics and Biomedical Engineering, University College London, London WC1E 6BT, United Kingdom and Diagnostic Radiology and Radiation Protection, Christie Medical Physics and Engineering, The Christie NHS Foundation Trust, Manchester M20 4BX (United Kingdom); Patel, Tushita [Department of Physics, University of Virginia, Charlottesville, Virginia 22908 (United States)

    2015-11-15

    Purpose: Large area x-ray imagers based on complementary metal-oxide-semiconductor (CMOS) active pixel sensor (APS) technology have been proposed for various medical imaging applications including digital breast tomosynthesis (DBT). The low electronic noise (50–300 e{sup −}) of CMOS APS x-ray imagers provides a possible route to shrink the pixel pitch to smaller than 75 μm for microcalcification detection and possible reduction of the DBT mean glandular dose (MGD). Methods: In this study, imaging performance of a large area (29 × 23 cm{sup 2}) CMOS APS x-ray imager [Dexela 2923 MAM (PerkinElmer, London)] with a pixel pitch of 75 μm was characterized and modeled. The authors developed a cascaded system model for CMOS APS x-ray imagers using both a broadband x-ray radiation and monochromatic synchrotron radiation. The experimental data including modulation transfer function, noise power spectrum, and detective quantum efficiency (DQE) were theoretically described using the proposed cascaded system model with satisfactory consistency to experimental results. Both high full well and low full well (LFW) modes of the Dexela 2923 MAM CMOS APS x-ray imager were characterized and modeled. The cascaded system analysis results were further used to extract the contrast-to-noise ratio (CNR) for microcalcifications with sizes of 165–400 μm at various MGDs. The impact of electronic noise on CNR was also evaluated. Results: The LFW mode shows better DQE at low air kerma (K{sub a} < 10 μGy) and should be used for DBT. At current DBT applications, air kerma (K{sub a} ∼ 10 μGy, broadband radiation of 28 kVp), DQE of more than 0.7 and ∼0.3 was achieved using the LFW mode at spatial frequency of 0.5 line pairs per millimeter (lp/mm) and Nyquist frequency ∼6.7 lp/mm, respectively. It is shown that microcalcifications of 165–400 μm in size can be resolved using a MGD range of 0.3–1 mGy, respectively. In comparison to a General Electric GEN2 prototype DBT system (at

  10. Performance comparison of single-view digital breast tomosynthesis plus single-view digital mammography with two-view digital mammography

    International Nuclear Information System (INIS)

    To determine the performance of combined single-view mediolateral oblique (MLO) digital breast tomosynthesis (DBT) plus single-view cranio-caudal (CC) mammography (MX) compared with that of standard two-view digital mammography. A multi-reader multi-case (MRMC) receiver-operating characteristic (ROC) study was conducted, involving six breast radiologists. Two hundred fifty patients underwent bilateral MX and DBT imaging. MX and DBT images with the adjunct of the CC-MX view from 469 breasts were evaluated and rated independently by six readers. Differences in mean areas under the ROC curves (AUCs), mean sensitivity and mean specificity were analysed by analysis of variance (ANOVA) to assess clinical performance. The combined technique was found to be non-inferior to standard two-view mammography (MX(CC+MLO)) in mean AUC (difference: +0.021;95 % LCL = -0.011), but was not statistically significant for superiority (P = 0.197). The combined technique had equivalent sensitivity to standard mammography (76.2 % vs. 72.8 %, P = 0.269) and equivalent specificity (84.9 % vs. 83.0 %, P = 0.130). Specificity for benign lesions was significantly higher with the combination of techniques versus mammography (45.6 % vs. 36.8 %, P = 0.002). In this enriched study population, the combination of single-view MLO tomosynthesis plus single-view CC mammography was non-inferior to that of standard two-view digital mammography in terms of ROC curve area, sensitivity and specificity. circle Breast tomosynthesis (DBT) has emerged as a valuable adjunct to mammography (MX). (orig.)

  11. Performance comparison of single-view digital breast tomosynthesis plus single-view digital mammography with two-view digital mammography

    Energy Technology Data Exchange (ETDEWEB)

    Gennaro, Gisella; Pescarini, Luigi; Polico, Ilaria; Proietti, Alessandro; Baldan, Enrica; Bezzon, Elisabetta; Pomerri, Fabio; Muzzio, Pier Carlo [Veneto Institute of Oncology (IOV)-IRCCS, Padua (Italy); Hendrick, R.E. [University of Colorado-Denver, School of Medicine, Department of Radiology, Aurora, CO (United States); Ruppel, Patricia [Innovative Analytics, Kalamazoo, MI (United States); Chersevani, Roberta [Private Clinical Practice, Gorizia (Italy); Di Maggio, Cosimo [Private Clinical Practice, Padua (Italy); La Grassa, Manuela [Oncological Reference Center (CRO)-IRCCS, Aviano, (Pordenone) (Italy)

    2013-03-15

    To determine the performance of combined single-view mediolateral oblique (MLO) digital breast tomosynthesis (DBT) plus single-view cranio-caudal (CC) mammography (MX) compared with that of standard two-view digital mammography. A multi-reader multi-case (MRMC) receiver-operating characteristic (ROC) study was conducted, involving six breast radiologists. Two hundred fifty patients underwent bilateral MX and DBT imaging. MX and DBT images with the adjunct of the CC-MX view from 469 breasts were evaluated and rated independently by six readers. Differences in mean areas under the ROC curves (AUCs), mean sensitivity and mean specificity were analysed by analysis of variance (ANOVA) to assess clinical performance. The combined technique was found to be non-inferior to standard two-view mammography (MX{sub (CC+MLO)}) in mean AUC (difference: +0.021;95 % LCL = -0.011), but was not statistically significant for superiority (P = 0.197). The combined technique had equivalent sensitivity to standard mammography (76.2 % vs. 72.8 %, P = 0.269) and equivalent specificity (84.9 % vs. 83.0 %, P = 0.130). Specificity for benign lesions was significantly higher with the combination of techniques versus mammography (45.6 % vs. 36.8 %, P = 0.002). In this enriched study population, the combination of single-view MLO tomosynthesis plus single-view CC mammography was non-inferior to that of standard two-view digital mammography in terms of ROC curve area, sensitivity and specificity. circle Breast tomosynthesis (DBT) has emerged as a valuable adjunct to mammography (MX). (orig.)

  12. 50 μm pixel pitch wafer-scale CMOS active pixel sensor x-ray detector for digital breast tomosynthesis

    International Nuclear Information System (INIS)

    Wafer-scale CMOS active pixel sensors (APSs) have been developed recently for x-ray imaging applications. The small pixel pitch and low noise are very promising properties for medical imaging applications such as digital breast tomosynthesis (DBT). In this work, we evaluated experimentally and through modeling the imaging properties of a 50 μm pixel pitch CMOS APS x-ray detector named DynAMITe (Dynamic Range Adjustable for Medical Imaging Technology). A modified cascaded system model was developed for CMOS APS x-ray detectors by taking into account the device nonlinear signal and noise properties. The imaging properties such as modulation transfer function (MTF), noise power spectrum (NPS), and detective quantum efficiency (DQE) were extracted from both measurements and the nonlinear cascaded system analysis. The results show that the DynAMITe x-ray detector achieves a high spatial resolution of 10 mm−1 and a DQE of around 0.5 at spatial frequencies  <1 mm−1. In addition, the modeling results were used to calculate the image signal-to-noise ratio (SNRi) of microcalcifications at various mean glandular dose (MGD). For an average breast (5 cm thickness, 50% glandular fraction), 165 μm microcalcifications can be distinguished at a MGD of 27% lower than the clinical value (∼1.3 mGy). To detect 100 μm microcalcifications, further optimizations of the CMOS APS x-ray detector, image aquisition geometry and image reconstruction techniques should be considered. (paper)

  13. Optimizing viewing procedures of breast tomosynthesis image volumes using eye tracking combined with a free response human observer study

    Science.gov (United States)

    Lång, Kristina; Zackrisson, Sophia; Holmqvist, Kenneth; Nystrom, Marcus; Andersson, Ingvar; Förnvik, Daniel; Tingberg, Anders; Timberg, Pontus

    2011-03-01

    The purpose of this study was to evaluate four different viewing procedures as part of improving viewing conditions of breast tomosynthesis (BT) image volumes. The procedures consisted of free scroll volume browsing, and a combination of initial cine loops at three different frame rates (9, 14 and 25 fps) terminated upon request followed by free scroll volume browsing. Fifty-five normal BT image volumes in MLO view were collected. In these, simulated lesions (20 masses and 20 clusters of microcalcifications) were randomly inserted, creating four unique image sets for each procedure. Four readers interpreted the cases in a random order. Their task was to locate a lesion, mark and assign a five level confidence scale. The diagnostic accuracy was analyzed using Jackknife Free Receiver Operating Characteristics (JAFROC). Time efficiency and visual search behavior were also investigated using eye tracking. The results indicate that there was no statistically significant difference in JAFROC FOM between the different viewing procedures, however the medium cine loop speed seemed to be the preferred viewing procedure in terms of total analyze time and dwell time.

  14. X-ray induced formation of γ-H2AX foci after full-field digital mammography and digital breast-tomosynthesis.

    Directory of Open Access Journals (Sweden)

    Siegfried A Schwab

    Full Text Available PURPOSE: To determine in-vivo formation of x-ray induced γ-H2AX foci in systemic blood lymphocytes of patients undergoing full-field digital mammography (FFDM and to estimate foci after FFDM and digital breast-tomosynthesis (DBT using a biological phantom model. MATERIALS AND METHODS: The study complies with the Declaration of Helsinki and was performed following approval by the ethic committee of the University of Erlangen-Nuremberg. Written informed consent was obtained from every patient. For in-vivo tests, systemic blood lymphocytes were obtained from 20 patients before and after FFDM. In order to compare in-vivo post-exposure with pre-exposure foci levels, the Wilcoxon matched pairs test was used. For in-vitro experiments, isolated blood lymphocytes from healthy volunteers were irradiated at skin and glandular level of a porcine breast using FFDM and DBT. Cells were stained against the phosphorylated histone variant γ-H2AX, and foci representing distinct DNA damages were quantified. RESULTS: Median in-vivo foci level/cell was 0.086 (range 0.067-0.116 before and 0.094 (0.076-0.126 after FFDM (p = 0.0004. In the in-vitro model, the median x-ray induced foci level/cell after FFDM was 0.120 (range 0.086-0.140 at skin level and 0.035 (range 0.030-0.050 at glandular level. After DBT, the median x-ray induced foci level/cell was 0.061 (range 0.040-0.081 at skin level and 0.015 (range 0.006-0.020 at glandular level. CONCLUSION: In patients, mammography induces a slight but significant increase of γ-H2AX foci in systemic blood lymphocytes. The introduced biological phantom model is suitable for the estimation of x-ray induced DNA damages in breast tissue in different breast imaging techniques.

  15. A comparison of the accuracy of film-screen mammography, full-field digital mammography, and digital breast tomosynthesis

    International Nuclear Information System (INIS)

    Aim: To measure the change in diagnostic accuracy of conventional film-screen mammography and full-field digital mammography (FFDM) with the addition of digital breast tomosynthesis (DBT) in women recalled for assessment following routine screening. Materials and methods: Ethics approval for the study was granted. Women recalled for assessment following routine screening with screen-film mammography were invited to participate. Participants underwent bilateral, two-view FFDM and two-view DBT. Readers scored each lesion separately for probability of malignancy on screen-film mammography, FFDM, and then DBT. The scores were compared with the presence or absence of malignancy based on the final histopathology outcome. Results: Seven hundred and thirty-eight women participated (93.2% recruitment rate). Following assessment 204 (26.8%) were diagnosed as malignant (147 invasive and 57 in-situ tumours), 286 (37.68%) as benign, and 269 (35.4%) as normal. The diagnostic accuracy was evaluated by using receiving operating characteristic (ROC) and measurement of area under the curve (AUC). The AUC values demonstrated a significant (p = 0.0001) improvement in the diagnostic accuracy with the addition of DBT combined with FFDM and film-screen mammography (AUC = 0.9671) when compared to FFDM plus film-screen mammography (AUC = 0.8949) and film-screen mammography alone (AUC = 0.7882). The effect was significantly greater for soft-tissue lesions [AUC was 0.9905 with the addition of DBT and AUC was 0.9201 for FFDM with film-screen mammography combined (p = 0.0001)] compared to microcalcification [with the addition of DBT (AUC = 0.7920) and for FFDM with film-screen mammography combined (AUC = 0.7843; p = 0.3182)]. Conclusion: The addition of DBT increases the accuracy of mammography compared to FFDM and film-screen mammography combined and film-screen mammography alone in the assessment of screen-detected soft-tissue mammographic abnormalities.

  16. Comparative evaluation of average glandular dose and breast cancer detection between single-view digital breast tomosynthesis (DBT) plus single-view digital mammography (DM) and two-view DM: correlation with breast thickness and density

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Sung Ui; Chang, Jung Min; Bae, Min Sun; Lee, Su Hyun; Cho, Nariya; Seo, Mirinae; Kim, Won Hwa; Moon, Woo Kyung [Seoul National University Hospital, Department of Radiology, Seoul (Korea, Republic of)

    2015-01-15

    To compare the average glandular dose (AGD) and diagnostic performance of mediolateral oblique (MLO) digital breast tomosynthesis (DBT) plus cranio-caudal (CC) digital mammography (DM) with two-view DM, and to evaluate the correlation of AGD with breast thickness and density. MLO and CC DM and DBT images of both breasts were obtained in 149 subjects. AGDs of DBT and DM per exposure were recorded, and their correlation with breast thickness and density were evaluated. Paired data of MLO DBT plus CC DM and two-view DM were reviewed for presence of malignancy in a jack-knife alternative free-response ROC (JAFROC) method. The AGDs of both DBT and DM, and differences in AGD between DBT and DM (ΔAGD), were correlated with breast thickness and density. The average JAFROC figure of merit (FOM) was significantly higher on the combined technique than two-view DM (P = 0.005). In dense breasts, the FOM and sensitivity of the combined technique was higher than that of two-view DM (P = 0.003) with small ΔAGD. MLO DBT plus CC DM provided higher diagnostic performance than two-view DM in dense breasts with a small increase in AGD. (orig.)

  17. Ranking inconsistencies in the assessment of digital breast tomosynthesis (DBT) reconstruction algorithms using a location-known task and a search task

    Science.gov (United States)

    He, Xin; Zeng, Rongping; Samuelson, Frank; Sahiner, Berkman

    2016-03-01

    In this work, we validated a task-based performance figure-of-merit (FOM) by investigating ranking inconsistencies due to lurking variable/factors. We applied a falsifiable search assessment theory to assessing digital breast tomosynthesis (DBT) image quality using a scanning channelized Hotelling observer (CHO) on a simulated DBT dataset. We compared the performance of five reconstruction algorithms: filter back projection (FBP), maximum likelihood (ML), simultaneous algebraic reconstruction technique (SART), total-variation regularized least square estimator (TVLS) with strong and mild regularization settings. The results showed that the location-known-exactly (LKE) detection performance was almost identical for the five reconstruction algorithms. However the search characteristic as described by effective set size (M*) and search AUC value, ranked them differently. To falsify/corroborate our evaluations on search characteristic and performance, we conducted an image-size test. This test demonstrated an agreement between theoretical predictions and empirically measured observer performance in absolute performance levels, except for the ML algorithm. We concluded that evidence corroborated our evaluations, except that for the ML algorithm where our evaluation was wrong. Further investigation of the wrong evaluation in the ML case revealed a lurking variable that affected system performance ranking in search when AUC value was used as the FOM. This further confirmed that our evaluation in its current form for the ML algorithm was indeed wrong. We also noted that the ranking inconsistencies exist even when the AUC value was used as the FOM, and the falsifiable nature of M* allowed such inconsistencies to be identified.

  18. Multichannel response analysis on 2D projection views for detection of clustered microcalcifications in digital breast tomosynthesis

    Energy Technology Data Exchange (ETDEWEB)

    Wei, Jun, E-mail: jvwei@umich.edu; Chan, Heang-Ping; Hadjiiski, Lubomir M.; Helvie, Mark A.; Lu, Yao; Zhou, Chuan; Samala, Ravi [Department of Radiology, University of Michigan, Ann Arbor, Michigan 48109-5842 (United States)

    2014-04-15

    Purpose: To investigate the feasibility of a new two-dimensional (2D) multichannel response (MCR) analysis approach for the detection of clustered microcalcifications (MCs) in digital breast tomosynthesis (DBT). Methods: With IRB approval and informed consent, a data set of two-view DBTs from 42 breasts containing biopsy-proven MC clusters was collected in this study. The authors developed a 2D approach for MC detection using projection view (PV) images rather than the reconstructed three-dimensional (3D) DBT volume. Signal-to-noise ratio (SNR) enhancement processing was first applied to each PV to enhance the potential MCs. The locations of MC candidates were then identified with iterative thresholding. The individual MCs were decomposed with Hermite–Gaussian (HG) and Laguerre–Gaussian (LG) basis functions and the channelized Hotelling model was trained to produce the MCRs for each MC on the 2D images. The MCRs from the PVs were fused in 3D by a coincidence counting method that backprojects the MC candidates on the PVs and traces the coincidence of their ray paths in 3D. The 3D MCR was used to differentiate the true MCs from false positives (FPs). Finally a dynamic clustering method was used to identify the potential MC clusters in the DBT volume based on the fact that true MCs of clinical significance appear in clusters. Using two-fold cross validation, the performance of the 3D MCR for classification of true and false MCs was estimated by the area under the receiver operating characteristic (ROC) curve and the overall performance of the MCR approach for detection of clustered MCs was assessed by free response receiver operating characteristic (FROC) analysis. Results: When the HG basis function was used for MCR analysis, the detection of MC cluster achieved case-based test sensitivities of 80% and 90% at the average FP rates of 0.65 and 1.55 FPs per DBT volume, respectively. With LG basis function, the average FP rates were 0.62 and 1.57 per DBT volume at

  19. Synchrotron based planar imaging and digital tomosynthesis of breast and biopsy phantoms using a CMOS active pixel sensor.

    Science.gov (United States)

    Szafraniec, Magdalena B; Konstantinidis, Anastasios C; Tromba, Giuliana; Dreossi, Diego; Vecchio, Sara; Rigon, Luigi; Sodini, Nicola; Naday, Steve; Gunn, Spencer; McArthur, Alan; Olivo, Alessandro

    2015-03-01

    The SYRMEP (SYnchrotron Radiation for MEdical Physics) beamline at Elettra is performing the first mammography study on human patients using free-space propagation phase contrast imaging. The stricter spatial resolution requirements of this method currently force the use of conventional films or specialized computed radiography (CR) systems. This also prevents the implementation of three-dimensional (3D) approaches. This paper explores the use of an X-ray detector based on complementary metal-oxide-semiconductor (CMOS) active pixel sensor (APS) technology as a possible alternative, for acquisitions both in planar and tomosynthesis geometry. Results indicate higher quality of the images acquired with the synchrotron set-up in both geometries. This improvement can be partly ascribed to the use of parallel, collimated and monochromatic synchrotron radiation (resulting in scatter rejection, no penumbra-induced blurring and optimized X-ray energy), and partly to phase contrast effects. Even though the pixel size of the used detector is still too large - and thus suboptimal - for free-space propagation phase contrast imaging, a degree of phase-induced edge enhancement can clearly be observed in the images. PMID:25498332

  20. X-ray digital intra-oral tomosynthesis for quasi-three-dimensional imaging: system, reconstruction algorithm, and experiments

    Science.gov (United States)

    Li, Liang; Chen, Zhiqiang; Zhao, Ziran; Wu, Dufan

    2013-01-01

    At present, there are mainly three x-ray imaging modalities for dental clinical diagnosis: radiography, panorama and computed tomography (CT). We develop a new x-ray digital intra-oral tomosynthesis (IDT) system for quasi-three-dimensional dental imaging which can be seen as an intermediate modality between traditional radiography and CT. In addition to normal x-ray tube and digital sensor used in intra-oral radiography, IDT has a specially designed mechanical device to complete the tomosynthesis data acquisition. During the scanning, the measurement geometry is such that the sensor is stationary inside the patient's mouth and the x-ray tube moves along an arc trajectory with respect to the intra-oral sensor. Therefore, the projection geometry can be obtained without any other reference objects, which makes it be easily accepted in clinical applications. We also present a compressed sensing-based iterative reconstruction algorithm for this kind of intra-oral tomosynthesis. Finally, simulation and experiment were both carried out to evaluate this intra-oral imaging modality and algorithm. The results show that IDT has its potentiality to become a new tool for dental clinical diagnosis.

  1. Application of a computed tomography based cystic fibrosis scoring system to chest tomosynthesis

    Science.gov (United States)

    Söderman, Christina; Johnsson, Åse; Vikgren, Jenny; Rystedt, Hans; Ivarsson, Jonas; Rossi Norrlund, Rauni; Nyberg Andersson, Lena; Bâth, Magnus

    2013-03-01

    In the monitoring of progression of lung disease in patients with cystic fibrosis (CF), recurrent computed tomography (CT) examinations are often used. The relatively new imaging technique chest tomosynthesis (CTS) may be an interesting alternative in the follow-up of these patients due to its visualization of the chest in slices at radiation doses and costs significantly lower than is the case with CT. A first step towards introducing CTS imaging in the diagnostics of CF patients is to establish a scoring system appropriate for evaluating the severity of CF pulmonary disease based on findings in CTS images. Previously, several such CF scoring systems based on CT imaging have been published. The purpose of the present study was to develop a CF scoring system for CTS, by starting from an existing scoring system dedicated for CT images and making modifications regarded necessary to make it appropriate for use with CTS images. In order to determine any necessary changes, three thoracic radiologists independently used a scoring system dedicated for CT on both CT and CTS images from CF patients. The results of the scoring were jointly evaluated by all the observers, which lead to suggestions for changes to the scoring system. Suggested modifications include excluding the scoring of air trapping and doing the scoring of the findings in quadrants of the image instead of in each lung lobe.

  2. Automatic segmentation of mammogram and tomosynthesis images

    Science.gov (United States)

    Sargent, Dusty; Park, Sun Young

    2016-03-01

    Breast cancer is a one of the most common forms of cancer in terms of new cases and deaths both in the United States and worldwide. However, the survival rate with breast cancer is high if it is detected and treated before it spreads to other parts of the body. The most common screening methods for breast cancer are mammography and digital tomosynthesis, which involve acquiring X-ray images of the breasts that are interpreted by radiologists. The work described in this paper is aimed at optimizing the presentation of mammography and tomosynthesis images to the radiologist, thereby improving the early detection rate of breast cancer and the resulting patient outcomes. Breast cancer tissue has greater density than normal breast tissue, and appears as dense white image regions that are asymmetrical between the breasts. These irregularities are easily seen if the breast images are aligned and viewed side-by-side. However, since the breasts are imaged separately during mammography, the images may be poorly centered and aligned relative to each other, and may not properly focus on the tissue area. Similarly, although a full three dimensional reconstruction can be created from digital tomosynthesis images, the same centering and alignment issues can occur for digital tomosynthesis. Thus, a preprocessing algorithm that aligns the breasts for easy side-by-side comparison has the potential to greatly increase the speed and accuracy of mammogram reading. Likewise, the same preprocessing can improve the results of automatic tissue classification algorithms for mammography. In this paper, we present an automated segmentation algorithm for mammogram and tomosynthesis images that aims to improve the speed and accuracy of breast cancer screening by mitigating the above mentioned problems. Our algorithm uses information in the DICOM header to facilitate preprocessing, and incorporates anatomical region segmentation and contour analysis, along with a hidden Markov model (HMM) for

  3. Evolution of Imaging in Breast Cancer.

    Science.gov (United States)

    Garcia, Evelyn M; Crowley, James; Hagan, Catherine; Atkinson, Lisa L

    2016-06-01

    The following topics are discussed in this article. A historical review of the evolution of breast cancer imaging from thermography through digital breast tomosynthesis, molecular breast imaging, and advanced breast magnetic resonance imaging. Discussion of multiple clinical trials, their strengths, and weaknesses. Historical perspective on the Mammography Quality Standards Act and its relationship with development and implementation of the Breast Imaging-Reporting and Data System (BI-RADS). PMID:27029017

  4. Comparative study of patient doses calculated with two methods for breast digital tomosynthesis; Estudio de los valores de dosis a pacientes en examenes de tomosintesis de mama estimados con dos metodos distintos

    Energy Technology Data Exchange (ETDEWEB)

    Castillo, M.; Chevalier, M.; Calzado, A.; Garayo, J.; Valverde, J.

    2015-07-01

    In this study, the average glandular doses (DG) delivered in breast tomosynthesis examinations were estimated over a sample of 150 patients using two different methods. In method 1, the conversion factors air-kerma to DG used were those tabulated by Dance et al. and in method 2 were the ones from Feng et al. The protocol for the examination followed in the unit of this study consists in two views per breast, each view composed by a 2D acquisition and a tomosynthesis scan (3D). The resulting DG values from both methods present statistically significant differences (p=0.02) for the 2D modality and were similar for the 3D scan (p=0.22). The estimated median value of DG for the most frequent breasts (thicknesses between 50 and 60 mm) delivered in a single 3D acquisition is 1.7 mGy (36% and 17% higher than the value for the 2D mode estimated with each method) which lies far below the tolerances established by the Spanish Protocol Quality Control in Radiodiagnostic (2011). The total DG for a tomosynthesis examination (6.0 mGy) is a factor 2.4 higher than the dose delivered in a 2D examination with two views (method 1). (Author)

  5. Task-based performance analysis of FBP, SART and ML for digital breast tomosynthesis using signal CNR and Channelised Hotelling Observers.

    Science.gov (United States)

    Van de Sompel, Dominique; Brady, Sir Michael; Boone, John

    2011-02-01

    We assess the performance of filtered backprojection (FBP), the simultaneous algebraic reconstruction technique (SART) and the maximum likelihood (ML) algorithm for digital breast tomosynthesis (DBT) under variations in key imaging parameters, including the number of iterations, number of projections, angular range, initial guess, and radiation dose. This is the first study to compare these algorithms for the application of DBT. We present a methodology for the evaluation of DBT reconstructions, and use it to conduct preliminary experiments investigating trade-offs between the selected imaging parameters. This investigation includes trade-offs not previously considered in the DBT literature, such as the use of a stationary detector versus a C-arm imaging geometry. A real breast CT volume serves as a ground truth digital phantom from which to simulate X-ray projections under the various acquisition parameters. The reconstructed image quality is measured using task-based metrics, namely signal CNR and the AUC of a Channelised Hotelling Observer with Laguerre-Gauss basis functions. The task at hand is the detection of a simulated mass inserted into the breast CT volume. We find that the image quality in limited view tomography is highly dependent on the particular acquisition and reconstruction parameters used. In particular, we draw the following conclusions. First, we find that optimising the FBP filter design and SART relaxation parameter yields significant improvements in reconstruction quality from the same projection data. Second, we show that the convergence rate of the maximum likelihood algorithm, optimised with paraboloidal surrogates and conjugate gradient ascent (ML-PSCG), can be greatly accelerated using view-by-view updates. Third, we find that the optimal initial guess is algorithm dependent. In particular, we obtained best results with a zero initial guess for SART, and an FBP initial guess for ML-PSCG. Fourth, when the exposure per view is constant

  6. Can horizontally oriented breast tomosynthesis image volumes or the use of a systematic search strategy improve interpretation? An eye tracking and free response human observer study

    Science.gov (United States)

    Lång, Kristina; Zackrisson, Sophia; Holmqvist, Kenneth; Nyström, Marcus; Andersson, Ingvar; Förnvik, Daniel; Tingberg, Anders; Timberg, Pontus

    2011-03-01

    Our aim was to evaluate if there is a benefit in diagnostic accuracy and efficiency of viewing breast tomosynthesis (BT) image volumes presented horizontally oriented, but also to evaluate the use of a systematic search strategy where the breast is divided, and analyzed consecutively, into two sections. These image presentations were compared to regular vertical image presentation. All methods were investigated using viewing procedures consisting of free scroll volume browsing, and a combination of initial cine loops at three different frame rates (9, 14, 25 fps) terminated upon request followed by free scroll volume browsing if needed. Fifty-five normal BT image volumes in MLO view were collected. In these, simulated lesions (20 masses and 20 clusters of microcalcifications) were randomly inserted, creating four unique image sets for each procedure. Four readers interpreted the cases in a random order. Their task was to locate the lesions, mark and assign a five level confidence scale. The diagnostic accuracy was analyzed using Jackknife Free Receiver Operating Characteristics (JAFROC). Time efficiency and visual search behavior were also investigated using eye tracking. Results indicate there was no statistically significant difference in JAFROC FOM between the different image presentations, although visual search was more time efficient when viewing horizontally oriented image volumes in medium cine loops.

  7. Breast cancer screening using tomosynthesis in combination with digital mammography compared to digital mammography alone: a cohort study within the PROSPR consortium.

    Science.gov (United States)

    Conant, Emily F; Beaber, Elisabeth F; Sprague, Brian L; Herschorn, Sally D; Weaver, Donald L; Onega, Tracy; Tosteson, Anna N A; McCarthy, Anne Marie; Poplack, Steven P; Haas, Jennifer S; Armstrong, Katrina; Schnall, Mitchell D; Barlow, William E

    2016-02-01

    Digital breast tomosynthesis (DBT) is emerging as the new standard of care for breast cancer screening based on improved cancer detection coupled with reductions in recall compared to screening with digital mammography (DM) alone. However, many prior studies lack follow-up data to assess false negatives examinations. The purpose of this study is to assess if DBT is associated with improved screening outcomes based on follow-up data from tumor registries or pathology. Retrospective analysis of prospective cohort data from three research centers performing DBT screening in the PROSPR consortium from 2011 to 2014 was performed. Recall and biopsy rates were assessed from 198,881 women age 40-74 years undergoing screening (142,883 DM and 55,998 DBT examinations). Cancer, cancer detection, and false negative rates and positive predictive values were assessed on examinations with one year of follow-up. Logistic regression was used to compare DBT to DM adjusting for research center, age, prior breast imaging, and breast density. There was a reduction in recall with DBT compared to DM (8.7 vs. 10.4 %, p < 0.0001), with adjusted OR = 0.68 (95 % CI = 0.65-0.71). DBT demonstrated a statistically significant increase in cancer detection over DM (5.9 vs. 4.4/1000 screened, adjusted OR = 1.45, 95 % CI = 1.12-1.88), an improvement in PPV1 (6.4 % for DBT vs. 4.1 % for DM, adjusted OR = 2.02, 95 % CI = 1.54-2.65), and no significant difference in false negative rates for DBT compared to DM (0.46 vs. 0.60/1000 screened, p = 0.347). Our data support implementation of DBT screening based on increased cancer detection, reduced recall, and no difference in false negative screening examinations. PMID:26931450

  8. Computer-aided detection of microcalcifications in digital breast tomosynthesis (DBT): a multichannel signal detection approach on projection views

    Science.gov (United States)

    Wei, Jun; Chan, Heang-Ping; Hadjiiski, Lubomir; Helvie, Mark A.; Zhou, Chuan; Lu, Yao

    2012-03-01

    DBT is one of the promising imaging modalities that may improve the sensitivity and specificity for breast cancer detection. We are developing a computer-aided detection (CADe) system for clustered microcalcifications (MC) in DBT. A data set of two-view DBTs from 42 breasts was collected with a GE prototype system. We investigated a 2D approach to MC detection using projection view (PV) images rather than reconstructed 3D DBT volume. Our 2D approach consisted of two major stages: 1) detecting individual MC candidates on each PV, and 2) correlating the MC candidates from the different PVs and detecting clusters in the breast volume. With the MC candidates detected by prescreening on PVs, a trained multi-channel (MCH) filter bank was used to extract signal response from each MC candidate. A ray-tracing process was performed to fuse the MCH responses and localize the MC candidates in 3D using the geometrical information of the DBT system. Potential MC clusters were then identified by dynamic clustering of the MCs in 3D. A two-fold cross-validation method was used to train and test the CADe system. The detection performance of clustered MCs was assessed by free receiver operating characteristic (FROC) analysis. It was found that the CADe system achieved a case-based sensitivity of 90% at an average false positive rate of 2.1 clusters per DBT volume. Our study demonstrated that the CADe system using 2D MCH filter bank is promising for detection of clustered MCs in DBT.

  9. Effect of postreconstruction filter strength on microcalcification detection at different imaging doses in digital breast tomosynthesis: human and model observer studies

    Science.gov (United States)

    Das, Mini; Connolly, Caitlin; Glick, Stephen J.; Gifford, Howard C.

    2012-03-01

    Improved visibility of microcalcifications (MCs) and masses in tomographic breast imaging is a major concern in the medical imaging community, with intense research activity considering both hardware and processing approaches to the problem. Much of the research involves digital breast tomosynthesis (DBT). In this paper, we present results of human-observer studies that investigated the effects of postreconstruction filter strength on MC detection in DBT images generated at various dose levels. The use of human observers poses severe limitations on objective-assessment studies involving multiple parameters and this paper also discusses our continued development of a visual-search mathematical model observer as a substitute for humans. In this work, DBT images were created using a rigorous computer simulation applied to realistic breast phantoms. Acquisitions with 0.7, 1.0 and 1.5 mGy doses were modeled and the Feldkamp FBP algorithm was used for reconstructions. A set of 3D Butterworth filters with cutoffs representing moderate (0.2 cycles/pixel, with pixel size = 100 microns) to no (0.5 cycles/pixel) postfiltering were tested. LROC studies were conducted with four observers. As expected, MC detectability fell off with reduced dose. At the same time, the best MC detection for a given dose was obtained with unfiltered images, suggesting that the increased noise levels associated with lower dose cannot be overcome with postfiltering. The model observer showed promising results in terms of agreement with the human observers. The causes for some points of disagreement merit examination.

  10. Oblique reconstructions in tomosynthesis. II. Super-resolution

    Energy Technology Data Exchange (ETDEWEB)

    Acciavatti, Raymond J.; Maidment, Andrew D. A. [Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania 19104-4206 (United States)

    2013-11-15

    Purpose: In tomosynthesis, super-resolution has been demonstrated using reconstruction planes parallel to the detector. Super-resolution allows for subpixel resolution relative to the detector. The purpose of this work is to develop an analytical model that generalizes super-resolution to oblique reconstruction planes.Methods: In a digital tomosynthesis system, a sinusoidal test object is modeled along oblique angles (i.e., “pitches”) relative to the plane of the detector in a 3D divergent-beam acquisition geometry. To investigate the potential for super-resolution, the input frequency is specified to be greater than the alias frequency of the detector. Reconstructions are evaluated in an oblique plane along the extent of the object using simple backprojection (SBP) and filtered backprojection (FBP). By comparing the amplitude of the reconstruction against the attenuation coefficient of the object at various frequencies, the modulation transfer function (MTF) is calculated to determine whether modulation is within detectable limits for super-resolution. For experimental validation of super-resolution, a goniometry stand was used to orient a bar pattern phantom along various pitches relative to the breast support in a commercial digital breast tomosynthesis system.Results: Using theoretical modeling, it is shown that a single projection image cannot resolve a sine input whose frequency exceeds the detector alias frequency. The high frequency input is correctly visualized in SBP or FBP reconstruction using a slice along the pitch of the object. The Fourier transform of this reconstructed slice is maximized at the input frequency as proof that the object is resolved. Consistent with the theoretical results, experimental images of a bar pattern phantom showed super-resolution in oblique reconstructions. At various pitches, the highest frequency with detectable modulation was determined by visual inspection of the bar patterns. The dependency of the highest

  11. Tomosynthesis-detected Architectural Distortion: Management Algorithm with Radiologic-Pathologic Correlation.

    Science.gov (United States)

    Durand, Melissa A; Wang, Steven; Hooley, Regina J; Raghu, Madhavi; Philpotts, Liane E

    2016-01-01

    As use of digital breast tomosynthesis becomes increasingly widespread, new management challenges are inevitable because tomosynthesis may reveal suspicious lesions not visible at conventional two-dimensional (2D) full-field digital mammography. Architectural distortion is a mammographic finding associated with a high positive predictive value for malignancy. It is detected more frequently at tomosynthesis than at 2D digital mammography and may even be occult at conventional 2D imaging. Few studies have focused on tomosynthesis-detected architectural distortions to date, and optimal management of these distortions has yet to be well defined. Since implementing tomosynthesis at our institution in 2011, we have learned some practical ways to assess architectural distortion. Because distortions may be subtle, tomosynthesis localization tools plus improved visualization of adjacent landmarks are crucial elements in guiding mammographic identification of elusive distortions. These same tools can guide more focused ultrasonography (US) of the breast, which facilitates detection and permits US-guided tissue sampling. Some distortions may be sonographically occult, in which case magnetic resonance imaging may be a reasonable option, both to increase diagnostic confidence and to provide a means for image-guided biopsy. As an alternative, tomosynthesis-guided biopsy, conventional stereotactic biopsy (when possible), or tomosynthesis-guided needle localization may be used to achieve tissue diagnosis. Practical uses for tomosynthesis in evaluation of architectural distortion are highlighted, potential complications are identified, and a working algorithm for management of tomosynthesis-detected architectural distortion is proposed. PMID:26963448

  12. Effects of projection-view distributions on image quality of calcifications in digital breast tomosynthesis (DBT) reconstruction

    Science.gov (United States)

    Lu, Yao; Chan, Heang-Ping; Goodsitt, Mitch; Wei, Jun; Hadjiiski, Lubomir; Schmitz, Andrea; Eberhard, Jeffrey W.; Claus, Bernhard E. H.

    2010-04-01

    We are investigating factors affecting the detection of microcalcifications in digital breast tomography (DBT). In this study, we analyzed the effects of projection-view (PV) distribution on spatial blurring of calcifications on the tomosynthesized slices (X-Y plane) and along the depth (Z) direction. DBT scans of a breast phantom with simulated microcalcifications were acquired with a GE prototype system at 21 angles in 3° increments over a +/-30° range. Six subsets of 11 PVs were selected from the full set to simulate DBT of different angular ranges and angular increments. SART was applied to each subset to reconstruct the DBT slices. The FWHMs of the line profiles of calcifications within their in-focus DBT slices and FWHMs of the inter-plane artifact spread function (ASF) in the Z-direction for the different PV distributions were compared. The results indicate that DBT acquired with a large angular range or a reasonable number of PVs at large angles yield superior ASF with smaller FWHM in the Z-direction. PV distributions with a narrow angular range have stronger inter-plane artifacts. In the X-Y focal planes, the effect of PV distributions on spatial blurring depends on the directions. The normalized line profiles of the calcifications reconstructed with the different PV distributions are similar in the X-direction. The differences in the FWHMs between the different PV distributions are less than half a pixel. In the Y-(x-ray tube motion) direction, the normalized line profiles of the calcifications reconstructed with DBT acquired with a narrow angular range or a reasonable number of PVs at small angles have less blurring in terms of smaller FWHMs of the line profiles. PV distributions with a wide angular range have stronger in-plane artifacts in the Y-direction. Further study is underway to compare different reconstruction techniques and parameters. The information will be useful for optimization of DBT for detection of microcalcifications.

  13. The value analysis and guidance of digital breast tomosynthesis for breast cancer scr eening and radical surgery breast augmentation surgery%数字乳腺断层摄影技术用于乳癌筛查的价值分析及对根治术后隆乳术的指导

    Institute of Scientific and Technical Information of China (English)

    蔡冬鹭; 蔡思清; 颜丽笙; 颜建湘

    2015-01-01

    目的:探讨数字乳腺断层摄影技术(digital breast tomosynthesis,DBT)在乳癌筛查及其根治术后隆乳术中的临床诊断价值。方法:对在我院进行检查的1837例女性资料进行分析,入院后采用数字乳腺断层摄影技术对其检测,分析数字乳腺断层摄影技术在乳腺癌中的检出率及其根治手术隆乳的指导,评价其对乳腺癌检出率的敏感度。结果:455例少量腺体型,BI-ARDS分类中117例1级,192例3级,76例2级;1051例多量腺体型,BI-ARDS分类中452例1级,319例3级,99例2级;194例致密性,BI-ARDS分类中71例3级,55例1级,44例2级;194例脂肪型,BI-ARDS分类中52例5级,36例3级;数字乳腺断层摄影技术中检出55例乳腺癌,患者年龄为(29~72)岁,检出率为2.99%(55/1837),其中4例间歇期癌。55例乳腺癌患者均手术治疗。数字乳腺断层摄影技术敏感度为93.22%(55/59)。对于确诊的55例患者均采用根治手术治疗,患者中53例治疗效果理想,治愈率为96.4%。结论:数字乳腺断层摄影技术在女性乳腺癌筛查中效果理想,检出率高,对于多量腺体型以及致密型乳腺可以联合其他方法进行筛查,并且这种方法对根治术后隆乳手术的指导有一定意义,值得推广使用。%Objective To explore the digital breast tomosynthesis(digital breast tomosynthesis,DBT) screening and diagnosis of breast augmentation surgery clinical value in its cure. Methods In our hospital examination were analyzed 1837 cases of women after admission digital breast tomosynthesis its detection, analysis,digital breast tomosynthesis in breast cancer detection rate of breast augmentation surgery and radical guide to evaluate the sensitivity of the detection rate of breast cancer. Results 455 cases a small amount of glandular type,BI-ARDS classification of 117 cases of grade 1 and grade 3 192 cases,76 cases of 2;1 051 cases of large

  14. Anatomical background and generalized detectability in tomosynthesis and cone-beam CT

    Energy Technology Data Exchange (ETDEWEB)

    Gang, G. J.; Tward, D. J.; Lee, J.; Siewerdsen, J. H. [Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Ontario M5G 2M9 (Canada); Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland 21205 (United States); Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, Maryland 21218 (United States); Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Ontario M5G 2M9 (Canada) and Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland 21205 (United States)

    2010-05-15

    Purpose: Anatomical background presents a major impediment to detectability in 2D radiography as well as 3D tomosynthesis and cone-beam CT (CBCT). This article incorporates theoretical and experimental analysis of anatomical background ''noise'' in cascaded systems analysis of 2D and 3D imaging performance to yield ''generalized'' metrics of noise-equivalent quanta (NEQ) and detectability index as a function of the orbital extent of the (circular arc) source-detector orbit. Methods: A physical phantom was designed based on principles of fractal self-similarity to exhibit power-law spectral density ({kappa}/f{sup {beta}}) comparable to various anatomical sites (e.g., breast and lung). Background power spectra [S{sub B}(f)] were computed as a function of source-detector orbital extent, including tomosynthesis ({approx}10 deg. - 180 deg.) and CBCT (180 deg. +fan to 360 deg.) under two acquisition schemes: (1) Constant angular separation between projections (variable dose) and (2) constant total number of projections (constant dose). The resulting S{sub B} was incorporated in the generalized NEQ, and detectability index was computed from 3D cascaded systems analysis for a variety of imaging tasks. Results: The phantom yielded power-law spectra within the expected spatial frequency range, quantifying the dependence of clutter magnitude ({kappa}) and correlation ({beta}) with increasing tomosynthesis angle. Incorporation of S{sub B} in the 3D NEQ provided a useful framework for analyzing the tradeoffs among anatomical, quantum, and electronic noise with dose and orbital extent. Distinct implications are posed for breast and chest tomosynthesis imaging system design--applications varying significantly in {kappa} and {beta}, and imaging task and, therefore, in optimal selection of orbital extent, number of projections, and dose. For example, low-frequency tasks (e.g., soft-tissue masses or nodules) tend to benefit from larger orbital

  15. Parallelizable 3D statistical reconstruction for C-arm tomosynthesis system

    Science.gov (United States)

    Wang, Beilei; Barner, Kenneth; Lee, Denny

    2005-04-01

    Clinical diagnosis and security detection tasks increasingly require 3D information which is difficult or impossible to obtain from 2D (two dimensional) radiographs. As a 3D (three dimensional) radiographic and non-destructive imaging technique, digital tomosynthesis is especially fit for cases where 3D information is required while a complete projection data is not available. Nowadays, FBP (filtered back projection) is extensively used in industry for its fast speed and simplicity. However, it is hard to deal with situations where only a limited number of projections from constrained directions are available, or the SNR (signal to noises ratio) of the projections is low. In order to deal with noise and take into account a priori information of the object, a statistical image reconstruction method is described based on the acquisition model of X-ray projections. We formulate a ML (maximum likelihood) function for this model and develop an ordered-subsets iterative algorithm to estimate the unknown attenuation of the object. Simulations show that satisfied results can be obtained after 1 to 2 iterations, and after that there is no significant improvement of the image quality. An adaptive wiener filter is also applied to the reconstructed image to remove its noise. Some approximations to speed up the reconstruction computation are also considered. Applying this method to computer generated projections of a revised Shepp phantom and true projections from diagnostic radiographs of a patient"s hand and mammography images yields reconstructions with impressive quality. Parallel programming is also implemented and tested. The quality of the reconstructed object is conserved, while the computation time is considerably reduced by almost the number of threads used.

  16. Synchrotron based planar imaging and digital tomosynthesis of breast and biopsy phantoms using a CMOS active pixel sensor

    OpenAIRE

    Szafraniec, M. B.; Konstantinidis, A. C.; Tromba, G.; Dreossi, D.; S. Vecchio; Rigon, L.; Sodini, N.; Naday, S.; Gunn, S.; McArthur, A.; Olivo, A.

    2015-01-01

    The SYRMEP (SYnchrotron Radiation for MEdical Physics) beamline at Elettra is performing the first mammography study on human patients using free-space propagation phase contrast imaging. The stricter spatial resolution requirements of this method currently force the use of conventional films or specialized computed radiography (CR) systems. This also prevents the implementation of three-dimensional (3D) approaches. This paper explores the use of an X-ray detector based on complementary metal...

  17. TOMOGRAPHIC MAMMOGRAPHY AND TOMOSYNTHESIS USING OPENGL

    Directory of Open Access Journals (Sweden)

    S. A. Zolotarev

    2016-01-01

    Full Text Available Computed tomography is still being intensively studied and widely used to solve a number of industrial and medical applications. The simultaneous algebraic reconstruction technique (SART and Bayesian inference reconstruction (BIR are considered as advantageous iteration methods that are most suitable for improving the quality of the reconstructed 3D-images. The paper deals with the parallel iterative algorithms to ensure the reconstruction of threedimensional images of the breast, recovered from a limited set of noisy X-ray projections. Algebraic method of reconstruction with simultaneous iterations – SART and iterative method for statistical reconstruction of BIR are deemed to be the most preferred iterative methods. We believe that these methods are particularly useful for improving the quality of breast reconstructed image. We use the graphics processor (GPU to accelerate the process of reconstruction. Preliminary results show that all investigated methods are useful in breast reconstruction layered images. However, it was found that the method of classical tomosynthesis SAA is less efficient than iterative methods SART and BIR as the worst suppress the anatomical noise. Despite the fact that the estimated ratio of the contrast / noise ratio in the presence of internal structures with low contrast is higher for classical tomosynthesis method the SAA, its effectiveness in the presence of highly structured background is low. In our opinion the best results can be achieved using statistical iterative reconstruction BIR.

  18. Optimization of exposure parameters in digital tomosynthesis considering effective dose and image quality

    Science.gov (United States)

    Choi, Seungyeon; Choi, Sunghoon; Kim, Ye-seul; Lee, Haenghwa; Lee, Donghoon; Jeon, Pil-Hyun; Jang, Dong-Hyuk; Kim, Hee-Joung

    2016-03-01

    Digital tomosynthesis system (DTS), which scans an object in a limited angle, has been considered as an innovative imaging modality which can present lower patient dose than computed tomography and solve the problem of poor depth resolution in conventional digital radiography. Although it has many powerful advantages, only breast tomosynthesis system has been adopted in many hospitals. In order to reduce the patient dose while maintaining image quality, the acquisition conditions need to be studied. In this study, we analyzed effective dose and image qualities of chest phantom using commercialized universal chest digital tomosynthesis (CDT) R/F system to study the optimized exposure parameters. We set 10 different acquisition conditions including the default acquisition condition by user manual of Shimadzu (100 kVp with 0.5 mAs). The effective dose was calculated from PCXMC software version 1.5.1 by utilizing the total X-ray exposure measured by ion chamber. The image quality was evaluated by signal difference to noise ratio (SDNR) in the regions of interest (ROIs) pulmonary arteries at different axial in-plane. We analyzed a figure of merit (FOM) which considers both the effective dose and the SDNR in order to determine the optimal acquisition condition. The results indicated that the most suitable acquisition parameters among 10 conditions were condition 7 and 8 (120 kVp with 0.04 mAs and 0.1 mAs, respectively), which indicated lower effective dose while maintaining reasonable SDNRs and FOMs for three specified regions. Further studies are needed to be conducted for detailed outcomes in CDT acquisition conditions.

  19. Adaptive spatially dependent weighting scheme for tomosynthesis reconstruction

    Science.gov (United States)

    Levakhina, Yulia; Duschka, Robert; Vogt, Florian; Barkhausen, JOErg; Buzug, Thorsten M.

    2012-03-01

    Digital Tomosynthesis (DT) is an x-ray limited-angle imaging technique. An accurate image reconstruction in tomosynthesis is a challenging task due to the violation of the tomographic sufficiency conditions. A classical "shift-and-add" algorithm (or simple backprojection) suffers from blurring artifacts, produced by structures located above and below the plane of interest. The artifact problem becomes even more prominent in the presence of materials and tissues with a high x-ray attenuation, such as bones, microcalcifications or metal. The focus of the current work is on reduction of ghosting artifacts produced by bones in the musculoskeletal tomosynthesis. A novel dissimilarity concept and a modified backprojection with an adaptive spatially dependent weighting scheme (ωBP) are proposed. Simulated data of software phantom, a structured hardware phantom and a human hand raw-data acquired with a Siemens Mammomat Inspiration tomosynthesis system were reconstructed using conventional backprojection algorithm and the new ωBP-algorithm. The comparison of the results to the non-weighted case demonstrates the potential of the proposed weighted backprojection to reduce the blurring artifacts in musculoskeletal DT. The proposed weighting scheme is not limited to the tomosynthesis limitedangle geometry. It can also be adapted for Computed Tomography (CT) and included in iterative reconstruction algorithms (e.g. SART).

  20. Comparison of patient specific dose metrics between chest radiography, tomosynthesis, and CT for adult patients of wide ranging body habitus

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Yakun [Department of Radiology, Duke University Medical Center, Durham, North Carolina 27705 (United States); Li, Xiang [Medical Physics Graduate Program, Department of Physics, Cleveland State University, Cleveland, Ohio 44115 (United States); Segars, W. Paul [Medical Physics Graduate Program, Carl E. Ravin Advanced Imaging Laboratories, and Department of Radiology, Duke University Medical Center, Durham, North Carolina 27705 (United States); Samei, Ehsan, E-mail: samei@duke.edu [Medical Physics Graduate Program, Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Departments of Physics, Biomedical Engineering, and Electrical and Computer Engineering, Duke University Medical Center, Durham, North Carolina 27705 (United States)

    2014-02-15

    Purpose: Given the radiation concerns inherent to the x-ray modalities, accurately estimating the radiation doses that patients receive during different imaging modalities is crucial. This study estimated organ doses, effective doses, and risk indices for the three clinical chest x-ray imaging techniques (chest radiography, tomosynthesis, and CT) using 59 anatomically variable voxelized phantoms and Monte Carlo simulation methods. Methods: A total of 59 computational anthropomorphic male and female extended cardiac-torso (XCAT) adult phantoms were used in this study. Organ doses and effective doses were estimated for a clinical radiography system with the capability of conducting chest radiography and tomosynthesis (Definium 8000, VolumeRAD, GE Healthcare) and a clinical CT system (LightSpeed VCT, GE Healthcare). A Monte Carlo dose simulation program (PENELOPE, version 2006, Universitat de Barcelona, Spain) was used to mimic these two clinical systems. The Duke University (Durham, NC) technique charts were used to determine the clinical techniques for the radiographic modalities. An exponential relationship between CTDI{sub vol} and patient diameter was used to determine the absolute dose values for CT. The simulations of the two clinical systems compute organ and tissue doses, which were then used to calculate effective dose and risk index. The calculation of the two dose metrics used the tissue weighting factors from ICRP Publication 103 and BEIR VII report. Results: The average effective dose of the chest posteroanterior examination was found to be 0.04 mSv, which was 1.3% that of the chest CT examination. The average effective dose of the chest tomosynthesis examination was found to be about ten times that of the chest posteroanterior examination and about 12% that of the chest CT examination. With increasing patient average chest diameter, both the effective dose and risk index for CT increased considerably in an exponential fashion, while these two dose

  1. Optical geometry calibration method for free-form digital tomosynthesis

    Science.gov (United States)

    Chtcheprov, Pavel; Hartman, Allison; Shan, Jing; Lee, Yueh Z.; Zhou, Otto; Lu, Jianping

    2016-03-01

    Digital tomosynthesis is a type of limited angle tomography that allows 3D information to be reconstructed from a set of x-ray projection images taken at various angles using an x-ray tube, a mechanical arm to rotate the tube about the object, and a digital detector. Tomosynthesis reconstruction requires the precise location of the detector with respect to each x-ray source, forcing all current clinical tomosynthesis systems to use a physically coupled source and detector so the geometry is always known and is always the same. This limits the imaging geometries and its large size is impractical for mobile or field operations. To counter this, we have developed a free form tomosynthesis with a decoupled, free-moving source and detector that uses a novel optical method for accurate and real-time geometry calibration to allow for manual, hand-held tomosynthesis and even CT imaging. We accomplish this by using a camera, attached to the source, to track the motion of the source relative to the detector. Attached to the detector is an optical pattern and the image captured by the camera is then used to determine the relative camera/pattern position and orientation by analyzing the pattern distortion and calculating the source positions for each projection, necessary for 3D reconstruction. This allows for portable imaging in the field and also as an inexpensive upgrade to existing 2D systems, such as in developing countries, to provide 3D image data. Here we report the first feasibility demonstrations of free form digital tomosynthesis systems using the method.

  2. Breast Imaging: How We Manage Diagnostic Technology at a Multidisciplinary Breast Center

    Directory of Open Access Journals (Sweden)

    Alejandro Tejerina Bernal

    2012-01-01

    Full Text Available This paper discusses the most important aspects and problems related to the management of breast cancer imaging, at a center specialized in breast pathology. We review the established and emerging diagnostic techniques, their indications, and peculiarities: digital mammography, CAD systems, and the recent digital breast tomosynthesis, ultrasound and complementary elastography, molecular imaging techniques, magnetic resonance imaging, advanced sequences (diffusion, and positron emission mammography (PEM. The adequate integration and rational management of these techniques is essential, but this is not always easy, in order to achieve a successful diagnosis.

  3. In-line phase shift tomosynthesis

    Energy Technology Data Exchange (ETDEWEB)

    Hammonds, Jeffrey C.; Price, Ronald R.; Pickens, David R.; Donnelly, Edwin F. [Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee 37232 (United States)

    2013-08-15

    Purpose: The purpose of this work is to (1) demonstrate laboratory measurements of phase shift images derived from in-line phase-contrast radiographs using the attenuation-partition based algorithm (APBA) of Yan et al.[Opt. Express 18(15), 16074–16089 (2010)], (2) verify that the APBA reconstructed images obey the linearity principle, and (3) reconstruct tomosynthesis phase shift images from a collection of angularly sampled planar phase shift images.Methods: An unmodified, commercially available cabinet x-ray system (Faxitron LX-60) was used in this experiment. This system contains a tungsten anode x-ray tube with a nominal focal spot size of 10 μm. The digital detector uses CsI/CMOS with a pixel size of 50 × 50 μm. The phantoms used consisted of one acrylic plate, two polystyrene plates, and a habanero pepper. Tomosynthesis images were reconstructed from 51 images acquired over a ±25° arc. All phase shift images were reconstructed using the APBA.Results: Image contrast derived from the planar phase shift image of an acrylic plate of uniform thickness exceeded the contrast of the traditional attenuation image by an approximate factor of two. Comparison of the planar phase shift images from a single, uniform thickness polystyrene plate with two polystyrene plates demonstrated an approximate linearity of the estimated phase shift with plate thickness (−1600 rad vs −2970 rad). Tomographic phase shift images of the habanero pepper exhibited acceptable spatial resolution and contrast comparable to the corresponding attenuation image.Conclusions: This work demonstrated the feasibility of laboratory-based phase shift tomosynthesis and suggests that phase shift imaging could potentially provide a new imaging biomarker. Further investigation will be needed to determine if phase shift contrast will be able to provide new tissue contrast information or improved clinical performance.

  4. Stationary digital chest tomosynthesis for coronary artery calcium scoring

    Science.gov (United States)

    Wu, Gongting; Wang, Jiong; Potuzko, Marci; Harman, Allison; Pearce, Caleb; Shan, Jing; Lee, Yueh Z.; Zhou, Otto; Lu, Jianping

    2016-03-01

    The coronary artery calcium score (CACS) measures the buildup of calcium on the coronary artery wall and has been shown to be an important predictor of the risk of coronary artery diseases (CAD). Currently CACS is measured using CT, though the relatively high cost and high radiation dose has limited its adoption as a routine screening procedure. Digital Chest Tomosynthesis (DCT), a low dose and low cost alternative to CT, and has been shown to achieve 90% of sensitivity of CT in lung disease screening. However commercial DCT requires long scanning time and cannot be adapted for high resolution gated cardiac imaging, necessary for CACS. The stationary DCT system (s- DCT), developed in our lab, has the potential to significantly shorten the scanning time and enables high resolution cardiac gated imaging. Here we report the preliminary results of using s-DCT to estimate the CACS. A phantom heart model was developed and scanned by the s-DCT system and a clinical CT in a phantom model with realistic coronary calcifications. The adapted fan-beam volume reconstruction (AFVR) method, developed specifically for stationary tomosynthesis systems, is used to obtain high resolution tomosynthesis images. A trained cardiologist segmented out the calcifications and the CACS was obtained. We observed a strong correlation between the tomosynthesis derived CACS and CT CACS (r2 = 0.88). Our results shows s-DCT imaging has the potential to estimate CACS, thus providing a possible low cost and low dose imaging protocol for screening and monitoring CAD.

  5. Initial application of digital tomosynthesis to improve brachytherapy treatment planning

    Science.gov (United States)

    Baydush, Alan H.; Mirzaei McKee, Mahta; King, June; Godfrey, Devon J.

    2007-03-01

    We present preliminary investigations that examine the feasibility of incorporating volumetric images generated using digital tomosynthesis into brachytherapy treatment planning. The Integrated Brachytherapy Unit (IBU) at our facility consists of an L-arm, C-arm isocentric motion system with an x-ray tube and fluoroscopic imager attached. Clinically, this unit is used to generate oblique, anterior-posterior, and lateral images for simple treatment planning and dose prescriptions. Oncologists would strongly prefer to have volumetric data to better determine three dimensional dose distributions (dose-volume histograms) to the target area and organs at risk. Moving the patient back and forth to CT causes undo stress on the patient, allows extensive motion of organs and treatment applicators, and adds additional time to patient treatment. We propose to use the IBU imaging system with digital tomosynthesis to generate volumetric patient data, which can be used for improving treatment planning and overall reducing treatment time. Initial image data sets will be acquired over a limited arc of a human-like phantom composed of real bones and tissue equivalent material. A brachytherapy applicator will be incorporated into one of the phantoms for visualization purposes. Digital tomosynthesis will be used to generate a volumetric image of this phantom setup. This volumetric image set will be visually inspected to determine the feasibility of future incorporation of these types of images into brachytherapy treatment planning. We conclude that initial images using the tomosynthesis reconstruction technique show much promise and bode well for future work.

  6. A novel solid-angle tomosynthesis (SAT) scanning scheme

    International Nuclear Information System (INIS)

    Purpose: Digital tomosynthesis (DTS) recently gained extensive research interests in both diagnostic and radiation therapy fields. Conventional DTS images are generated by scanning an x-ray source and flat-panel detector pair on opposite sides of an object, with the scanning trajectory on a one-dimensional curve. A novel tomosynthesis method named solid-angle tomosynthesis (SAT) is proposed, where the x-ray source scans on an arbitrary shaped two-dimensional surface. Methods: An iterative algorithm in the form of total variation regulated expectation maximization is developed for SAT image reconstruction. The feasibility and effectiveness of SAT is corroborated by computer simulation studies using three-dimensional (3D) numerical phantoms including a 3D Shepp-Logan phantom and a volumetric CT image set of a human breast. Results: SAT is able to cover more space in Fourier domain more uniformly than conventional DTS. Greater coverage and more isotropy in the frequency domain translate to fewer artifacts and more accurately restored features in the in-plane reconstruction. Conclusions: Comparing with conventional DTS, SAT allows cone-shaped x-ray beams to project from more solid angles, thus provides more coverage in the spatial-frequency domain, resulting in better quality of reconstructed image.

  7. A novel solid-angle tomosynthesis (SAT) scanning scheme

    Energy Technology Data Exchange (ETDEWEB)

    Zhang Jin; Yu, Cedric [Department of Radiation Oncology, University of Maryland School of Medicine, 22 S. Greene Street, Baltimore, Maryland 21201 and Xcision Medical System, LLC, 12707 Chapel Chase Drive, Clarksville, Maryland 21209 (United States)

    2010-08-15

    Purpose: Digital tomosynthesis (DTS) recently gained extensive research interests in both diagnostic and radiation therapy fields. Conventional DTS images are generated by scanning an x-ray source and flat-panel detector pair on opposite sides of an object, with the scanning trajectory on a one-dimensional curve. A novel tomosynthesis method named solid-angle tomosynthesis (SAT) is proposed, where the x-ray source scans on an arbitrary shaped two-dimensional surface. Methods: An iterative algorithm in the form of total variation regulated expectation maximization is developed for SAT image reconstruction. The feasibility and effectiveness of SAT is corroborated by computer simulation studies using three-dimensional (3D) numerical phantoms including a 3D Shepp-Logan phantom and a volumetric CT image set of a human breast. Results: SAT is able to cover more space in Fourier domain more uniformly than conventional DTS. Greater coverage and more isotropy in the frequency domain translate to fewer artifacts and more accurately restored features in the in-plane reconstruction. Conclusions: Comparing with conventional DTS, SAT allows cone-shaped x-ray beams to project from more solid angles, thus provides more coverage in the spatial-frequency domain, resulting in better quality of reconstructed image.

  8. Whole-Body Clinical Applications of Digital Tomosynthesis.

    Science.gov (United States)

    Machida, Haruhiko; Yuhara, Toshiyuki; Tamura, Mieko; Ishikawa, Takuya; Tate, Etsuko; Ueno, Eiko; Nye, Katelyn; Sabol, John M

    2016-01-01

    With flat-panel detector mammography, radiography, and fluoroscopy systems, digital tomosynthesis (DT) has been recently introduced as an advanced clinical application that removes overlying structures, enhances local tissue separation, and provides depth information about structures of interest by providing high-quality tomographic images. DT images are generated from projection image data, typically using filtered back-projection or iterative reconstruction. These low-dose x-ray projection images are easily and swiftly acquired over a range of angles during a single linear or arc sweep of the x-ray tube assembly. DT is advantageous in a variety of clinical contexts, including breast, chest, head and neck, orthopedic, emergency, and abdominal imaging. Specifically, compared with conventional mammography, radiography, and fluoroscopy, as a result of reduced tissue overlap DT can improve detection of breast cancer, pulmonary nodules, sinonasal mucosal thickening, and bone fractures and delineation of complex anatomic structures such as the ostiomeatal unit, atlantoaxial joint, carpal and tarsal bones, and pancreatobiliary and gastrointestinal tracts. Compared with computed tomography, DT offers reduced radiation exposure, better in-plane resolution to improve assessment of fine bony changes, and less metallic artifact, improving postoperative evaluation of patients with metallic prostheses and osteosynthesis materials. With more flexible patient positioning, DT is also useful for functional, weight-bearing, and stress tests. To optimize patient management, a comprehensive understanding of the clinical applications and limitations of whole-body DT applications is important for improvement of diagnostic quality, workflow, and cost-effectiveness. Online supplemental material is available for this article. (©)RSNA, 2016. PMID:27163590

  9. Breast Cancer in Systemic Lupus Erythematosus

    DEFF Research Database (Denmark)

    Tessier Cloutier, B; Clarke, A E; Ramsey-Goldman, R;

    2013-01-01

    Evidence points to a decreased breast cancer risk in systemic lupus erythematosus (SLE). We analyzed data from a large multisite SLE cohort, linked to cancer registries.......Evidence points to a decreased breast cancer risk in systemic lupus erythematosus (SLE). We analyzed data from a large multisite SLE cohort, linked to cancer registries....

  10. Characterisation of microcalcification clusters on 2D digital mammography (FFDM) and digital breast tomosynthesis (DBT): does DBT underestimate microcalcification clusters? Results of a multicentre study

    Energy Technology Data Exchange (ETDEWEB)

    Tagliafico, Alberto [University of Genoa, Institute of Anatomy, Department of Experimental Medicine (DIMES), Genoa (Italy); Mariscotti, Giovanna; Durando, Manuela [Azienda Ospedaliero-Universitaria Citta della Salute e della Scienza di Torino, Radiology University of Torino, Department of Diagnostic Imaging and Radiotherapy, Torino (Italy); Stevanin, Carmen [Ospedale Regionale di Bolzano, Bolzano (Italy); Tagliafico, Giulio [Istituto di Matematica Applicata e Tecnologie Informatiche, CNR-IMATI, Consiglio Nazionale delle Ricerche, Genova (Italy); Martino, Lucia; Bignotti, Bianca [University of Genoa, Department of Health Sciences (DISSAL), Genoa (Italy); Calabrese, Massimo [IRCCS AOU San Martino-IST, Department of Breast Radiology, Genova (Italy); Houssami, Nehmat [University of Sydney, Screening and Test Evaluation Program (STEP), School of Public Health, Sydney Medical School, Sydney (Australia)

    2015-01-15

    To compare DBT and FFDM in the classification of microcalcification clusters (MCs) using BI-RADS. This Institutional Review Board-approved study was undertaken in three centres. A total of 107 MCs evaluated with both DBT and FFDM were randomised for prospective reading by six experienced breast radiologists and classified using BI-RADS. The benign/malignant ratio of MC was 66/41. Of 11/107 discordant results, DBT classified MCs as R2 whereas FFDM classified them as R3 in 9 and R4 in 2. Three of these (3/107 = 2.8 %) were malignant; 8 (7.5 %) were nonmalignant and were correctly classified as R2 on DBT but incorrectly classified as R3 on FFDM. Estimated sensitivity and specificity, respectively, were 100 % (95 % CI: 91 % to 100 %) and 94.6 % (95 % CI: 86.7 % to 98.5 %) for FFDM and 91.1 % (95 % CI: 78.8 % to 97.5 %) and 100 % (95 % CI: 94.8 % to 100 %) for DBT. Overall intra- and interobserver agreements were 0.75 (95 % CI: 0.61-0.84) and 0.73 (95 % CI: 0.62-0.78). Most MCs are scored similarly on FFDM and DBT. Although a minority (11/107) of MCs are classified differently on FFDM (benign MC classified as R3) and DBT (malignant MC classified as R2), this may have clinical relevance. (orig.)

  11. Anatomic Breast Coordinate System for Mammogram Analysis

    DEFF Research Database (Denmark)

    Karemore, Gopal Raghunath; Brandt, S; Karssemeijer, N;

    2011-01-01

    inside the breast. Most of the risk assessment and CAD modules use a breast region in a image centered Cartesian x,y coordinate system. Nevertheless, anatomical structure follows curve-linear trajectories. We examined an anatomical breast coordinate system that preserves the anatomical correspondence...... between the mammograms and allows extracting not only the aligned position but also the orientation aligned with the anatomy of the breast tissue structure. Materials and Methods The coordinate system used the nipple location as the point A and the border of the pectoral muscle as a line BC. The skin air...... was represented by geodesic distance (s) from nipple and parametric angle (¿) as shown in figure 1. The scoring technique called MTR (mammographic texture resemblance marker) used this breast coordinate system to extract Gaussian derivative features. The features extracted using the (x,y) and the curve...

  12. Breast cancer screening in Korean woman with dense breast tissue

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Hee Jung [Dept. of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of); Ko, Eun Sook [Dept. of Radiology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul (Korea, Republic of); Yi, Ann [Dept. of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul (Korea, Republic of)

    2015-11-15

    Asian women, including Korean, have a relatively higher incidence of dense breast tissue, compared with western women. Dense breast tissue has a lower sensitivity for the detection of breast cancer and a higher relative risk for breast cancer, compared with fatty breast tissue. Thus, there were limitations in the mammographic screening for women with dense breast tissue, and many studies for the supplemental screening methods. This review included appropriate screening methods for Korean women with dense breasts. We also reviewed the application and limitation of supplemental screening methods, including breast ultrasound, digital breast tomosynthesis, and breast magnetic resonance imaging; and furthermore investigated the guidelines, as well as the study results.

  13. Glandular dose in breast tomosynthesis examinations: Preliminary study with a sample of patients; Dosis glandular en examenes de tomosintesis de mama: estudio preliminar con una muestra de pacientes

    Energy Technology Data Exchange (ETDEWEB)

    Castillo, M.; Chevalier, M.; Calzado, A.; Valverde, J.

    2013-07-01

    The aim of this study is to analyze the mean glandular dose administered to a group of patients with a tomography system (Selenia Dimensions) service installed on a large hospital in which routine tests are done and screening. (Author)

  14. Dose assessment of digital tomosynthesis in pediatric imaging

    Science.gov (United States)

    Gislason, Amber; Elbakri, Idris A.; Reed, Martin

    2009-02-01

    We investigated the potential for digital tomosynthesis (DT) to reduce pediatric x-ray dose while maintaining image quality. We utilized the DT feature (VolumeRadTM) on the GE DefiniumTM 8000 flat panel system installed in the Winnipeg Children's Hospital. Facial bones, cervical spine, thoracic spine, and knee of children aged 5, 10, and 15 years were represented by acrylic phantoms for DT dose measurements. Effective dose was estimated for DT and for corresponding digital radiography (DR) and computed tomography (CT) patient image sets. Anthropomorphic phantoms of selected body parts were imaged by DR, DT, and CT. Pediatric radiologists rated visualization of selected anatomic features in these images. Dose and image quality comparisons between DR, DT, and CT determined the usefulness of tomosynthesis for pediatric imaging. CT effective dose was highest; total DR effective dose was not always lowest - depending how many projections were in the DR image set. For the cervical spine, DT dose was close to and occasionally lower than DR dose. Expert radiologists rated visibility of the central facial complex in a skull phantom as better than DR and comparable to CT. Digital tomosynthesis has a significantly lower dose than CT. This study has demonstrated DT shows promise to replace CT for some facial bones and spinal diagnoses. Other clinical applications will be evaluated in the future.

  15. A simple method to retrospectively estimate patient dose-area product for chest tomosynthesis examinations performed using VolumeRAD

    Energy Technology Data Exchange (ETDEWEB)

    Båth, Magnus, E-mail: magnus.bath@vgregion.se; Svalkvist, Angelica [Department of Radiation Physics, Institute of Clinical Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg SE-413 45, Sweden and Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Gothenburg SE-413 45 (Sweden); Söderman, Christina [Department of Radiation Physics, Institute of Clinical Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg SE-413 45 (Sweden)

    2014-10-15

    Purpose: The purpose of the present work was to develop and validate a method of retrospectively estimating the dose-area product (DAP) of a chest tomosynthesis examination performed using the VolumeRAD system (GE Healthcare, Chalfont St. Giles, UK) from digital imaging and communications in medicine (DICOM) data available in the scout image. Methods: DICOM data were retrieved for 20 patients undergoing chest tomosynthesis using VolumeRAD. Using information about how the exposure parameters for the tomosynthesis examination are determined by the scout image, a correction factor for the adjustment in field size with projection angle was determined. The correction factor was used to estimate the DAP for 20 additional chest tomosynthesis examinations from DICOM data available in the scout images, which was compared with the actual DAP registered for the projection radiographs acquired during the tomosynthesis examination. Results: A field size correction factor of 0.935 was determined. Applying the developed method using this factor, the average difference between the estimated DAP and the actual DAP was 0.2%, with a standard deviation of 0.8%. However, the difference was not normally distributed and the maximum error was only 1.0%. The validity and reliability of the presented method were thus very high. Conclusions: A method to estimate the DAP of a chest tomosynthesis examination performed using the VolumeRAD system from DICOM data in the scout image was developed and validated. As the scout image normally is the only image connected to the tomosynthesis examination stored in the picture archiving and communication system (PACS) containing dose data, the method may be of value for retrospectively estimating patient dose in clinical use of chest tomosynthesis.

  16. Ectopic Axillary Breast during Systemic Lupus

    Directory of Open Access Journals (Sweden)

    Besma Ben Dhaou

    2012-01-01

    Full Text Available Many breast changes may occur in systemic lupus erythematosus. We report a 41-year-old woman with lupus who presented three years after the onset of lupus an ectopic mammary gland confirmed by histological study.

  17. Insight into osteo-articular digital tomosynthesis: a pictorial essay

    International Nuclear Information System (INIS)

    The objectives of this pictorial essay are to describe osteo-articular imaging using digital tomosynthesis. We provide characteristic examples in eight patients. Digital tomosynthesis allows easy, fast and low-dose imaging, with excellent spatial resolution.

  18. An anatomically oriented breast coordinate system for mammogram analysis

    NARCIS (Netherlands)

    Brandt, S.S.; Karemore, G.; Karssemeijer, N.; Nielsen, M.

    2011-01-01

    We have developed a breast coordinate system that is based on breast anatomy to register female breasts into a common coordinate frame in 2-D mediolateral (ML) or mediolateral oblique (MLO) view mammograms. The breasts are registered according to the location of the pectoral muscle and the nipple an

  19. An Anatomically Oriented Breast Coordinate System for Mammogram Analysis

    DEFF Research Database (Denmark)

    Brandt, Sami; Karemore, Gopal Raghunath; Karssemeijer, Nico;

    2011-01-01

    We have developed a breast coordinate system that is based on breast anatomy to register female breasts into a common coordinate frame in 2D mediolateral (ML) or mediolateral oblique (MLO) view mammograms. The breasts are registered according to the location of the pectoral muscle and the nipple...... and the shape of the breast boundary because these are the most robust features independent of the breast size and shape. On the basis of these landmarks, we have constructed a nonlinear mapping between the parameter frame and the breast region in the mammogram. This mapping makes it possible to identify...... and orientations are registered and extracted without non-linearly deforming the images. We use the proposed breast coordinate transform in a cross-sectional breast cancer risk assessment study of 490 women, in which we attempt to learn breast cancer risk factors from mammograms that were taken prior to when...

  20. TH-A-18A-01: Innovation in Clinical Breast Imaging

    Energy Technology Data Exchange (ETDEWEB)

    Liu, B [Massachusetts General Hospital, Boston, MA (United States); Yang, K [University of Oklahoma, Oklahomoa City, OK (United States); Yaffe, M [University Toronto, Toronto, ON (Canada); Chen, J [GE/U-Systems, Sunnyvale, CA (United States)

    2014-06-15

    Several novel modalities have been or are on the verge of being introduced into the breast imaging clinic. These include tomosynthesis imaging, dedicated breast CT, contrast-enhanced digital mammography, and automated breast ultrasound, all of which are covered in this course. Tomosynthesis and dedicated breast CT address the problem of tissue superimposition that limits mammography screening performance, by improved or full resolution of the 3D breast morphology. Contrast-enhanced digital mammography provides functional information that allows for visualization of tumor angiogenesis. 3D breast ultrasound has high sensitivity for tumor detection in dense breasts, but the imaging exam was traditionally performed by radiologists. In automated breast ultrasound, the scan is performed in an automated fashion, making for a more practical imaging tool, that is now used as an adjunct to digital mammography in breast cancer screening. This course will provide medical physicists with an in-depth understanding of the imaging physics of each of these four novel imaging techniques, as well as the rationale and implementation of QC procedures. Further, basic clinical applications and work flow issues will be discussed. Learning Objectives: To be able to describe the underlying physical and physiological principles of each imaging technique, and to understand the corresponding imaging acquisition process. To be able to describe the critical system components and their performance requirements. To understand the rationale and implementation of quality control procedures, as well as regulatory requirements for systems with FDA approval. To learn about clinical applications and understand risks and benefits/strength and weakness of each modality in terms of clinical breast imaging.

  1. Dose to patient in tomosynthesis; Dosis a paciente en tomosintesis

    Energy Technology Data Exchange (ETDEWEB)

    Minambres Moro, A.; Fernandez Leton, P.; Garcia Rui-Zorrilla, J.; Perez Moreno, J. M.; Zucca Aparicio, D.

    2013-07-01

    They are beginning to implement digital mammography with the possibility of acquiring in tomosynthesis, whose biggest advantage is to distinguish structures without overlapping through of pseudotridimensionals images. With these modified mammograms can acquire a planar mammography, with fixed x-ray tube, or a tomosynthesis with tube by turning. For acquire tomosynthesis is necessary a detector of high efficiency together with tungsten white tubes. The objective of this study is to know the dose received by the patient with this new imaging. (Author)

  2. Interventional C-arm tomosynthesis for vascular imaging: initial results

    Science.gov (United States)

    Langan, David A.; Claus, Bernhard E. H.; Al Assad, Omar; Trousset, Yves; Riddell, Cyril; Avignon, Gregoire; Solomon, Stephen B.; Lai, Hao; Wang, Xin

    2015-03-01

    As percutaneous endovascular procedures address more complex and broader disease states, there is an increasing need for intra-procedure 3D vascular imaging. In this paper, we investigate C-Arm 2-axis tomosynthesis ("Tomo") as an alternative to C-Arm Cone Beam Computed Tomography (CBCT) for workflow situations in which the CBCT acquisition may be inconvenient or prohibited. We report on our experience in performing tomosynthesis acquisitions with a digital angiographic imaging system (GE Healthcare Innova 4100 Angiographic Imaging System, Milwaukee, WI). During a tomo acquisition the detector and tube each orbit on a plane above and below the table respectively. The tomo orbit may be circular or elliptical, and the tomographic half-angle in our studies varied from approximately 16 to 28 degrees as a function of orbit period. The trajectory, geometric calibration, and gantry performance are presented. We overview a multi-resolution iterative reconstruction employing compressed sensing techniques to mitigate artifacts associated with incomplete data reconstructions. In this work, we focus on the reconstruction of small high contrast objects such as iodinated vasculature and interventional devices. We evaluate the overall performance of the acquisition and reconstruction through phantom acquisitions and a swine study. Both tomo and comparable CBCT acquisitions were performed during the swine study thereby enabling the use of CBCT as a reference in the evaluation of tomo vascular imaging. We close with a discussion of potential clinical applications for tomo, reflecting on the imaging and workflow results achieved.

  3. Effective dose from chest tomosynthesis in children

    International Nuclear Information System (INIS)

    Tomosynthesis (digital tomography) is a recently introduced low-dose alternative to CT in the evaluation of the lungs in patients with cystic fibrosis and pulmonary nodules. Previous studies have reported an adult effective dose of 0.12-0.13 mSv for chest tomosynthesis. The aim of this study was to determine the paediatric effective dose from the dose-area-product. During a 3-y period, 38 children with cystic fibrosis and 36 paediatric oncology patients were examined with chest tomosynthesis, totally 169 posteroanterior and 17 anteroposterior examinations (40 boys and 34 girls, mean age 13.7 y, range 7-20 y). Using recently reported paediatric chest tomosynthesis conversion factors (0.23-1.09 mSv Gy cm-2) corrected for sex, age and energy, the mean posteroanterior effective dose calculated was 0.17 mSv; using the proposed simplified conversion factors of 0.6 (8-10 y), 0.4 (11-14 y) and 0.3 mSv Gy cm-2 (15-19 y), the mean posteroanterior effective dose calculated was 0.15 mSv. As the difference in the calculated effective dose was minor, it is recommendable to use the simplified conversion factors. Using the conversion factor for adult chest tomosynthesis (0.26 mSv Gy cm-2), the mean effective dose was 0.11 mSv. Anteroposterior exposures had considerably higher effective dose. By using conversion factors adapted for children, the calculated risks from radiologic procedures will be more accurate. (authors)

  4. Prospective gated chest tomosynthesis using CNT X-ray source array

    Science.gov (United States)

    Shan, Jing; Burk, Laurel; Wu, Gongting; Lee, Yueh Z.; Heath, Michael D.; Wang, Xiaohui; Foos, David; Lu, Jianping; Zhou, Otto

    2015-03-01

    Chest tomosynthesis is a low-dose 3-D imaging modality that has been shown to have comparable sensitivity as CT in detecting lung nodules and other lung pathologies. We have recently demonstrated the feasibility of stationary chest tomosynthesis (s-DCT) using a distributed CNT X-ray source array. The technology allows acquisition of tomographic projections without moving the X-ray source. The electronically controlled CNT x-ray source also enables physiologically gated imaging, which will minimize image blur due to the patient's respiration motion. In this paper, we investigate the feasibility of prospective gated chest tomosynthesis using a bench-top s-DCT system with a CNT source array, a high- speed at panel detector and realistic patient respiratory signals captured using a pressure sensor. Tomosynthesis images of inflated pig lungs placed inside an anthropomorphic chest phantom were acquired at different respiration rate, with and without gating for image quality comparison. Metal beads of 2 mm diameter were placed on the pig lung for quantitative measure of the image quality. Without gating, the beads were blurred to 3:75 mm during a 3 s tomosynthesis acquisition. When gated to the end of the inhalation and exhalation phase the detected bead size reduced to 2:25 mm, much closer to the actual bead size. With gating the observed airway edges are sharper and there are more visible structural details in the lung. Our results demonstrated the feasibility of prospective gating in the s-DCT, which substantially reduces image blur associated with lung motion.

  5. Initial clinical evaluation of stationary digital chest tomosynthesis

    Science.gov (United States)

    Hartman, Allison E.; Shan, Jing; Wu, Gongting; Lee, Yueh Z.; Zhou, Otto; Lu, Jianping; Heath, Michael; Wang, Xiaohui; Foos, David

    2016-03-01

    Computed Tomography (CT) is the gold standard for image evaluation of lung disease, including lung cancer and cystic fibrosis. It provides detailed information of the lung anatomy and lesions, but at a relatively high cost and high dose of radiation. Chest radiography is a low dose imaging modality but it has low sensitivity. Digital chest tomosynthesis (DCT) is an imaging modality that produces 3D images by collecting x-ray projection images over a limited angle. DCT is less expensive than CT and requires about 1/10th the dose of radiation. Commercial DCT systems acquire the projection images by mechanically scanning an x-ray tube. The movement of the tube head limits acquisition speed. We recently demonstrated the feasibility of stationary digital chest tomosynthesis (s-DCT) using a carbon nanotube (CNT) x-ray source array in benchtop phantom studies. The stationary x-ray source allows for fast image acquisition. The objective of this study is to demonstrate the feasibility of s-DCT for patient imaging. We have successfully imaged 31 patients. Preliminary evaluation by board certified radiologists suggests good depiction of thoracic anatomy and pathology.

  6. Grating-based phase contrast tomosynthesis imaging: Proof-of-concept experimental studies

    International Nuclear Information System (INIS)

    Purpose: This paper concerns the feasibility of x-ray differential phase contrast (DPC) tomosynthesis imaging using a grating-based DPC benchtop experimental system, which is equipped with a commercial digital flat-panel detector and a medical-grade rotating-anode x-ray tube. An extensive system characterization was performed to quantify its imaging performance. Methods: The major components of the benchtop system include a diagnostic x-ray tube with a 1.0 mm nominal focal spot size, a flat-panel detector with 96 μm pixel pitch, a sample stage that rotates within a limited angular span of ±30°, and a Talbot-Lau interferometer with three x-ray gratings. A total of 21 projection views acquired with 3° increments were used to reconstruct three sets of tomosynthetic image volumes, including the conventional absorption contrast tomosynthesis image volume (AC-tomo) reconstructed using the filtered-backprojection (FBP) algorithm with the ramp kernel, the phase contrast tomosynthesis image volume (PC-tomo) reconstructed using FBP with a Hilbert kernel, and the differential phase contrast tomosynthesis image volume (DPC-tomo) reconstructed using the shift-and-add algorithm. Three inhouse physical phantoms containing tissue-surrogate materials were used to characterize the signal linearity, the signal difference-to-noise ratio (SDNR), the three-dimensional noise power spectrum (3D NPS), and the through-plane artifact spread function (ASF). Results: While DPC-tomo highlights edges and interfaces in the image object, PC-tomo removes the differential nature of the DPC projection data and its pixel values are linearly related to the decrement of the real part of the x-ray refractive index. The SDNR values of polyoxymethylene in water and polystyrene in oil are 1.5 and 1.0, respectively, in AC-tomo, and the values were improved to 3.0 and 2.0, respectively, in PC-tomo. PC-tomo and AC-tomo demonstrate equivalent ASF, but their noise characteristics quantified by the 3D NPS

  7. Dosimetry in x-ray-based breast imaging

    Science.gov (United States)

    Dance, David R.; Sechopoulos, Ioannis

    2016-10-01

    The estimation of the mean glandular dose to the breast (MGD) for x-ray based imaging modalities forms an essential part of quality control and is needed for risk estimation and for system design and optimisation. This review considers the development of methods for estimating the MGD for mammography, digital breast tomosynthesis (DBT) and dedicated breast CT (DBCT). Almost all of the methodology used employs Monte Carlo calculated conversion factors to relate the measurable quantity, generally the incident air kerma, to the MGD. After a review of the size and composition of the female breast, the various mathematical models used are discussed, with particular emphasis on models for mammography. These range from simple geometrical shapes, to the more recent complex models based on patient DBCT examinations. The possibility of patient-specific dose estimates is considered as well as special diagnostic views and the effect of breast implants. Calculations using the complex models show that the MGD for mammography is overestimated by about 30% when the simple models are used. The design and uses of breast-simulating test phantoms for measuring incident air kerma are outlined and comparisons made between patient and phantom-based dose estimates. The most widely used national and international dosimetry protocols for mammography are based on different simple geometrical models of the breast, and harmonisation of these protocols using more complex breast models is desirable.

  8. Possible Laminographic and Tomosynthesis Applications for Wolter Microscope Scan Geometries

    International Nuclear Information System (INIS)

    The Wolter microscope includes a number of attractive features for x-ray imaging, and possible connections to laminographic and tomosynthesis 3D object recovery algorithms. This type of instrument employs x-ray optics to sift out single energy x-rays from a broader spectral energy source, and direct those x-rays to a ''focus plane'' similar to the operation of a optical microscope (see Figure 1 for schematic of a Wolter instrument). Unlike optical microscopes the 3D object can be thick in the direction of the x-rays and in this case more of the intensity of the image is affected by the out-of-focus planes, since the ray-paths span the entire depth of the object. It is clear that the ''in-focus'' plane of a Wolter contain more 3D information than a simple ''point-projection'' radiograph. However, it is not clear just how the impact of the out-of-focus planes obscures or distorts features of interest for the in-focus planes. Further, it is not clear just how object positioning can be combined with multiple acquisitions to enable recovery of other planes within the object function or the entire object function. Of particular interest here are Wolter microscopes configured for mesoscale objects (mm extent with um features). Laminographic and tomosynthesis scanning methods can be strategic for this type of inspection instrument. First, photon output for inspection purposes can be meager in this type of ''small field of view'' system. With laboratory x-ray sources a single image can require up to 10 minutes to accumulate adequate signal. Techniques that can obtain 3D object information from small numbers of views, rotational or translational, are consequently at a premium. Laminographic and tomosynthesis scanning methods require relatively small numbers of views (2-30). Secondly, the Wolter microscope scan geometry in a single view is a fit with the type of source-detector geometry achieved through source-object-detector re-positioning in laminographic and tomosynthesis

  9. Anatomical decomposition in dual energy chest digital tomosynthesis

    Science.gov (United States)

    Lee, Donghoon; Kim, Ye-seul; Choi, Sunghoon; Lee, Haenghwa; Choi, Seungyeon; Kim, Hee-Joung

    2016-03-01

    Lung cancer is the leading cause of cancer death worldwide and the early diagnosis of lung cancer has recently become more important. For early screening lung cancer, computed tomography (CT) has been used as a gold standard for early diagnosis of lung cancer [1]. The major advantage of CT is that it is not susceptible to the problem of misdiagnosis caused by anatomical overlapping while CT has extremely high radiation dose and cost compared to chest radiography. Chest digital tomosynthesis (CDT) is a recently introduced new modality for lung cancer screening with relatively low radiation dose compared to CT [2] and also showing high sensitivity and specificity to prevent anatomical overlapping occurred in chest radiography. Dual energy material decomposition method has been proposed for better detection of pulmonary nodules as means of reducing the anatomical noise [3]. In this study, possibility of material decomposition in CDT was tested by simulation study and actual experiment using prototype CDT. Furthermore organ absorbed dose and effective dose were compared with single energy CDT. The Gate v6 (Geant4 application for tomographic emission), and TASMIP (Tungsten anode spectral model using the interpolating polynomial) code were used for simulation study and simulated cylinder shape phantom consisted of 4 inner beads which were filled with spine, rib, muscle and lung equivalent materials. The patient dose was estimated by PCXMC 1.5 Monte Carlo simulation tool [4]. The tomosynthesis scan was performed with a linear movement and 21 projection images were obtained over 30 degree of angular range with 1.5° degree of angular interval. The proto type CDT system has same geometry with simulation study and composed of E7869X (Toshiba, Japan) x-ray tube and FDX3543RPW (Toshiba, Japan) detector. The result images showed that reconstructed with dual energy clearly visualize lung filed by removing unnecessary bony structure. Furthermore, dual energy CDT could enhance

  10. Initial application of digital tomosynthesis for detection of pulmonary nodules

    International Nuclear Information System (INIS)

    Objective: To discuss the value of digital tomosynthesis for detection of pulmonary nodules. Methods: Thirty patients suspected of having pulmonary nodules underwent chest radiography, digital tomosynthesis and CT examination. Above image data were transferred to postprocessing work station and were reviewed by 2 radiologists with 3 years of chest-radiology diagnosis experience in a double-blind method. The number, location and size of nodules were recorded. Then, 2 radiologists reviewed the all images once more, and discuss in consensus. The sensitivities of chest radiography and digital tomosynthesis for detection of pulmonary nodules were respectively calculated according to the CT results. Chi-square test was used for radiography, digital tomosynthesis and CT examination. Results: Of 30 patients, 21 were detected having pulmonary nodules by X-ray radiography and 9 were negative, the total number of 40 nodules was detected, while 89 nodules in 26 patients were detected by digital tomosynthesis, and only 4 patients were negative. CT demonstrated 102 nodules in 27 patients, and 3 patients were negative. Taking CT as 'gold standard', the sensitivities of X-ray radiography and digital tomosynthesis were 27.4%(28/102)and 87.2%(89/102), X2=4.35, P<0.05, respectively. Conclusion: Digital tomosynthesis has a high sensitivity for detection of pulmonary nodules compared with X-ray radiography, and could be an excellent and necessary supplementary technique of X-ray radiography. (authors)

  11. Refraction-based tomosynthesis: Proof of the concept

    Science.gov (United States)

    Maksimenko, Anton; Yuasa, Tetsuya; Ando, Masami; Hashimoto, Eiko

    2007-12-01

    Tomosynthesis is a well known technique for imaging a plane in a target by blurring other planes in the target. Commonly, the tomosynthesis is based on the x-ray absorption contrast. Recently, methods for generating other x-ray contrasts were developed. One of them, the so-called refraction contrast, is extremely sensitive to soft tissues and small defects. It was used as the base for the computed tomography. However, a very promising application of this contrast in the tomosynthesis remains undeveloped. This letter is dedicated to this problem. It includes both theoretical background and experimental implementation of the idea.

  12. 21 CFR 866.5170 - Breast milk immunological test system.

    Science.gov (United States)

    2010-04-01

    ... that consists of the reagents used to measure by immunochemical techniques the breast milk proteins. (b... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Breast milk immunological test system. 866.5170 Section 866.5170 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN...

  13. Combined photoacoustic and ultrasound imaging of human breast in vivo in the mammographic geometry

    Science.gov (United States)

    Xie, Zhixing; Lee, Won-Mean; Hooi, Fong Ming; Fowlkes, J. Brian; Pinsky, Renee W.; Mueller, Dean; Wang, Xueding; Carson, Paul L.

    2013-03-01

    This photoacoustic volume imaging (PAVI) system is designed to study breast cancer detection and diagnosis in the mammographic geometry in combination with automated 3D ultrasound (AUS). The good penetration of near-infrared (NIR) light and high receiving sensitivity of a broad bandwidth, 572 element, 2D PVDF array at a low center-frequency of 1MHz were utilized with 20 channel simultaneous acquisition. The feasibility of this system in imaging optically absorbing objects in deep breast tissues was assessed first through experiments on ex vivo whole breasts. The blood filled pseudo lesions were imaged at depths up to 49 mm in the specimens. In vivo imaging of human breasts has been conducted. 3D PAVI image stacks of human breasts were coregistered and compared with 3D ultrasound image stacks of the same breasts. Using the designed system, PAVI shows satisfactory imaging depth and sensitivity for coverage of the entire breast when imaged from both sides with mild compression in the mammographic geometry. With its unique soft tissue contrast and excellent sensitivity to the tissue hemodynamic properties of fractional blood volume and blood oxygenation, PAVI, as a complement to 3D ultrasound and digital tomosynthesis mammography, might well contribute to detection, diagnosis and prognosis for breast cancer.

  14. Stationary chest tomosynthesis using a carbon nanotube x-ray source array: a feasibility study

    Science.gov (United States)

    Shan, Jing; Tucker, Andrew W.; Lee, Yueh Z.; Heath, Michael D.; Wang, Xiaohui; Foos, David H.; Lu, Jianping; Zhou, Otto

    2015-01-01

    Chest tomosynthesis is a low-dose, quasi-3D imaging modality that has been demonstrated to improve the detection sensitivity for small lung nodules, compared to 2D chest radiography. The purpose of this study is to investigate the feasibility and system requirements of stationary chest tomosynthesis (s-DCT) using a spatially distributed carbon nanotube (CNT) x-ray source array, where the projection images are collected by electronically activating individual x-ray focal spots in the source array without mechanical motion of the x-ray source, detector, or the patient. A bench-top system was constructed using an existing CNT field emission source array and a flat panel detector. The tube output, beam quality, focal spot size, system in-plane and in-depth resolution were characterized. Tomosynthesis slices of an anthropomorphic chest phantom were reconstructed for image quality assessment. All 75 CNT sources in the source array were shown to operate reliably at 80 kVp and 5 mA tube current. Source-to-source consistency in the tube current and focal spot size was observed. The incident air kerma reading per mAs was measured as 74.47 uGy mAs-1 at 100 cm. The first half value layer of the beam was 3 mm aluminum. An average focal spot size of 2.5  ×  0.5 mm was measured. The system MTF was measured to be 1.7 cycles mm-1 along the scanning direction, and 3.4 cycles mm-1 perpendicular to the scanning direction. As the angular coverage of 11.6°-34°, the full width at half maximum of the artifact spread function improved greatly from 9.5 to 5.2 mm. The reconstructed tomosynthesis slices clearly show airways and pulmonary vascular structures in the anthropomorphic lung phantom. The results show the CNT source array is capable of generating sufficient dose for chest tomosynthesis imaging. The results obtained so far suggest an s-DCT using a distributed CNT x-ray source array is feasible.

  15. Computerized database management system for breast cancer patients

    OpenAIRE

    Sim, Kok Swee; Chong, Sze Siang; Tso, Chih Ping; Nia, Mohsen Esmaeili; Chong, Aun Kee; Abbas, Siti Fathimah

    2014-01-01

    Data analysis based on breast cancer risk factors such as age, race, breastfeeding, hormone replacement therapy, family history, and obesity was conducted on breast cancer patients using a new enhanced computerized database management system. My Structural Query Language (MySQL) is selected as the application for database management system to store the patient data collected from hospitals in Malaysia. An automatic calculation tool is embedded in this system to assist the data analysis. The r...

  16. Drug delivery system and breast cancer cells

    Science.gov (United States)

    Colone, Marisa; Kaliappan, Subramanian; Calcabrini, Annarica; Tortora, Mariarosaria; Cavalieri, Francesca; Stringaro, Annarita

    2016-06-01

    Recently, nanomedicine has received increasing attention for its ability to improve the efficacy of cancer therapeutics. Nanosized polymer therapeutic agents offer the advantage of prolonged circulation in the blood stream, targeting to specific sites, improved efficacy and reduced side effects. In this way, local, controlled delivery of the drug will be achieved with the advantage of a high concentration of drug release at the target site while keeping the systemic concentration of the drug low, thus reducing side effects due to bioaccumulation. Various drug delivery systems such as nanoparticles, liposomes, microparticles and implants have been demonstrated to significantly enhance the preventive/therapeutic efficacy of many drugs by increasing their bioavailability and targetability. As these carriers significantly increase the therapeutic effect of drugs, their administration would become less cost effective in the near future. The purpose of our research work is to develop a delivery system for breast cancer cells using a microvector of drugs. These results highlight the potential uses of these responsive platforms suited for biomedical and pharmaceutical applications. At the request of all authors of the paper an updated version was published on 12 July 2016. The manuscript was prepared and submitted without Dr. Francesca Cavalieri's contribution and her name was added without her consent. Her name has been removed in the updated and re-published article.

  17. Adjuvant systemic therapy in older women with breast cancer.

    Science.gov (United States)

    Leone, Julieta; Leone, Bernardo Amadeo; Leone, José Pablo

    2016-01-01

    Breast cancer in the elderly is an increasing clinical problem. In addition, ~60% of deaths from breast cancer occur in women aged 65 years and older. Despite this, older women with breast cancer have been underrepresented in clinical trials, and this has led to less than optimal evidence to guide their therapy. The management of elderly women with early breast cancer is a complex process that requires careful evaluation of life expectancy, comorbidities, patient values, and risks and benefits of available treatment options. This review will focus on current adjuvant systemic therapy options for older women with breast cancer, discuss the principles in the decision-making process, and define the role of endocrine therapy, chemotherapy, and targeted agents. PMID:27524919

  18. Adjuvant systemic therapy in older women with breast cancer

    Science.gov (United States)

    Leone, Julieta; Leone, Bernardo Amadeo; Leone, José Pablo

    2016-01-01

    Breast cancer in the elderly is an increasing clinical problem. In addition, ~60% of deaths from breast cancer occur in women aged 65 years and older. Despite this, older women with breast cancer have been underrepresented in clinical trials, and this has led to less than optimal evidence to guide their therapy. The management of elderly women with early breast cancer is a complex process that requires careful evaluation of life expectancy, comorbidities, patient values, and risks and benefits of available treatment options. This review will focus on current adjuvant systemic therapy options for older women with breast cancer, discuss the principles in the decision-making process, and define the role of endocrine therapy, chemotherapy, and targeted agents. PMID:27524919

  19. A comparison of reconstruction algorithms for C-arm mammography tomosynthesis

    International Nuclear Information System (INIS)

    Digital tomosynthesis is an imaging technique to produce a tomographic image from a series of angular digital images in a manner similar to conventional focal plane tomography. Unlike film focal plane tomography, the acquisition of the data in a C-arm geometry causes the image receptor to be positioned at various angles to the reconstruction tomogram. The digital nature of the data allows for input images to be combined into the desired plane with the flexibility of generating tomograms of many separate planes from a single set of input data. Angular datasets were obtained of a low contrast detectability (LCD) phantom and cadaver breast utilizing a Lorad stereotactic biopsy unit with a coupled source and digital detector in a C-arm configuration. Datasets of 9 and 41 low-dose projections were collected over a 30 deg. angular range. Tomographic images were reconstructed using a Backprojection (BP) algorithm, an Iterative Subtraction (IS) algorithm that allows the partial subtraction of out-of-focus planes, and an Algebraic Reconstruction (AR) algorithm. These were compared with single view digital radiographs. The methods' effectiveness at enhancing visibility of an obscured LCD phantom was quantified in terms of the Signal to Noise Ratio (SNR), and Signal to Background Ratio (SBR), all normalized to the metric value for the single projection image. The methods' effectiveness at removing ghosting artifacts in a cadaver breast was quantified in terms of the Artifact Spread Function (ASF). The technology proved effective at partially removing out of focus structures and enhancing SNR and SBR. The normalized SNR was highest at 4.85 for the obscured LCD phantom, using nine projections and IS algorithm. The normalized SBR was highest at 23.2 for the obscured LCD phantom, using 41 projections and an AR algorithm. The highest normalized metric values occurred with the obscured phantom. This supports the assertion that the greatest value of tomosynthesis is in imaging

  20. Investigation of a scanned cylindrical ultrasound system for breast hyperthermia

    International Nuclear Information System (INIS)

    This paper investigates the feasibility of a scanned cylindrical ultrasound system for producing uniform heating from the central to the superficial portions of the breast or localized heating within the breast at a specific location. The proposed system consists of plane ultrasound transducer(s) mounted on a scanned cylindrical support. The breast was immersed in water and surrounded by this system during the treatment. The control parameters considered are the size of the transducer, the ultrasound frequency, the scan angle and the shifting distance between the axes of the breast and the system. Three-dimensional acoustical and thermal models were used to calculate the temperature distribution. Non-perfused phantom experiments were performed to verify the simulation results. Simulation results indicate that high frequency ultrasound could be used for the superficial heating, and the scan angle of the transducer could be varied to obtain an appropriate high temperature region to cover the desired treatment region. Low frequency ultrasound could be used for deep heating and the high temperature region could be moved by shifting the system. In addition, a combination of low and high frequency ultrasound could result in a portion treatment from the central to the superficial breast or an entire breast treatment. Good agreement was obtained between non-perfused experiments and simulation results. The findings of this study can be used to determine the effects of the control parameters of this system, as well as to select the optimal parameters for a specific treatment

  1. Breast cancer screening controversies: who, when, why, and how?

    Science.gov (United States)

    Chetlen, Alison; Mack, Julie; Chan, Tiffany

    2016-01-01

    Mammographic screening is effective in reducing mortality from breast cancer. The issue is not whether mammography is effective, but whether the false positive rate and false negative rates can be reduced. This review will discuss controversies including the reduction in breast cancer mortality, overdiagnosis, the ideal screening candidate, and the optimal imaging modality for breast cancer screening. The article will compare and contrast screening mammography, tomosynthesis, whole-breast screening ultrasound, magnetic resonance imaging, and molecular breast imaging. Though supplemental imaging modalities are being utilized to improve breast cancer diagnosis, mammography still remains the gold standard for breast cancer screening.

  2. Novel systemic therapies for breast cancer.

    Science.gov (United States)

    Lo, Soo; Johnston, Stephen R D

    2003-12-01

    The rapid expansion in our knowledge of the molecular pathogenesis of cancer has created several opportunities for novel strategies in anti-cancer drug design and development. Recent developments have included a series of new endocrine therapies such as pure anti-oestrogens and selective oestrogen receptor modulators, and trials are in progress to determine their role in the sequence of therapies given the first-line role now occupied by the aromatase inhibitors. Novel cytotoxic drugs have been developed with an improved toxicity profile, including oral prodrugs that are activated within tumour cells, and liposomal delivery mechanisms for conventional drugs that reduce some of the systemic toxicities. There has been much success with monoclonal antibodies targeted against growth factor receptors, both as monotherapy and in enhancing the efficacy of cytotoxic drugs. A number of small molecule signal transduction inhibitors are in early stages of clinical development for breast cancer, including tyrosine-kinase inhibitors and farnesyl transferase inhibitors. Emerging pre-clinical evidence suggests that these drugs may best be used in combination with endocrine therapy. Other novel strategies that are being tested include vaccines and anti-angiogenesis drugs. As these new therapies evolve towards the clinic, the challenge to oncologists is whether their potential seen in the laboratory can be matched by further substantial improvements in clinical outcome.

  3. Geometric calibration for a SPECT system dedicated to breast imaging

    Institute of Scientific and Technical Information of China (English)

    WU Li-Wei; WEI Long; CAO Xue-Xiang; WANG Lu; HUANG Xian-Chao; CHAI Pei; YUN Ming-Kai; ZHANG Yu-Bao; ZHANG Long; SHAN Bao-Ci

    2012-01-01

    Geometric calibration is critical to the accurate SPECT reconstruction.In this paper,a geometric calibration method was developed for a dedicated breast SPECT system with a tilted parallel beam (TPB)orbit.The acquisition geometry of the breast SPECT was firstly characterized.And then its projection model was established based on the acquisition geometry.Finally,the calibration results were obtained using a nonlinear optimization method that fitted the measured projections to the model.Monte Carlo data of the breast SPECT were used to verify the calibration method.Simulation results showed that the geometric parameters with reasonable accuracy could be obtained by the proposed method.

  4. Computerized database management system for breast cancer patients.

    Science.gov (United States)

    Sim, Kok Swee; Chong, Sze Siang; Tso, Chih Ping; Nia, Mohsen Esmaeili; Chong, Aun Kee; Abbas, Siti Fathimah

    2014-01-01

    Data analysis based on breast cancer risk factors such as age, race, breastfeeding, hormone replacement therapy, family history, and obesity was conducted on breast cancer patients using a new enhanced computerized database management system. My Structural Query Language (MySQL) is selected as the application for database management system to store the patient data collected from hospitals in Malaysia. An automatic calculation tool is embedded in this system to assist the data analysis. The results are plotted automatically and a user-friendly graphical user interface is developed that can control the MySQL database. Case studies show breast cancer incidence rate is highest among Malay women, followed by Chinese and Indian. The peak age for breast cancer incidence is from 50 to 59 years old. Results suggest that the chance of developing breast cancer is increased in older women, and reduced with breastfeeding practice. The weight status might affect the breast cancer risk differently. Additional studies are needed to confirm these findings.

  5. Digital tomosynthesis (DTS) with a Circular X-ray tube: Its image reconstruction based on total-variation minimization and the image characteristics

    Science.gov (United States)

    Park, Y. O.; Hong, D. K.; Cho, H. S.; Je, U. K.; Oh, J. E.; Lee, M. S.; Kim, H. J.; Lee, S. H.; Jang, W. S.; Cho, H. M.; Choi, S. I.; Koo, Y. S.

    2013-09-01

    In this paper, we introduce an effective imaging system for digital tomosynthesis (DTS) with a circular X-ray tube, the so-called circular-DTS (CDTS) system, and its image reconstruction algorithm based on the total-variation (TV) minimization method for low-dose, high-accuracy X-ray imaging. Here, the X-ray tube is equipped with a series of cathodes distributed around a rotating anode, and the detector remains stationary throughout the image acquisition. We considered a TV-based reconstruction algorithm that exploited the sparsity of the image with substantially high image accuracy. We implemented the algorithm for the CDTS geometry and successfully reconstructed images of high accuracy. The image characteristics were investigated quantitatively by using some figures of merit, including the universal-quality index (UQI) and the depth resolution. For selected tomographic angles of 20, 40, and 60°, the corresponding UQI values in the tomographic view were estimated to be about 0.94, 0.97, and 0.98, and the depth resolutions were about 4.6, 3.1, and 1.2 voxels in full width at half maximum (FWHM), respectively. We expect the proposed method to be applicable to developing a next-generation dental or breast X-ray imaging system.

  6. Impact of breast MRI on surgical treatment, axillary approach, and systemic therapy for breast cancer.

    Science.gov (United States)

    Mameri, Claudia S; Kemp, Claudio; Goldman, Suzan M; Sobral, Luiz A; Ajzen, Sergio

    2008-01-01

    The purpose of this study is to determine how often breast magnetic resonance imaging (MRI) brings additional information that influences management of patients with breast cancer concerning surgical treatment, axillary lymph node approach, and systemic therapy. From July 2004 to July 2005, 99 patients recently diagnosed with breast cancer in clinical stages 0, I, and II were prospectively evaluated about their therapeutic plans, at first based on usual protocol (physical examination, mammography and ultrasound) and next going through bilateral breast MR. Examinations were carried out at 1.5 T on five sequences of FSPGR 3D for 90 seconds (four post-gadolinium diethylenetriaminepenta acetic acid 0.16 mM/Kg). Parameters analyzed on MRI were extension of primary lesion; detection of multifocality, multicentricity, or contra lateral lesion; muscular or skin involvement; and presence of lymph node involvement. Pathologic confirmation of additional lesions was achieved by core or excisional biopsy. MRI made 69 additional findings in 53 patients. Fifty-one findings were true-positives (51/69 = 73.9%) including 16 larger single lesions; 18 cases of multifocality; 7 cases of multicentricity; 3 cases of contra lateral lesion; 5 cases of lymph node involvement (one of them involved medial thoracic chain); 1 with muscular involvement; 1 with skin involvement. MRI has changed previous management plans in 44.4% of 99 patients. We observed increase in mastectomies (26.8%) on axillary lymph node dissection (25%) and changes on systemic therapy (20.2%), all because of additional MRI true-positive findings. Breast MRI alters significantly the rate of mastectomy, the approach of axillary chain for staging, and the use of systemic therapy because of its accuracy in evaluating breast cancer local extent. PMID:18476882

  7. Limited angle C-arm tomosynthesis reconstruction algorithms

    Science.gov (United States)

    Malalla, Nuhad A. Y.; Xu, Shiyu; Chen, Ying

    2015-03-01

    In this paper, C-arm tomosynthesis with digital detector was investigated as a novel three dimensional (3D) imaging technique. Digital tomosythses is an imaging technique to provide 3D information of the object by reconstructing slices passing through the object, based on a series of angular projection views with respect to the object. C-arm tomosynthesis provides two dimensional (2D) X-ray projection images with rotation (-/+20 angular range) of both X-ray source and detector. In this paper, four representative reconstruction algorithms including point by point back projection (BP), filtered back projection (FBP), simultaneous algebraic reconstruction technique (SART) and maximum likelihood expectation maximization (MLEM) were investigated. Dataset of 25 projection views of 3D spherical object that located at center of C-arm imaging space was simulated from 25 angular locations over a total view angle of 40 degrees. With reconstructed images, 3D mesh plot and 2D line profile of normalized pixel intensities on focus reconstruction plane crossing the center of the object were studied with each reconstruction algorithm. Results demonstrated the capability to generate 3D information from limited angle C-arm tomosynthesis. Since C-arm tomosynthesis is relatively compact, portable and can avoid moving patients, it has been investigated for different clinical applications ranging from tumor surgery to interventional radiology. It is very important to evaluate C-arm tomosynthesis for valuable applications.

  8. Ray tracing reconstruction investigation for C-arm tomosynthesis

    Science.gov (United States)

    Malalla, Nuhad A. Y.; Chen, Ying

    2016-04-01

    C-arm tomosynthesis is a three dimensional imaging technique. Both x-ray source and the detector are mounted on a C-arm wheeled structure to provide wide variety of movement around the object. In this paper, C-arm tomosynthesis was introduced to provide three dimensional information over a limited view angle (less than 180o) to reduce radiation exposure and examination time. Reconstruction algorithms based on ray tracing method such as ray tracing back projection (BP), simultaneous algebraic reconstruction technique (SART) and maximum likelihood expectation maximization (MLEM) were developed for C-arm tomosynthesis. C-arm tomosynthesis projection images of simulated spherical object were simulated with a virtual geometric configuration with a total view angle of 40 degrees. This study demonstrated the sharpness of in-plane reconstructed structure and effectiveness of removing out-of-plane blur for each reconstruction algorithms. Results showed the ability of ray tracing based reconstruction algorithms to provide three dimensional information with limited angle C-arm tomosynthesis.

  9. Breast vasculitis in association with breast gigantism in a pregnant patient with systemic lupus erythematosus.

    OpenAIRE

    Propper, D J; Reid, D.M.; Stankler, L.; Eastmond, C J

    1991-01-01

    A 24 year old woman with systemic lupus erythematosus (SLE) developed widespread necrotic skin ulceration and gigantism of both breasts during an exacerbation of SLE in the last trimester of her second pregnancy. Over the remainder of the pregnancy the ulceration was only controlled by high dose corticosteroids. After parturition, however, it was possible to reduce the steroid dose without recurrence of the ulceration.

  10. Systemic Treatment Approaches in Breast Cancer

    NARCIS (Netherlands)

    M. Bontenbal (Marijke)

    1997-01-01

    textabstractBreast cancer is the most conmlon malignant tumor among women, with an estimated 135,000 new cases and 58,000 recorded deaths per year in the Europeau Community in 1990. With respect to the Netherlands, the most recent data of The Netherlands Cancer Registry show an incidence of nearly 1

  11. A review of biomechanically informed breast image registration

    Science.gov (United States)

    Hipwell, John H.; Vavourakis, Vasileios; Han, Lianghao; Mertzanidou, Thomy; Eiben, Björn; Hawkes, David J.

    2016-01-01

    Breast radiology encompasses the full range of imaging modalities from routine imaging via x-ray mammography, magnetic resonance imaging and ultrasound (both two- and three-dimensional), to more recent technologies such as digital breast tomosynthesis, and dedicated breast imaging systems for positron emission mammography and ultrasound tomography. In addition new and experimental modalities, such as Photoacoustics, Near Infrared Spectroscopy and Electrical Impedance Tomography etc, are emerging. The breast is a highly deformable structure however, and this greatly complicates visual comparison of imaging modalities for the purposes of breast screening, cancer diagnosis (including image guided biopsy), tumour staging, treatment monitoring, surgical planning and simulation of the effects of surgery and wound healing etc. Due primarily to the challenges posed by these gross, non-rigid deformations, development of automated methods which enable registration, and hence fusion, of information within and across breast imaging modalities, and between the images and the physical space of the breast during interventions, remains an active research field which has yet to translate suitable methods into clinical practice. This review describes current research in the field of breast biomechanical modelling and identifies relevant publications where the resulting models have been incorporated into breast image registration and simulation algorithms. Despite these developments there remain a number of issues that limit clinical application of biomechanical modelling. These include the accuracy of constitutive modelling, implementation of representative boundary conditions, failure to meet clinically acceptable levels of computational cost, challenges associated with automating patient-specific model generation (i.e. robust image segmentation and mesh generation) and the complexity of applying biomechanical modelling methods in routine clinical practice.

  12. Value of breast imaging reporting and data system in Chinese breast cancer screening

    International Nuclear Information System (INIS)

    Objective: To study the value of breast imaging reporting and data system (BI-RADS) in Chinese breast cancer screening. Methods: A total number of 3483 women participated in breast cancer screening with mammography in Hexi district in Tianjin from August to December 2009, which was organized by ministry of public health. BI-RADS assessment categories and recommendations were compared with histological findings. The precision, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated. Results: Among 3483 screening mammography cases, 267 were almost entirely fat breast, 1245 were scattered fibroglandular, 1890 were dense and 81 extremely dense. There were 1011 patients (29.0%) with category 1, 1741 (50.0%) with category 2, 383 (11.0%) with category 3, 59 patients (1.7%) with category 4 and 16 (0.5%) with category 5 according to BI-RADS assessment categories. Totally, 71 women with 77 lesions were confirmed by histological examinations. There were 29 malignant and 48 benign lesions. The diagnostic precision, sensitivity, specificity of' BI-RADS were 63.6% (49/77), 93.1% (27/29) and 45.8% (22/48). The general PPV of BI-RADS was 50.9% (27/53). The PPV of categories 0.4, 5 were 25.0% (1/4), 36.4% (12/33) and 87.5% (14/16). The NPV of categories 2 and 3 were 90.9% (10/11), 100.0% (12/12). Conclusions: BI-RADS is of much value in assessing the breast malignancy. It is applicable in Chinese breast cancer screening. (authors)

  13. Preliminary attempt on maximum likelihood tomosynthesis reconstruction of DEI data

    International Nuclear Information System (INIS)

    Tomosynthesis is a three-dimension reconstruction method that can remove the effect of superimposition with limited angle projections. It is especially promising in mammography where radiation dose is concerned. In this paper, we propose a maximum likelihood tomosynthesis reconstruction algorithm (ML-TS) on the apparent absorption data of diffraction enhanced imaging (DEI). The motivation of this contribution is to develop a tomosynthesis algorithm in low-dose or noisy circumstances and make DEI get closer to clinic application. The theoretical statistical models of DEI data in physics are analyzed and the proposed algorithm is validated with the experimental data at the Beijing Synchrotron Radiation Facility (BSRF). The results of ML-TS have better contrast compared with the well known 'shift-and-add' algorithm and FBP algorithm. (authors)

  14. 21 CFR 866.6040 - Gene expression profiling test system for breast cancer prognosis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Gene expression profiling test system for breast... Associated Antigen immunological Test Systems § 866.6040 Gene expression profiling test system for breast cancer prognosis. (a) Identification. A gene expression profiling test system for breast cancer...

  15. Prototype of Microwave Imaging System for Breast-Cancer Screening

    DEFF Research Database (Denmark)

    Rubæk, Tonny; Zhurbenko, Vitaliy

    2009-01-01

    Microwave imaging for breast-cancer detection has received the attention of a large number of research groups in the last decade. In this paper, the imaging system currently being developed at the Technical university of Denmark is presented. This includes a description of the antenna system...

  16. The thioredoxin system in breast cancer cell invasion and migration

    Directory of Open Access Journals (Sweden)

    Maneet Bhatia

    2016-08-01

    Full Text Available Metastasis is the most life threatening aspect of breast cancer. It is a multi-step process involving invasion and migration of primary tumor cells with a subsequent colonization of these cells at a secondary location. The aim of the present study was to investigate the role of thioredoxin (Trx1 in the invasion and migration of breast cancer cells and to assess the strength of the association between high levels of Trx1 and thioredoxin reductase (TrxR1 expression with breast cancer patient survival. Our results indicate that the expression of both Trx1 and TrxR1 are statistically significantly increased in breast cancer patient cells compared with paired normal breast tissue from the same patient. Over-expression of Trx1 in MDA-MB-231 breast cancer cell lines enhanced cell invasion in in vitro assays while expression of a redox inactive mutant form of Trx1 (designated 1SS or the antisense mRNA inhibited cell invasion. Addition of exogenous Trx1 also enhanced cell invasion, while addition of a specific monoclonal antibody that inhibits Trx1 redox function decreased cell invasion. Over-expression of intracellular Trx1 did not increase cell migration but expression of intracellular 1SS inhibited migration. Addition of exogenous Trx1 enhanced cell migration while 1SS had no effect. Treatment with auranofin inhibited TrxR activity, cell migration and clonogenic activity of MDA-MB-231 cells, while increasing reactive oxygen species (ROS levels. Analysis of 25 independent cohorts with 5910 patients showed that Trx1 and TrxR1 were both associated with a poor patient prognosis in terms of overall survival, distant metastasis free survival and disease free survival. Therefore, targeting the Trx system with auranofin or other specific inhibitors may provide improved breast cancer patient outcomes through inhibition of cancer invasion and migration.

  17. The thioredoxin system in breast cancer cell invasion and migration.

    Science.gov (United States)

    Bhatia, Maneet; McGrath, Kelly L; Di Trapani, Giovanna; Charoentong, Pornpimol; Shah, Fenil; King, Mallory M; Clarke, Frank M; Tonissen, Kathryn F

    2016-08-01

    Metastasis is the most life threatening aspect of breast cancer. It is a multi-step process involving invasion and migration of primary tumor cells with a subsequent colonization of these cells at a secondary location. The aim of the present study was to investigate the role of thioredoxin (Trx1) in the invasion and migration of breast cancer cells and to assess the strength of the association between high levels of Trx1 and thioredoxin reductase (TrxR1) expression with breast cancer patient survival. Our results indicate that the expression of both Trx1 and TrxR1 are statistically significantly increased in breast cancer patient cells compared with paired normal breast tissue from the same patient. Over-expression of Trx1 in MDA-MB-231 breast cancer cell lines enhanced cell invasion in in vitro assays while expression of a redox inactive mutant form of Trx1 (designated 1SS) or the antisense mRNA inhibited cell invasion. Addition of exogenous Trx1 also enhanced cell invasion, while addition of a specific monoclonal antibody that inhibits Trx1 redox function decreased cell invasion. Over-expression of intracellular Trx1 did not increase cell migration but expression of intracellular 1SS inhibited migration. Addition of exogenous Trx1 enhanced cell migration while 1SS had no effect. Treatment with auranofin inhibited TrxR activity, cell migration and clonogenic activity of MDA-MB-231 cells, while increasing reactive oxygen species (ROS) levels. Analysis of 25 independent cohorts with 5910 patients showed that Trx1 and TrxR1 were both associated with a poor patient prognosis in terms of overall survival, distant metastasis free survival and disease free survival. Therefore, targeting the Trx system with auranofin or other specific inhibitors may provide improved breast cancer patient outcomes through inhibition of cancer invasion and migration.

  18. The thioredoxin system in breast cancer cell invasion and migration.

    Science.gov (United States)

    Bhatia, Maneet; McGrath, Kelly L; Di Trapani, Giovanna; Charoentong, Pornpimol; Shah, Fenil; King, Mallory M; Clarke, Frank M; Tonissen, Kathryn F

    2016-08-01

    Metastasis is the most life threatening aspect of breast cancer. It is a multi-step process involving invasion and migration of primary tumor cells with a subsequent colonization of these cells at a secondary location. The aim of the present study was to investigate the role of thioredoxin (Trx1) in the invasion and migration of breast cancer cells and to assess the strength of the association between high levels of Trx1 and thioredoxin reductase (TrxR1) expression with breast cancer patient survival. Our results indicate that the expression of both Trx1 and TrxR1 are statistically significantly increased in breast cancer patient cells compared with paired normal breast tissue from the same patient. Over-expression of Trx1 in MDA-MB-231 breast cancer cell lines enhanced cell invasion in in vitro assays while expression of a redox inactive mutant form of Trx1 (designated 1SS) or the antisense mRNA inhibited cell invasion. Addition of exogenous Trx1 also enhanced cell invasion, while addition of a specific monoclonal antibody that inhibits Trx1 redox function decreased cell invasion. Over-expression of intracellular Trx1 did not increase cell migration but expression of intracellular 1SS inhibited migration. Addition of exogenous Trx1 enhanced cell migration while 1SS had no effect. Treatment with auranofin inhibited TrxR activity, cell migration and clonogenic activity of MDA-MB-231 cells, while increasing reactive oxygen species (ROS) levels. Analysis of 25 independent cohorts with 5910 patients showed that Trx1 and TrxR1 were both associated with a poor patient prognosis in terms of overall survival, distant metastasis free survival and disease free survival. Therefore, targeting the Trx system with auranofin or other specific inhibitors may provide improved breast cancer patient outcomes through inhibition of cancer invasion and migration. PMID:26760912

  19. Systemic chemotherapy for metastatic breast cancer

    Institute of Scientific and Technical Information of China (English)

    Yannan Zhao; Biyun Wang

    2015-01-01

    Breast cancer is the leading cause of cancer among women worldwide and the most common cancer in China. Many factors influence the treatment strategy for metastatic breast cancer (MBC). Chemotherapy should be administered to patients with hormone receptor-negative tumors, symptomatic visceral metastasis, and a short disease-free interval. Sequential single-agent chemotherapy has similar efficacy as combination agents in terms of overall survival and quality of life. Anthracyclines are the cornerstone of first-line treatment for MBC, and taxanes represent the second treatment option after resistance. When progression or intolerable toxicity occurs after optimal treatment, the alternative treatments include capecitabine, vinorel-bine, and gemcitabine. Ixabepilone and eribulin are relatively new effective single agents. A combination of cytotoxic agents for patients with rapid clinical progression can further improve the overall response rate and time to progression compared to single-agent treatment. For patients with MBC who were pretreated with anthracyclines in the neoadjuvant/adjuvant setting, a taxane-containing regimen such as docetaxel plus capecitabine or gemcitabine plus paclitaxel should be administered. Platinum-based therapies such as cisplatin or carboplatin have a role in the treatment of triple-negative breast cancer. Meanwhile, the efficacy of the addition of targeted drugs such as iniparib, bevacizumab, and cetuximab to chemotherapy remains unproven. Maintenance chemotherapy is routinely recommended in clinical practice at present. Patients who were previously treated with paclitaxel and gemcitabine have better progression-free and overall survival with maintenance chemotherapy according to a Korean phase Ⅲ clinical trial. Sequential maintenance treatment with capecitabine monotherapy after capecitabine-based combination chemotherapy (X-based X) appears favorable based on a series of domestic studies.

  20. Introducing DeBRa: a detailed breast model for radiological studies

    Energy Technology Data Exchange (ETDEWEB)

    Ma, Andy K W; Darambara, Dimitra G [Joint Department of Physics, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Fulham Road, London SW3 6JJ (United Kingdom); Gunn, Spencer [Dexela Ltd, Wenlock Business Centre, 50/52 Wharf Road, London N1 7SF (United Kingdom)], E-mail: andyma@physics.org, E-mail: dimitra.darambara@icr.ac.uk, E-mail: spencer@dexelaimaging.com

    2009-07-21

    Currently, x-ray mammography is the method of choice in breast cancer screening programmes. As the mammography technology moves from 2D imaging modalities to 3D, conventional computational phantoms do not have sufficient detail to support the studies of these advanced imaging systems. Studies of these 3D imaging systems call for a realistic and sophisticated computational model of the breast. DeBRa (Detailed Breast model for Radiological studies) is the most advanced, detailed, 3D computational model of the breast developed recently for breast imaging studies. A DeBRa phantom can be constructed to model a compressed breast, as in film/screen, digital mammography and digital breast tomosynthesis studies, or a non-compressed breast as in positron emission mammography and breast CT studies. Both the cranial-caudal and mediolateral oblique views can be modelled. The anatomical details inside the phantom include the lactiferous duct system, the Cooper ligaments and the pectoral muscle. The fibroglandular tissues are also modelled realistically. In addition, abnormalities such as microcalcifications, irregular tumours and spiculated tumours are inserted into the phantom. Existing sophisticated breast models require specialized simulation codes. Unlike its predecessors, DeBRa has elemental compositions and densities incorporated into its voxels including those of the explicitly modelled anatomical structures and the noise-like fibroglandular tissues. The voxel dimensions are specified as needed by any study and the microcalcifications are embedded into the voxels so that the microcalcification sizes are not limited by the voxel dimensions. Therefore, DeBRa works with general-purpose Monte Carlo codes. Furthermore, general-purpose Monte Carlo codes allow different types of imaging modalities and detector characteristics to be simulated with ease. DeBRa is a versatile and multipurpose model specifically designed for both x-ray and {gamma}-ray imaging studies.

  1. Digital tomosynthesis of hands using simultaneous algebraic reconstruction technique with distance driven projector

    Energy Technology Data Exchange (ETDEWEB)

    Levakhina, Y.M. [Luebeck Univ. (Germany). Graduate School for Computing in Medicine and Life Sciences; Luebeck Univ. (Germany). Inst. of Medical Engineering; Duschka, R.L.; Barkhausen, J. [Universitaetsklinikum Schleswig-Holstein, Luebeck (Germany). Klinik fuer Radiologie und Nuklearmedizin; Buzug, T.M. [Luebeck Univ. (Germany). Inst. of Medical Engineering

    2011-07-01

    Digital tomosynthesis (DT) is an X-ray tomographic technique for producing a three-dimensional stack of crosssectional images, based on a limited number of low-dose two-dimensional projections, acquired over a limited angular range. Currently, DT has mainly been investigated for the breast and chest imaging. Another application of DT may be an orthopaedic imaging of hands. A three-dimensional reconstruction with a high in-plane resolution, a low dose and potentially low costs make DT attractive for hand imaging comparing with the planar radiography or computed tomography. However, it should be noted that an accurate image reconstruction in DT is a challenging task due to the high degree of data incompleteness. Images are affected by the residual blur of structures that are located above and below the plane of interest. A human hand consists of 27 bones and therefore the artifact problem becomes even more acute in this case, since the magnitude of artifacts is related not only to the chosen reconstruction type but also to the size and contrast of the artifact-generating object. The study presented in the current work has been performed to show a capability of Simultaneous Algebraic Reconstruction Technique (SART) for hand visualization in tomosynthesis. A distance-driven type for the projector and backprojector operator has been used to make the calculation fast and accurate. Studies have been carried out on a phantom with an uniform background and millimeter-sized balls, a dried finger bone and an in toto hand phantom. A Siemens Mammomat Inspiration device has been used to acquire the projection data. Experimental results show that SART is able to reduce out-of-plane artifacts caused by bone tissue. It provides reconstruction with acceptable quality in only one iteration with the recovered visibility of the obscured trabecular structures as well as the joint spaces and the margins. (orig.)

  2. Development of realistic physical breast phantoms matched to virtual breast phantoms based on human subject data

    International Nuclear Information System (INIS)

    Purpose: Physical phantoms are essential for the development, optimization, and evaluation of x-ray breast imaging systems. Recognizing the major effect of anatomy on image quality and clinical performance, such phantoms should ideally reflect the three-dimensional structure of the human breast. Currently, there is no commercially available three-dimensional physical breast phantom that is anthropomorphic. The authors present the development of a new suite of physical breast phantoms based on human data. Methods: The phantoms were designed to match the extended cardiac-torso virtual breast phantoms that were based on dedicated breast computed tomography images of human subjects. The phantoms were fabricated by high-resolution multimaterial additive manufacturing (3D printing) technology. The glandular equivalency of the photopolymer materials was measured relative to breast tissue-equivalent plastic materials. Based on the current state-of-the-art in the technology and available materials, two variations were fabricated. The first was a dual-material phantom, the Doublet. Fibroglandular tissue and skin were represented by the most radiographically dense material available; adipose tissue was represented by the least radiographically dense material. The second variation, the Singlet, was fabricated with a single material to represent fibroglandular tissue and skin. It was subsequently filled with adipose-equivalent materials including oil, beeswax, and permanent urethane-based polymer. Simulated microcalcification clusters were further included in the phantoms via crushed eggshells. The phantoms were imaged and characterized visually and quantitatively. Results: The mammographic projections and tomosynthesis reconstructed images of the fabricated phantoms yielded realistic breast background. The mammograms of the phantoms demonstrated close correlation with simulated mammographic projection images of the corresponding virtual phantoms. Furthermore, power

  3. Development of realistic physical breast phantoms matched to virtual breast phantoms based on human subject data

    Energy Technology Data Exchange (ETDEWEB)

    Kiarashi, Nooshin [Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Duke University Medical Center, Durham, North Carolina 27710 and Department of Electrical and Computer Engineering, Duke University, Durham, North Carolina 27708 (United States); Nolte, Adam C. [Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Duke University Medical Center, Durham, North Carolina 27710 and Department of Biomedical Engineering, Duke University, Durham, North Carolina 27708 (United States); Sturgeon, Gregory M.; Ghate, Sujata V. [Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Duke University Medical Center, Durham, North Carolina 27710 (United States); Segars, William P. [Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Duke University Medical Center, Durham, North Carolina 27710 and Medical Physics Graduate Program, Duke University, Durham, North Carolina 27708 (United States); Nolte, Loren W. [Department of Electrical and Computer Engineering, Duke University, Durham, North Carolina 27708 and Department of Biomedical Engineering, Duke University, Durham, North Carolina 27708 (United States); Samei, Ehsan [Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Duke University Medical Center, Durham, North Carolina 27710 (United States); Department of Electrical and Computer Engineering, Duke University, Durham, North Carolina 27708 (United States); Department of Biomedical Engineering, Duke University, Durham, North Carolina 27708 (United States); Medical Physics Graduate Program, Duke University, Durham, North Carolina 27708 (United States); Department of Physics, Duke University, Durham, North Carolina 27708 (United States); and others

    2015-07-15

    Purpose: Physical phantoms are essential for the development, optimization, and evaluation of x-ray breast imaging systems. Recognizing the major effect of anatomy on image quality and clinical performance, such phantoms should ideally reflect the three-dimensional structure of the human breast. Currently, there is no commercially available three-dimensional physical breast phantom that is anthropomorphic. The authors present the development of a new suite of physical breast phantoms based on human data. Methods: The phantoms were designed to match the extended cardiac-torso virtual breast phantoms that were based on dedicated breast computed tomography images of human subjects. The phantoms were fabricated by high-resolution multimaterial additive manufacturing (3D printing) technology. The glandular equivalency of the photopolymer materials was measured relative to breast tissue-equivalent plastic materials. Based on the current state-of-the-art in the technology and available materials, two variations were fabricated. The first was a dual-material phantom, the Doublet. Fibroglandular tissue and skin were represented by the most radiographically dense material available; adipose tissue was represented by the least radiographically dense material. The second variation, the Singlet, was fabricated with a single material to represent fibroglandular tissue and skin. It was subsequently filled with adipose-equivalent materials including oil, beeswax, and permanent urethane-based polymer. Simulated microcalcification clusters were further included in the phantoms via crushed eggshells. The phantoms were imaged and characterized visually and quantitatively. Results: The mammographic projections and tomosynthesis reconstructed images of the fabricated phantoms yielded realistic breast background. The mammograms of the phantoms demonstrated close correlation with simulated mammographic projection images of the corresponding virtual phantoms. Furthermore, power

  4. A New CAD System for Breast Microcalcifications Diagnosis

    Directory of Open Access Journals (Sweden)

    H. Boulehmi

    2016-04-01

    Full Text Available Breast cancer is one of the most deadly cancers in the world, especially among women. With no identified causes and absence of effective treatment, early detection remains necessary to limit the damages and provide possible cure. Submitting women with family antecedent to mammography periodically can provide an early diagnosis of breast tumors. Computer Aided Diagnosis (CAD is a powerful tool that can help radiologists improving their diagnostic accuracy at earlier stages. Several works have been developed in order to analyze digital mammographies, detect possible lesions (especially masses and microcalcifications and evaluate their malignancy. In this paper a new approach of breast microcalcifications diagnosis on digital mammograms is introduced. The proposed approach begins with a preprocessing procedure aiming artifacts and pectoral muscle removal based on morphologic operators and contrast enhancement based on galactophorous tree interpolation. The second step of the proposed CAD system consists on segmenting microcalcifications clusters, using Generalized Gaussian Density (GGD estimation and a Bayesian back-propagation neural network. The last step is microcalcifications characterization using morphologic features which are used to feed a neuro-fuzzy system to classify the detected breast microcalcifications into benign and malignant classes.

  5. Development of a physical 3D anthropomorphic breast phantom

    International Nuclear Information System (INIS)

    Purpose: Develop a technique to fabricate a 3D anthropomorphic breast phantom with known ground truth for image quality assessment of 2D and 3D breast x-ray imaging systems. Methods: The phantom design is based on an existing computer model that can generate breast voxel phantoms of varying composition, size, and shape. The physical phantom is produced in two steps. First, the portion of the voxel phantom consisting of the glandular tissue, skin, and Cooper's ligaments is separated into sections. These sections are then fabricated by high-resolution rapid prototyping using a single material with 50% glandular equivalence. The remaining adipose compartments are then filled using an epoxy-based resin (EBR) with 100% adipose equivalence. The phantom sections are stacked to form the physical anthropomorphic phantom. Results: The authors fabricated a prototype phantom corresponding to a 450 ml breast with 45% dense tissue, deformed to a 5 cm compressed thickness. Both the rapid prototype (RP) and EBR phantom materials are radiographically uniform. The coefficient of variation (CoV) of the relative attenuation between RP and EBR phantom samples was <1% and the CoV of the signal intensity within RP and EBR phantom samples was <1.5% on average. Digital mammography and reconstructed digital breast tomosynthesis images of the authors' phantom were reviewed by two radiologists; they reported that the images are similar in appearance to clinical images, noting there are still artifacts from air bubbles in the EBR. Conclusions: The authors have developed a technique to produce 3D anthropomorphic breast phantoms with known ground truth, yielding highly realistic x-ray images. Such phantoms may serve both qualitative and quantitative performance assessments for 2D and 3D breast x-ray imaging systems.

  6. Breast

    International Nuclear Information System (INIS)

    Ultrasound is not an efficacious screening modality to detect early-stage breast malignancy in a clinically unremarkable population of women. Computed body tomography is similarly not practical for screening because of slice thickness and partial volume averaging, a higher radiation dose than modern mammography, and the lack of availability of such units for such a high throughput requirement. Nevertheless, these two imaging modalities can be very useful in management to guide the least invasive and efficacious treatment of the patient. X-ray mammography remains the principal imaging modality in the search for breast malignancy, but ultrasound is the single most important second study in the diagnostic evaluation of the breast. The combined use of these techniques and the ability to perform guided aspiration and localization procedures can result in a reduction in the surgical removal of benign cysts and reduction in the amount of tissue volume required if excision becomes necessary

  7. Protective Effects of Breast Milk on Central Nervous System and the Incidence of Febrile Convulsion in Breast-Fed Children

    OpenAIRE

    A Tayarani Bathayi; KH Farivar

    1999-01-01

    It is known that central nervous system is well protected in breast-fed children, recognized in decreased incidence of multiple sclerosis, infectious and malignant diseases of the central nervous system, sudden infant death syndrome, 5th day convulsion, and botulism as well as an increase in IQ rates. In this retrospective study we have found also an indirect correlation between in incidence of febrile convulsion and length of breast-feeding. Among 270 cases of febrile convulsion 144 (53.3%) ...

  8. Assessing and improving cobalt-60 digital tomosynthesis image quality

    Science.gov (United States)

    Marsh, Matthew B.; Schreiner, L. John; Kerr, Andrew T.

    2014-03-01

    Image guidance capability is an important feature of modern radiotherapy linacs, and future cobalt-60 units will be expected to have similar capabilities. Imaging with the treatment beam is an appealing option, for reasons of simplicity and cost, but the dose needed to produce cone beam CT (CBCT) images in a Co-60 treatment beam is too high for this modality to be clinically useful. Digital tomosynthesis (DT) offers a quasi-3D image, of sufficient quality to identify bony anatomy or fiducial markers, while delivering a much lower dose than CBCT. A series of experiments were conducted on a prototype Co-60 cone beam imaging system to quantify the resolution, selectivity, geometric accuracy and contrast sensitivity of Co-60 DT. Although the resolution is severely limited by the penumbra cast by the ~2 cm diameter source, it is possible to identify high contrast objects on the order of 1 mm in width, and bony anatomy in anthropomorphic phantoms is clearly recognizable. Low contrast sensitivity down to electron density differences of 3% is obtained, for uniform features of similar thickness. The conventional shift-and-add reconstruction algorithm was compared to several variants of the Feldkamp-Davis-Kress filtered backprojection algorithm result. The Co-60 DT images were obtained with a total dose of 5 to 15 cGy each. We conclude that Co-60 radiotherapy units upgraded for modern conformal therapy could also incorporate imaging using filtered backprojection DT in the treatment beam. DT is a versatile and promising modality that would be well suited to image guidance requirements.

  9. Overview of two years of clinical experience of chest tomo-synthesis at Sahlgrenska university hospital

    International Nuclear Information System (INIS)

    Since December 2006, ∼ 3800 clinical chest tomo-synthesis examinations have been performed at our department at Sahlgrenska Univ. Hospital. A subset of the examinations has been included in studies of the detectability of pulmonary nodules, using computed tomography (CT) as the gold standard. Visibility studies, in which chest tomo-synthesis and CT have been compared side-by side, have been used to determine the depiction potential of chest tomo-synthesis. Comparisons with conventional chest radiography have been made. In the clinical setting, chest tomo-synthesis has mostly been used as an additional examination. The most frequent indication for chest tomo-synthesis has been suspicion of a nodule or tumour. In visibility studies, tomo-synthesis has depicted over 90% of the nodules seen on the CT scan. The corresponding figure for chest radiography has been <30%. In the detection studies, the lesion-level sensitivity has been ∼ 60% for tomo-synthesis and 20% for chest radiography. In one of the detection studies, an analysis of all false-positive nodules was performed. This analysis showed that all findings had morphological correlates on the CT examinations. The majority of the false-positive nodules were localised in the immediate sub-pleural region. In conclusion, chest tomo-synthesis is an improved chest radiography method, which can be used to optimise the use of CT resources, thereby reducing the radiation dose to the patient population. However, there are some limitations with chest tomo-synthesis. For example, patients undergoing tomo-synthesis have to be able to stand still and hold their breath firmly for 10 s. Also, chest tomo-synthesis has a limited depth resolution, which may explain why pathology in the sub-pleural region is more difficult to interpret and artefacts from medical devices may occur. (authors)

  10. The endothelin system in breast tumour–endothelial cell interactions

    Directory of Open Access Journals (Sweden)

    Julia Botha

    2011-01-01

    Full Text Available The role of endothelin-1 (ET-1 and its receptors (ET-RA and ET-RB in tumour development and progression involves complex interactions. ET-1, produced by tumours and associated cells like endothelial cells, functions in an autocrine and paracrine manner to promote tumour angiogenesis. Thus, we hypothesised that endothelin, released into the tumour milieu by both tumours and the tumour vasculature, would influence angiogenesis. Therefore, this preliminary study aimed to investigate changes in ET1, ET-RA and ET-RB in breast tumour and microvascular endothelial cultures when each cell type was exposed directly to the other (co-culture model as well as to the conditioned-medium metabolites of the other (challenge model. ET-1 secretion was measured by an enzyme-linked immunosorbent assay and ET-1, ET-RA and ET-RB expression investigated by the linked streptavidin–biotin method. In challenge experiments, endothelial metabolites significantly increased secretion of breast tumour ET-1. Tumour metabolites promoted endothelial membrane projections with no effect on ET-1 secretion. ET-1 and its receptors were immunolocalised in both cell types, including in projections. Increasing cancer cell conditioned medium resulted in decreased endothelial ET-RA and increased ET-RB staining. Co-cultures demonstrated ET proteins in projections of both cell types as well as at heterogeneous contact points. The findings support a role for the endothelin system in endothelial cell and breast cancer cell invasion. It is tempting to consider that early endothelial and tumour cell alterations may be promoted by ET-1 produced by both cell types. Further work is required that will examine localised cellular gene expression of the endothelin system as well as its pro-invasive and angiogenic effects in breast cancer models.

  11. Progress in diagnosis of breast cancer: Advances in radiology technology

    Directory of Open Access Journals (Sweden)

    J Mari Beth Linder

    2015-01-01

    Full Text Available Breast cancer is the leading cause of cancer in females between the ages of 15 and 54, and the second leading cause of cancer death in women in the United States. Diagnosis begins with detection by breast examination (clinical breast exam or breast self-exam or by radiologic studies, like mammography. Many advances in the diagnosis of breast cancer have taken place in recent years. This article will review the history of radiologic advances in the diagnosis of breast cancer. Use of technological advancements in digital breast tomosynthesis, magnetic resonance imaging, and ultrasound in breast cancer diagnosis will be presented. Advantages and disadvantages of these diagnostic interventions when compared to older, traditional X-ray films will be discussed. It is important for all nurses, including radiology and oncology nurses, to be well informed about these varied diagnostic modalities, and appreciate the fact that advances in radiologic imaging technologies can yield improved outcomes for breast cancer patients.

  12. The role of intratumoral and systemic IL-6 in breast cancer

    DEFF Research Database (Denmark)

    Dethlefsen, Christine; Højfeldt, Grith Westergaard; Hojman, Pernille

    2013-01-01

    Chronic low-grade inflammation plays an important role in the pathogenesis of several cancer forms including breast cancer. The pleiotropic cytokine IL-6 is a key player in systemic inflammation, regulating both the inflammatory response and tissue metabolism during acute stimulations. Here, we...... review the associations between IL-6 and breast cancer ranging from in vitro cell culture studies to clinical studies, covering the role of IL-6 in controlling breast cancer cell growth, regulation of cancer stem cell renewal, as well as breast cancer cell migration. Moreover, associations between...... is important for controlling breast cancer cell growth, metastasis, and self renewal of cancer stem cells....

  13. SU-E-J-56: Static Gantry Digital Tomosynthesis From the Beam’s-Eye-View

    Energy Technology Data Exchange (ETDEWEB)

    Partain, L; Kwon, J; Boyd, D [TeleSecurity Sciences, Las Vegas, NV (United States); Rottmann, J; Berbeco, R [Brigham and Woman’s Hospital, Boston, MA (United States); Zentai, G [Varian Medical Systems, Palo Alto, CA (United States)

    2015-06-15

    Purpose We have designed a novel TumoTrak™ x-ray system that delivers 19 distinct kV views with the linac gantry stationary. It images MV treatment beam above and below the patient with a kV tomosysthesis slice image from the therapy beam’s-eye-view. Results will be high quality images without MLC shadowing for notable improvements relative to conventional fluoroscopic MV imaging and fluoroscopic kV imaging. Methods A complete design has a kV electron beam multisource X-ray tube that fits around the MV treatment beam path, with little interference with normal radiotherapy and unblocked by the multi-leaf-collimator. To simulate digital tomosynthesis, we used cone-beam CT projection data from a lung SBRT patient. These data were acquired at 125 kVp and 11 fps (0.4 mAs per projection). We chose 19 projections evenly spaced over 27° around one of the treatment angles (240°). Digital tomosynthesis reconstruction of a slice through the tumor was performed using iterative reconstruction. The visibility of the lesion was assessed for the reconstructed digital tomosynthesis (DTS), using fluoroscopy MV images acquired during radiation therapy, and a kV single projection image acquired at the same angle as the treatment field (240°). Results The fluoroscopic DTS images provide the best tumor contrast, surpassing the conventional radiographic and the in-treatment MV portal images. The electron beam multisource X-ray tube design has been completed and the tube is being fabricated. The estimated time to cycle through all 19 projections is 700 ms, enabling high frame-rate imaging. While the initial proposed use case is for image guided and gated treatment delivery, the enhanced imaging will also deliver superior radiographic images for patient setup. Conclusion The proposed device will deliver high quality planar images from the beam’s-eye-view without MLC obstruction. The prototype has been designed and is being assembled with first imaging scheduled for May 2015. L

  14. SU-E-J-56: Static Gantry Digital Tomosynthesis From the Beam’s-Eye-View

    International Nuclear Information System (INIS)

    Purpose We have designed a novel TumoTrak™ x-ray system that delivers 19 distinct kV views with the linac gantry stationary. It images MV treatment beam above and below the patient with a kV tomosysthesis slice image from the therapy beam’s-eye-view. Results will be high quality images without MLC shadowing for notable improvements relative to conventional fluoroscopic MV imaging and fluoroscopic kV imaging. Methods A complete design has a kV electron beam multisource X-ray tube that fits around the MV treatment beam path, with little interference with normal radiotherapy and unblocked by the multi-leaf-collimator. To simulate digital tomosynthesis, we used cone-beam CT projection data from a lung SBRT patient. These data were acquired at 125 kVp and 11 fps (0.4 mAs per projection). We chose 19 projections evenly spaced over 27° around one of the treatment angles (240°). Digital tomosynthesis reconstruction of a slice through the tumor was performed using iterative reconstruction. The visibility of the lesion was assessed for the reconstructed digital tomosynthesis (DTS), using fluoroscopy MV images acquired during radiation therapy, and a kV single projection image acquired at the same angle as the treatment field (240°). Results The fluoroscopic DTS images provide the best tumor contrast, surpassing the conventional radiographic and the in-treatment MV portal images. The electron beam multisource X-ray tube design has been completed and the tube is being fabricated. The estimated time to cycle through all 19 projections is 700 ms, enabling high frame-rate imaging. While the initial proposed use case is for image guided and gated treatment delivery, the enhanced imaging will also deliver superior radiographic images for patient setup. Conclusion The proposed device will deliver high quality planar images from the beam’s-eye-view without MLC obstruction. The prototype has been designed and is being assembled with first imaging scheduled for May 2015. L

  15. Breast Glandularity in Malaysian Women from a Full-Field Digital Mammography System

    International Nuclear Information System (INIS)

    This study is undertaken to estimate breast glandularity in Malaysian women from a Full-Field Digital mammography System. This study involved 223 women (Malay=100;Chinese=101 and Indian=22) underwent voluntary screening mammography at Breast Centre, International Islamic University Malaysia (IIUM Breast Centre) for the first quarter of year 2009. Those are women aged between 31 to 69 years old (median age, 49 years). Data on miliampere-seconds, kilo voltage and compressed breast thickness for each cranio caudal view are used to estimate breast glandularity for an individual breast. Breast glandularity is calculated using the fitted equation reported earlier. The difference in breast glandularity among ethnic groups was tested for significance using the nonparametric Kruskal-Wallis test. The average breast glandularity estimated in our study, using FFDM system is 52.94±27.63 %. No significant difference was seen in breast glandularity among the ethnic groups (p>0.05, Kruskan Wallis test). Breast glandularity decrease as age increases, up to 60 years old. (author)

  16. Parallel-scanning tomosynthesis using a slot scanning technique: Fixed-focus reconstruction and the resulting image quality

    Energy Technology Data Exchange (ETDEWEB)

    Shibata, Koichi, E-mail: shibatak@suzuka-u.ac.jp [Department of Radiological Technology, Faculty of Health Science, Suzuka University of Medical Science 1001-1, Kishioka-cho, Suzuka 510-0293 (Japan); Notohara, Daisuke; Sakai, Takihito [R and D Department, Medical Systems Division, Shimadzu Corporation 1, Nishinokyo-Kuwabara-cho, Nakagyo-ku, Kyoto 604-8511 (Japan)

    2014-11-01

    Purpose: Parallel-scanning tomosynthesis (PS-TS) is a novel technique that fuses the slot scanning technique and the conventional tomosynthesis (TS) technique. This approach allows one to obtain long-view tomosynthesis images in addition to normally sized tomosynthesis images, even when using a system that has no linear tomographic scanning function. The reconstruction technique and an evaluation of the resulting image quality for PS-TS are described in this paper. Methods: The PS-TS image-reconstruction technique consists of several steps (1) the projection images are divided into strips, (2) the strips are stitched together to construct images corresponding to the reconstruction plane, (3) the stitched images are filtered, and (4) the filtered stitched images are back-projected. In the case of PS-TS using the fixed-focus reconstruction method (PS-TS-F), one set of stitched images is used for the reconstruction planes at all heights, thus avoiding the necessity of repeating steps (1)–(3). A physical evaluation of the image quality of PS-TS-F compared with that of the conventional linear TS was performed using a R/F table (Sonialvision safire, Shimadzu Corp., Kyoto, Japan). The tomographic plane with the best theoretical spatial resolution (the in-focus plane, IFP) was set at a height of 100 mm from the table top by adjusting the reconstruction program. First, the spatial frequency response was evaluated at heights of −100, −50, 0, 50, 100, and 150 mm from the IFP using the edge of a 0.3-mm-thick copper plate. Second, the spatial resolution at each height was visually evaluated using an x-ray test pattern (Model No. 38, PTW Freiburg, Germany). Third, the slice sensitivity at each height was evaluated via the wire method using a 0.1-mm-diameter tungsten wire. Phantom studies using a knee phantom and a whole-body phantom were also performed. Results: The spatial frequency response of PS-TS-F yielded the best results at the IFP and degraded slightly as the

  17. Design and evaluation of a laboratory prototype system for 3D photoacoustic full breast tomography

    OpenAIRE

    Xia, W; Piras, D; Singh, M. K. A.; van Hespen, J. C. G.; Van Leeuwen, T. G.; Steenbergen, W Van; Manohar, S.

    2013-01-01

    Photoacoustic imaging can visualize vascularization-driven optical absorption contrast with great potential for breast cancer detection and diagnosis. State-of-the-art photoacoustic breast imaging systems are promising but are limited either by only a 2D imaging capability or by an insufficient imaging field-of-view (FOV). We present a laboratory prototype system designed for 3D photoacoustic full breast tomography, and comprehensively characterize it and evaluate its performance in imaging p...

  18. Design and Analysis of Breast Cancer Detection System Using Mammogram Features Extraction

    Directory of Open Access Journals (Sweden)

    Satish Saini

    2014-12-01

    Full Text Available Breast cancer is the most frequently diagnosed among women. Mammogram is a radiograph of the breast tissue and is one of the most effective, non-invasive methods of detecting breast cancer in its earliest and most treatable stage This paper aims at designing a breast cancer detection system based on Artificial Neural Network (ANN and Image Processing Techniques in digital mammography. The effectiveness of the ANN based detection system will be investigated for different number of layers and optimum number of layers will be chosen. The performance of the system will be analyzed on the basis of Mean Square Error (MSE.

  19. A second generation of physical anthropomorphic 3D breast phantoms based on human subject data

    Science.gov (United States)

    Nolte, Adam; Kiarashi, Nooshin; Samei, Ehsan; Segars, W. P.; Lo, Joseph Y.

    2014-03-01

    Previous fabrication of anthropomorphic breast phantoms has demonstrated their viability as a model for 2D (mammography) and 3D (tomosynthesis) breast imaging systems. Further development of these models will be essential for the evaluation of breast x-ray systems. There is also the potential to use them as the ground truth in virtual clinical trials. The first generation of phantoms was segmented from human subject dedicated breast computed tomography data and fabricated into physical models using highresolution 3D printing. Two variations were made. The first was a multi-material model (doublet) printed with two photopolymers to represent glandular and adipose tissues with the greatest physical contrast available, mimicking 75% and 35% glandular tissue. The second model was printed with a single 75% glandular equivalent photopolymer (singlet) to represent glandular tissue, which can be filled independently with an adipose-equivalent material such as oil. For this study, we have focused on improving the latter, the singlet phantom. First, the temporary oil filler has been replaced with a permanent adipose-equivalent urethane-based polymer. This offers more realistic contrast as compared to the multi-material approach at the expense of air bubbles and pockets that form during the filling process. Second, microcalcification clusters have been included in the singlet model via crushed eggshells, which have very similar chemical composition to calcifications in vivo. The results from these new prototypes demonstrate significant improvement over the first generation of anthropomorphic physical phantoms.

  20. Feasibility study of the diagnosis and monitoring of cystic fibrosis in pediatric patients using stationary digital chest tomosynthesis

    Science.gov (United States)

    Potuzko, Marci; Shan, Jing; Pearce, Caleb; Lee, Yueh Z.; Lu, Jianping; Zhou, Otto

    2015-03-01

    Digital chest tomosynthesis (DCT) is a 3D imaging modality which has been shown to approach the diagnostic capability of CT, but uses only one-tenth the radiation dose of CT. One limitation of current commercial DCT is the mechanical motion of the x-ray source which prolongs image acquisition time and introduces motion blurring in images. By using a carbon nanotube (CNT) x-ray source array, we have developed a stationary digital chest tomosynthesis (s- DCT) system which can acquire tomosynthesis images without mechanical motion, thus enhancing the image quality. The low dose and high quality 3D image makes the s-DCT system a viable imaging tool for monitoring cystic fibrosis (CF) patients. The low dose is especially important in pediatric patients who are both more radiosensitive and have a longer lifespan for radiation symptoms to develop. The purpose of this research is to evaluate the feasibility of using s-DCT as a faster, lower dose means for diagnosis and monitoring of CF in pediatric patients. We have created an imaging phantom by injecting a gelatinous mucus substitute into porcine lungs and imaging the lungs from within an anthropomorphic hollow chest phantom in order to mimic the human conditions of a CF patient in the laboratory setting. We have found that our s-DCT images show evidence of mucus plugging in the lungs and provide a clear picture of the airways in the lung, allowing for the possibility of using s- DCT to supplement or replace CT as the imaging modality for CF patients.

  1. Effects of angular range on image quality of chest digital tomosynthesis

    Science.gov (United States)

    Lee, Haenghwa; Kim, Ye-seul; Choi, Sunghoon; Lee, Dong-Hoon; Choi, Seungyeon; Kim, Hee-Joung

    2016-03-01

    Chest digital tomosynthesis (CDT) is a new 3D imaging technique that can be expected to improve clinical diagnosis over conventional chest radiography. We investigated the effect of the angular range of data acquisition on the image quality using newly developed CDT system. The four different acquisition sets were studied using +/-15°, +/-20°, +/-30°, and +/-35° angular ranges with 21 projection views (PVs). The point spread function (PSF), modulation transfer function (MTF), artifact spread function (ASF), and normalized contrast-to-noise ratio (CNR) were used to evaluate the image quality. We found that increasing angular ranges improved vertical resolution. The results indicated that there was the opposite relationship of the CNR with angular range for the two tissue types. While CNR for heart tissue increased with increasing angular range, CNR for spine bone decreased. The results showed that the angular range is an important parameter for the CDT exam.

  2. A systems approach to clinical oncology: Focus on breast cancer

    Directory of Open Access Journals (Sweden)

    Leyland-Jones Brian

    2006-04-01

    Full Text Available Abstract During the past decade, genomic microarrays have been applied with some success to the molecular profiling of breast tumours, which has resulted in a much more detailed classification scheme as well as in the identification of potential gene signature sets. These gene sets have been applied to both the prognosis and prediction of outcome to treatment and have performed better than the current clinical criteria. One of the main limitations of microarray analysis, however, is that frozen tumour samples are required for the assay. This imposes severe limitations on access to samples and precludes large scale validation studies from being conducted. Quantitative reverse transcriptase polymerase chain reaction (qRT-PCR, on the other hand, can be used with degraded RNAs derived from formalin-fixed paraffin-embedded (FFPE tumour samples, the most important and abundant source of clinical material available. More recently, the novel DASL (cDNA-mediated Annealing, Selection, extension and Ligation assay has been developed as a high throughput gene expression profiling system specifically designed for use with FFPE tumour tissue samples. However, we do not believe that genomics is adequate as a sole prognostic and predictive platform in breast cancer. The key proteins driving oncogenesis, for example, can undergo post-translational modifications; moreover, if we are ever to move individualization of therapy into the practical world of blood-based assays, serum proteomics becomes critical. Proteomic platforms, including tissue micro-arrays (TMA and protein chip arrays, in conjunction with surface-enhanced laser desorption ionization time-of-flight mass spectrometry (SELDI-TOF/MS, have been the technologies most widely applied to the characterization of tumours and serum from breast cancer patients, with still limited but encouraging results. This review will focus on these genomic and proteomic platforms, with an emphasis placed on the utilization

  3. Virtual reality and women's health: a breast biopsy system.

    Science.gov (United States)

    Vahora, F; Temkin, B; Marcy, W; Gorman, P J; Krummel, T M; Heinrichs, W L

    1999-01-01

    Minimally invasive procedures are becoming much more common in surgical practice because of the many advantages for patient comfort and convenience, and improved surgical access. However some of the major problems leading to occasional surgical errors with this minimal access method are restricted vision, limited sense of touch, difficulties in identification in 3D space of the position of the instrument tips, and their handling during delicate, short-distance movements toward the surgical target area. These factors emphasize the need for computer simulated training in surgical manipulations and procedures in preparation for conducting them in patients. The key new feature of our proof-of-concept training simulator is a preventive mechanism that serves at least two functions. As the surgical target (or a critical structure) is approached, a haptically generated preventive force forewarns the surgeon, making it possible to abort those maneuvers that may lead to adverse results. By announcing a potential collision of a virtual instrument tip with a surgical target, the time used for searching for the target is shortened, and the haptic signal minimizes the potential of tissue damage. This real-time, interactive, virtual reality based, haptic breast biopsy-training simulation is a PC/NT based multitasking, multithreading system. It is based upon an advanced force feedback device. The system monitors and indirectly guides the surgeon's movements, while providing high fidelity visual and force feedback cues as the area of surgical interest is approached. Our first application is with human breast. PMID:10538389

  4. Feasibility study for image reconstruction in circular digital tomosynthesis (CDTS) from limited-scan angle data based on compressed-sensing theory

    International Nuclear Information System (INIS)

    In this work, we performed a feasibility study for image reconstruction in a circular digital tomosynthesis (CDTS) from limited-scan angle data based on compressed-sensing (CS) theory. Here, the X-ray source moves along an arc within a limited-scan angle (≤ 180°) on a circular path set perpendicularly to the axial direction during the image acquisition. This geometry, compared to full-angle (360°) scan geometry, allows imaging system to be designed more compactly and gives better tomographic quality than conventional linear digital tomosynthesis (DTS). We implemented an efficient CS-based reconstruction algorithm for the proposed geometry and performed systematic simulations to investigate the image characteristics. We successfully reconstructed CDTS images with incomplete projections acquired at several selected limited-scan angles of 45°, 90°, 135°, and 180° for a given tomographic angle of 80° and evaluated the reconstruction quality. Our simulation results indicate that the proposed method can provide superior tomographic quality for axial view and even for the other views (i.e., sagittal and coronal), as in computed tomography, to conventional DTS. - Highlights: • Image reconstruction is done in circular digital tomosynthesis (CDTS). • The designed geometry allows imaging system to be the better image. • An efficient compressed-sensing (CS)-based reconstruction algorithm is performed. • Proposed method can provide superior tomographic quality for the axial view

  5. Breast cancer metastasis to the central nervous system.

    Science.gov (United States)

    Weil, Robert J; Palmieri, Diane C; Bronder, Julie L; Stark, Andreas M; Steeg, Patricia S

    2005-10-01

    Clinically symptomatic metastases to the central nervous system (CNS) occur in approximately 10 to 15% of patients with metastatic beast cancer. CNS metastases are traditionally viewed as a late complication of systemic disease, for which few effective treatment options exist. Recently, patients with Her-2-positive breast tumors who were treated with trastuzumab have been reported to develop CNS metastases at higher rates, often while responding favorably to treatment. The blood:brain barrier and the unique brain microenvironment are hypothesized to promote distinct molecular features in CNS metastases that may require tailored therapeutic approaches. New research approaches using cell lines that reliably and preferentially metastasize in vivo to the brain have been reported. Using such model systems, as well as in vitro analogs of blood-brain barrier penetration and tissue-based studies, new molecular leads into this disease are unfolding. PMID:16192626

  6. Defining the Survival Benchmark for Breast Cancer Patients with Systemic Relapse

    OpenAIRE

    Zeichner, Simon B.; Tadeu Ambros; John Zaravinos; Montero, Alberto J.; Mahtani, Reshma L; Ahn, Eugene R; Aruna Mani; Markward, Nathan J; Vogel, Charles L.

    2015-01-01

    BACKGROUND Our original paper, published in 1992, reported a median overall survival after first relapse in breast cancer of 26 months. The current retrospective review concentrates more specifically on patients with first systemic relapse, recognizing that subsets of patients with local recurrence are potentially curable. METHODS Records of 5,168 patients from a largely breast-cancer-specific oncology practice were reviewed to identify breast cancer patients with their first relapse between ...

  7. Three dimensional anatomy of complete duct systems in human breast: pathological and developmental implications.

    OpenAIRE

    Moffat, D. F.; Going, J J

    1996-01-01

    AIMS: To reconstruct the arrangement in space of all major ducts and their branches from nipple to periphery of a human breast obtained at necropsy. METHODS: Duct tracing through cleared haematoxylin stained 2 mm sub-gross coronal slices of a complete necropsy breast and computer modelling of duct territories. RESULTS: All branches were traced for 10 complete duct systems of a single breast from a 19 year old girl. Their complexity prevented comprehensive modelling of individual ducts and ram...

  8. A feasibility study for anatomical noise reduction in dual-energy chest digital tomosynthesis

    Science.gov (United States)

    Lee, D.; Kim, Y.-s.; Choi, S.; Lee, H.; Choi, S.; Kim, H.-J.

    2016-01-01

    Lung cancer is the leading cause of cancer death worldwide. Thus, early diagnosis is of considerable importance. For early screening of lung cancer, computed tomography (CT) has been used as the gold standard. Chest digital tomosynthesis (CDT) is a recently introduced modality for lung cancer screening with a relatively low radiation dose compared to CT. The dual energy material decomposition method has been proposed for better detection of pulmonary nodules by means of reducing anatomical noise. In this study, the possibility of material decomposition in CDT was tested by both a simulation study and an experimental study using a CDT prototype. The Geant4 application for tomographic emission (GATE) v6 and tungsten anode spectral model using interpolating polynomials (TASMIP) codes were used for the simulation study to create simulated phantom shapes consisting of five inner cylinders filled with different densities of bone and airequivalent materials. Furthermore, the CDT prototype system and human phantom chest were used for the experimental study. CDT scan in both the simulation and experimental studies was performed with linear movement and 21 projection images were obtained over a 30 degree angular range with a 1.5 degree angular interval. To obtain materialselective images, a projectionbased energy subtraction technique was applied to high and low energy images. The resultant simulation images showed that dual-energy reconstruction could achieve an approximately 32% higher contrast to noise ratio (CNR) in images and the difference in CNR value according to bone density was significant compared to single energy CDT. Additionally, image artifacts were effectively corrected in dual energy CDT simulation studies. Likewise the experimental study with dual energy produced clear images of lung fields and bone structure by removing unnecessary anatomical structures. Dual energy tomosynthesis is a new technique; therefore, there is little guidance regarding its

  9. A feasibility study for anatomical noise reduction in dual-energy chest digital tomosynthesis

    International Nuclear Information System (INIS)

    Lung cancer is the leading cause of cancer death worldwide. Thus, early diagnosis is of considerable importance. For early screening of lung cancer, computed tomography (CT) has been used as the gold standard. Chest digital tomosynthesis (CDT) is a recently introduced modality for lung cancer screening with a relatively low radiation dose compared to CT. The dual energy material decomposition method has been proposed for better detection of pulmonary nodules by means of reducing anatomical noise. In this study, the possibility of material decomposition in CDT was tested by both a simulation study and an experimental study using a CDT prototype. The Geant4 application for tomographic emission (GATE) v6 and tungsten anode spectral model using interpolating polynomials (TASMIP) codes were used for the simulation study to create simulated phantom shapes consisting of five inner cylinders filled with different densities of bone and airequivalent materials. Furthermore, the CDT prototype system and human phantom chest were used for the experimental study. CDT scan in both the simulation and experimental studies was performed with linear movement and 21 projection images were obtained over a 30 degree angular range with a 1.5 degree angular interval. To obtain materialselective images, a projectionbased energy subtraction technique was applied to high and low energy images. The resultant simulation images showed that dual-energy reconstruction could achieve an approximately 32% higher contrast to noise ratio (CNR) in images and the difference in CNR value according to bone density was significant compared to single energy CDT. Additionally, image artifacts were effectively corrected in dual energy CDT simulation studies. Likewise the experimental study with dual energy produced clear images of lung fields and bone structure by removing unnecessary anatomical structures. Dual energy tomosynthesis is a new technique; therefore, there is little guidance regarding its

  10. Breast Imaging Reporting and Data System (BI-RADS) breast composition descriptors: Automated measurement development for full field digital mammography

    Energy Technology Data Exchange (ETDEWEB)

    Fowler, E. E.; Sellers, T. A.; Lu, B. [Department of Cancer Epidemiology, Division of Population Sciences, H. Lee Moffitt Cancer Center, Tampa, Florida 33612 (United States); Heine, J. J. [Department of Cancer Imaging and Metabolism, H. Lee Moffitt Cancer Center, Tampa, Florida 33612 (United States)

    2013-11-15

    Purpose: The Breast Imaging Reporting and Data System (BI-RADS) breast composition descriptors are used for standardized mammographic reporting and are assessed visually. This reporting is clinically relevant because breast composition can impact mammographic sensitivity and is a breast cancer risk factor. New techniques are presented and evaluated for generating automated BI-RADS breast composition descriptors using both raw and calibrated full field digital mammography (FFDM) image data.Methods: A matched case-control dataset with FFDM images was used to develop three automated measures for the BI-RADS breast composition descriptors. Histograms of each calibrated mammogram in the percent glandular (pg) representation were processed to create the new BR{sub pg} measure. Two previously validated measures of breast density derived from calibrated and raw mammograms were converted to the new BR{sub vc} and BR{sub vr} measures, respectively. These three measures were compared with the radiologist-reported BI-RADS compositions assessments from the patient records. The authors used two optimization strategies with differential evolution to create these measures: method-1 used breast cancer status; and method-2 matched the reported BI-RADS descriptors. Weighted kappa (κ) analysis was used to assess the agreement between the new measures and the reported measures. Each measure's association with breast cancer was evaluated with odds ratios (ORs) adjusted for body mass index, breast area, and menopausal status. ORs were estimated as per unit increase with 95% confidence intervals.Results: The three BI-RADS measures generated by method-1 had κ between 0.25–0.34. These measures were significantly associated with breast cancer status in the adjusted models: (a) OR = 1.87 (1.34, 2.59) for BR{sub pg}; (b) OR = 1.93 (1.36, 2.74) for BR{sub vc}; and (c) OR = 1.37 (1.05, 1.80) for BR{sub vr}. The measures generated by method-2 had κ between 0.42–0.45. Two of these

  11. A Clinical Decision Support System for Breast Cancer Patients

    Science.gov (United States)

    Fernandes, Ana S.; Alves, Pedro; Jarman, Ian H.; Etchells, Terence A.; Fonseca, José M.; Lisboa, Paulo J. G.

    This paper proposes a Web clinical decision support system for clinical oncologists and for breast cancer patients making prognostic assessments, using the particular characteristics of the individual patient. This system comprises three different prognostic modelling methodologies: the clinically widely used Nottingham prognostic index (NPI); the Cox regression modelling and a partial logistic artificial neural network with automatic relevance determination (PLANN-ARD). All three models yield a different prognostic index that can be analysed together in order to obtain a more accurate prognostic assessment of the patient. Missing data is incorporated in the mentioned models, a common issue in medical data that was overcome using multiple imputation techniques. Risk group assignments are also provided through a methodology based on regression trees, where Boolean rules can be obtained expressed with patient characteristics.

  12. A multi-image approach to CADx of breast cancer with integration into PACS

    Science.gov (United States)

    Elter, Matthias; Wittenberg, Thomas; Schulz-Wendtland, Rüdiger; Deserno, Thomas M.

    2009-02-01

    While screening mammography is accepted as the most adequate technique for the early detection of breast cancer, its low positive predictive value leads to many breast biopsies performed on benign lesions. Therefore, we have previously developed a knowledge-based system for computer-aided diagnosis (CADx) of mammographic lesions. It supports the radiologist in the discrimination of benign and malignant lesions. So far, our approach operates on the lesion level and employs the paradigm of content-based image retrieval (CBIR). Similar lesions with known diagnosis are retrieved automatically from a library of references. However, radiologists base their diagnostic decisions on additional resources, such as related mammographic projections, other modalities (e.g. ultrasound, MRI), and clinical data. Nonetheless, most CADx systems disregard the relation between the craniocaudal (CC) and mediolateral-oblique (MLO) views of conventional mammography. Therefore, we extend our approach to the full case level: (i) Multi-frame features are developed that jointly describe a lesion in different views of mammography. Taking into account the geometric relation between different images, these features can also be extracted from multi-modal data; (ii) the CADx system architecture is extended appropriately; (iii) the CADx system is integrated into the radiology information system (RIS) and the picture archiving and communication system (PACS). Here, the framework for image retrieval in medical applications (IRMA) is used to support access to the patient's health care record. Of particular interest is the application of the proposed CADx system to digital breast tomosynthesis (DBT), which has the potential to succeed digital mammography as the standard technique for breast cancer screening. The proposed system is a natural extension of CADx approaches that integrate only two modalities. However, we are still collecting a large enough database of breast lesions with images from

  13. Systemic therapy for breast cancer and risk of subsequent contralateral breast cancer in the WECARE Study

    OpenAIRE

    Langballe, Rikke; Mellemkjær, Lene; Malone, Kathleen E.; Lynch, Charles F.; John, Esther M.; Julia A. Knight; Bernstein, Leslie; Brooks, Jennifer; Andersson, Michael; Reiner, Anne S.; Liang, Xiaolin; Woods, Meghan; Concannon, Patrick J.; ,; Bernstein, Jonine L.

    2016-01-01

    Background Treatment with tamoxifen or chemotherapy reduces the risk of contralateral breast cancer (CBC). However, it is uncertain how long the protection lasts and whether the protective effect is modified by patient, tumor, or treatment characteristics. Methods The population-based WECARE Study included 1521 cases with CBC and 2212 age- and year of first diagnosis-matched controls with unilateral breast cancer recruited during two phases in the USA, Canada, and Denmark. Women were diagnose...

  14. Coded aperture coherent scatter imaging for breast cancer detection: a Monte Carlo evaluation

    Science.gov (United States)

    Lakshmanan, Manu N.; Morris, Robert E.; Greenberg, Joel A.; Samei, Ehsan; Kapadia, Anuj J.

    2016-03-01

    It is known that conventional x-ray imaging provides a maximum contrast between cancerous and healthy fibroglandular breast tissues of 3% based on their linear x-ray attenuation coefficients at 17.5 keV, whereas coherent scatter signal provides a maximum contrast of 19% based on their differential coherent scatter cross sections. Therefore in order to exploit this potential contrast, we seek to evaluate the performance of a coded- aperture coherent scatter imaging system for breast cancer detection and investigate its accuracy using Monte Carlo simulations. In the simulations we modeled our experimental system, which consists of a raster-scanned pencil beam of x-rays, a bismuth-tin coded aperture mask comprised of a repeating slit pattern with 2-mm periodicity, and a linear-array of 128 detector pixels with 6.5-keV energy resolution. The breast tissue that was scanned comprised a 3-cm sample taken from a patient-based XCAT breast phantom containing a tomosynthesis- based realistic simulated lesion. The differential coherent scatter cross section was reconstructed at each pixel in the image using an iterative reconstruction algorithm. Each pixel in the reconstructed image was then classified as being either air or the type of breast tissue with which its normalized reconstructed differential coherent scatter cross section had the highest correlation coefficient. Comparison of the final tissue classification results with the ground truth image showed that the coded aperture imaging technique has a cancerous pixel detection sensitivity (correct identification of cancerous pixels), specificity (correctly ruling out healthy pixels as not being cancer) and accuracy of 92.4%, 91.9% and 92.0%, respectively. Our Monte Carlo evaluation of our experimental coded aperture coherent scatter imaging system shows that it is able to exploit the greater contrast available from coherently scattered x-rays to increase the accuracy of detecting cancerous regions within the breast.

  15. Inter-plane artifact suppression in tomosynthesis using 3D CT image data

    OpenAIRE

    Kim Jae G; Jin Seung O; Cho Min H; Lee Soo Y

    2011-01-01

    Abstract Background Despite its superb lateral resolution, flat-panel-detector (FPD) based tomosynthesis suffers from low contrast and inter-plane artifacts caused by incomplete cancellation of the projection components stemming from outside the focal plane. The incomplete cancellation of the projection components, mostly due to the limited scan angle in the conventional tomosynthesis scan geometry, often makes the image contrast too low to differentiate the malignant tissues from the backgro...

  16. Tomosynthesis-based localization of radioactive seeds in prostate brachytherapy

    International Nuclear Information System (INIS)

    Accurately assessing the quality of prostate brachytherapy intraoperatively would be valuable for improved clinical outcome by ensuring the delivery of a prescribed tumoricidal radiation dose to the entire prostate gland. One necessary step towards this goal is the robust and rapid localization of implanted seeds. Several methods have been developed to locate seeds from x-ray projection images, but they fail to detect completely-overlapping seeds, thus necessitating manual intervention. To overcome this limitation, we have developed a new method where (1) a three-dimensional volume is reconstructed from x-ray projection images using a brachytherapy-specific tomosynthesis reconstruction algorithm with built-in blur compensation and (2) the seeds are located in this reconstructed volume. In contrast to other projection-based methods, our method can detect completely overlapping seeds. Our simulation results indicate that we can locate all implanted seeds in the prostate using a tomosynthesis angle of 30 deg. and seven projection images. The mean localization error is 1.27 mm for a case with 100 seeds. We have also tested our method using a prostate phantom with 61 implanted seeds and succeeded in locating all seeds automatically. We believe this new method can be useful for the intraoperative quality assessment of prostate brachytherapy in the future

  17. Eigenbreasts for statistical breast phantoms

    Science.gov (United States)

    Sturgeon, Gregory M.; Tward, Daniel J.; Ketcha, M.; Ratnanather, J. T.; Miller, M. I.; Park, Subok; Segars, W. P.; Lo, Joseph Y.

    2016-03-01

    To facilitate rigorous virtual clinical trials using model observers for breast imaging optimization and evaluation, we demonstrated a method of defining statistical models, based on 177 sets of breast CT patient data, in order to generate tens of thousands of unique digital breast phantoms. In order to separate anatomical texture from variation in breast shape, each training set of breast phantoms were deformed to a consistent atlas compressed geometry. Principal component analysis (PCA) was then performed on the shape-matched breast CT volumes to capture the variation of patient breast textures. PCA decomposes the training set of N breast CT volumes into an N-1-dimensional space of eigenvectors, which we call eigenbreasts. By summing weighted combinations of eigenbreasts, a large ensemble of different breast phantoms can be newly created. Different training sets can be used in eigenbreast analysis for designing basis models to target sub-populations defined by breast characteristics, such as size or density. In this work, we plan to generate ensembles of 30,000 new phantoms based on glandularity for an upcoming virtual trial of lesion detectability in digital breast tomosynthesis. Our method extends our series of digital and physical breast phantoms based on human subject anatomy, providing the capability to generate new, unique ensembles consisting of tens of thousands or more virtual subjects. This work represents an important step towards conducting future virtual trials for tasks-based assessment of breast imaging, where it is vital to have a large ensemble of realistic phantoms for statistical power as well as clinical relevance.

  18. Serum calcium levels, TRPM7, TRPC1, microcalcifications, and breast cancer using breast imaging reporting and data system scores

    Directory of Open Access Journals (Sweden)

    Mandavilli S

    2012-12-01

    Full Text Available Shravya Mandavilli,1 Brij B Singh,2 Abe E Sahmoun11Department of Internal Medicine, University of North Dakota School of Medicine and Health Sciences, Fargo, ND, USA; 2Department of Biochemistry and Molecular Biology, University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND, USABackground: An association between higher serum calcium (Ca2+ levels and breast cancer has been previously reported. However, little is known regarding the relationship between serum Ca2+ levels and the expression of Ca2+ channels in the presence of breast microcalcifications.Methods: A retrospective analysis of women newly diagnosed with breast microcalcifications was performed based on the Breast Imaging Reporting and Data System (BI-RADS. The expression of TRPC1, TRPC3, and TRPM7 using normal biopsy without microcalcifications (controls and infiltrating ductal carcinoma with microcalcifications was evaluated.Results: Data on 138 women were analyzed. Seventy percent of women had a BI-RADS score (1–3 corresponding to benign disease. Seventy-six percent of women with a BI-RADS score (4 or 5 were diagnosed with breast cancer, 56% were cancers in situ, and 93% were infiltrating ductal carcinomas. No difference in the distribution of corrected serum Ca2+ levels between BI-RADS scores (1–3 and BI-RADS scores (4–5 (P = 0.82 was observed. Serum Ca2+ levels were similar in women without cancer and women diagnosed with breast cancer (P = 0.94. However, the expression of TRPM7 and TRPC1, but not TRPC3, Ca2+ channels were increased in infiltrating ductal carcinoma samples with microcalcifications when compared with age-matched controls without calcification or cancer.Conclusion: We observed an increase in the expression of TRPM7 and TRPC1 Ca2+ channels in infiltrating ductal carcinoma samples with microcalcifications, whereas no change in serum Ca2+ levels was observed. Together these data suggest that increased expression of these channels might

  19. Clinical utility of tomosynthesis in suspected scaphoid fracture. A pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Geijer, Mats [Lund University, Skaane University Hospital, Center for Medical Imaging and Physiology, Lund (Sweden); Boerjesson, Annika M.; Goethlin, Jan H. [Sahlgrenska University Hospital, Department of Radiology, Moelndal (Sweden)

    2011-07-15

    Radiography alone will not detect all scaphoid fractures. There is a reported prevalence between 9 and 33% of occult scaphoid fractures. The evidence-based literature suggests that magnetic resonance imaging (MRI) is the most suitable secondary imaging modality due to the ability to evaluate the bone marrow directly and to also identify other injuries. However, there is no consensus on the choice of follow-up imaging strategy - computed tomography, MRI, or bone scan - across different institutions. Tomosynthesis is a new digital tomographic method creating multiple thin tomographic sections. The purpose of this study was to evaluate the clinical utility of tomosynthesis in suspected occult fracture. Thirty-five patients with a clinically suspected occult scaphoid fracture after initial normal radiography were imaged with repeat radiography and tomosynthesis scan 2 weeks after trauma. Repeat radiography revealed one previously undetected scaphoid tubercle avulsion and one scaphoid waist fracture, confirmed by tomosynthesis. Tomosynthesis revealed two additional scaphoid waist fractures. In total, three initially occult scaphoid waist fractures were detected (9%). No additional fractures were detected in the remaining 32 patients during a 1-year follow-up. Tomosynthesis can demonstrate occult scaphoid fractures not visible at radiography. (orig.)

  20. Analysis of breast imaging reporting and data system category 4 complex cystic masses of the breast: Do all the complex cystic breast masses merit a biopsy?

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ha Yeon; Chang, Yun Woo [Soonchunhyang University College of Medicine, Soonchunhyang University Hospital, Seoul (Korea, Republic of)

    2013-07-15

    To investigate whether sonographic findings can predict malignancy in complex echoic breast masses using the Breast Imaging Reporting and Data System (BI-RADS) lexicon and to demonstrate the need for biopsy recommendations for all complex breast masses. 135 pathologically proven complex echoic masses detected on sonography were identified. We retrospectively reviewed the sonographic findings according to the BI-RADS lexicon which include shape, margin, orientation, lesion boundary, posterior acoustic features, and vascularity. The sonographic findings were correlated with the pathology and mammographic findings. Differentiation between the sonographic appearance of benign and malignant complex cystic lesions was evaluated using the chi-square test or the Mann-Whitney U test. 59.3% (80/135) were benign lesions and 40.7% (55/135) were malignant lesions. Malignant lesions were correlated with irregular (p < 0.001), nonparallel (p = 0.023), noncircumscribed (p < 0.001), echogenic halo (p < 0.001), increased vascularity (p = 0.001) and large size (p = 0.002) compared to benign lesions. However, 12.7% (7/55) of benign looking complex cystic masses were proved to be malignant. All seven lesions had malignant microcalcifications or abnormality on mammography. Using the sonographic BI-RADS lexicon can be useful for differentiating between malignant and benign complex cystic breast masses. Notably, 12.7% of the complex cystic lesions showing a benign appearance on sonography were pathologically proven malignant. Therefore, radiologist should recommend biopsy for complex cystic lesions.

  1. Analysis of breast imaging reporting and data system category 4 complex cystic masses of the breast: Do all the complex cystic breast masses merit a biopsy?

    International Nuclear Information System (INIS)

    To investigate whether sonographic findings can predict malignancy in complex echoic breast masses using the Breast Imaging Reporting and Data System (BI-RADS) lexicon and to demonstrate the need for biopsy recommendations for all complex breast masses. 135 pathologically proven complex echoic masses detected on sonography were identified. We retrospectively reviewed the sonographic findings according to the BI-RADS lexicon which include shape, margin, orientation, lesion boundary, posterior acoustic features, and vascularity. The sonographic findings were correlated with the pathology and mammographic findings. Differentiation between the sonographic appearance of benign and malignant complex cystic lesions was evaluated using the chi-square test or the Mann-Whitney U test. 59.3% (80/135) were benign lesions and 40.7% (55/135) were malignant lesions. Malignant lesions were correlated with irregular (p < 0.001), nonparallel (p = 0.023), noncircumscribed (p < 0.001), echogenic halo (p < 0.001), increased vascularity (p = 0.001) and large size (p = 0.002) compared to benign lesions. However, 12.7% (7/55) of benign looking complex cystic masses were proved to be malignant. All seven lesions had malignant microcalcifications or abnormality on mammography. Using the sonographic BI-RADS lexicon can be useful for differentiating between malignant and benign complex cystic breast masses. Notably, 12.7% of the complex cystic lesions showing a benign appearance on sonography were pathologically proven malignant. Therefore, radiologist should recommend biopsy for complex cystic lesions.

  2. Experimental dosimetry in conformal breast teletherapy compared with the planning system

    International Nuclear Information System (INIS)

    The objective of this study was to compare and analyse the absorbed dose profiles from the conformal radiotherapy planning and experimental dosimetry taken in a breast anthropomorphic and anthropometric phantom. Conformal radiotherapy planning was elaborated in the Treatment Planning System (TPS). EBT2 Gafchromic radiochromic films were applied as dosimeters, positioned internally and superficially in the breast phantom. The standard radiation protocol was applied in the breast phantom. The films were digitalised, and their responses were analysed in RGB. The optical densities were processed, reproducing the spatial dose distribution. - Highlights: • Distributions of absorbed doses were generated by the TPS and measured by radiochromic films. • The breast phantom simulated a human breast in position for treatment. • A large portion of the glandular tissue absorbed doses that were equivalent to the radiotherapy planning. • There were regions of hot spots and small areas of under dosage in deeper areas at the lung interface

  3. Breast cancer in limited-resource countries: health care systems and public policy.

    Science.gov (United States)

    Anderson, Benjamin O; Yip, Cheng-Har; Ramsey, Scott D; Bengoa, Rafael; Braun, Susan; Fitch, Margaret; Groot, Martijn; Sancho-Garnier, Helene; Tsu, Vivien D

    2006-01-01

    As the largest cancer killer of women around the globe, breast cancer adversely impacts countries at all levels of economic development. Despite major advances in the early detection, diagnosis, and treatment of breast cancer, health care ministries face multitiered challenges to create and support health care programs that can improve breast cancer outcomes. In addition to the financial and organizational problems inherent in any health care system, breast health programs are hindered by a lack of recognition of cancer as a public health priority, trained health care personnel shortages and migration, public and health care provider educational deficits, and social barriers that impede patient entry into early detection and cancer treatment programs. No perfect health care system exists, even in the wealthiest countries. Based on inevitable economic and practical constraints, all health care systems are compelled to make trade-offs among four factors: access to care, scope of service, quality of care, and cost containment. Given these trade-offs, guidelines can define stratified approaches by which economically realistic incremental improvements can be sequentially implemented within the context of resource constraints to improve breast health care. Disease-specific "vertical" programs warrant "horizontal" integration with existing health care systems in limited-resource countries. The Breast Health Global Initiative (BHGI) Health Care Systems and Public Policy Panel defined a stratified framework outlining recommended breast health care interventions for each of four incremental levels of resources (basic, limited, enhanced, and maximal). Reallocation of existing resources and integration of a breast health care program with existing programs and infrastructure can potentially improve outcomes in a cost-sensitive manner. This adaptable framework can be used as a tool by policymakers for program planning and research design to make best use of available resources

  4. The thioredoxin system in breast cancer cell invasion and migration

    OpenAIRE

    Maneet Bhatia; Kelly L. McGrath; Giovanna Di Trapani; Pornpimol Charoentong; Fenil Shah; Mallory M. King; Clarke, Frank M.; Tonissen, Kathryn F

    2016-01-01

    Metastasis is the most life threatening aspect of breast cancer. It is a multi-step process involving invasion and migration of primary tumor cells with a subsequent colonization of these cells at a secondary location. The aim of the present study was to investigate the role of thioredoxin (Trx1) in the invasion and migration of breast cancer cells and to assess the strength of the association between high levels of Trx1 and thioredoxin reductase (TrxR1) expression with breast cancer patient ...

  5. An Integrated Knowledge Base System Architecture for Histopathological Diagnosis of Breast Diseases

    OpenAIRE

    Aderonke A Kayode; Babajide S.Afolabi; Adelusola, Kayode A

    2012-01-01

    The histopathological diagnosis of breast diseases requires highly trained and experienced experts, and often strains pathologists’ cognitive capabilities. Accurate and timely diagnosis of breast diseases is essential for the appropriate management of the patients. The paper presents a knowledge base system that uses a combination of rule-based and case-based techniques to achieve the diagnosis. Rule-based systems handle problems with well-defined knowledge bases this limits the flexibility o...

  6. Noise power properties of a cone-beam CT system for breast cancer detection

    OpenAIRE

    Yang, Kai; Kwan, Alexander L.C.; Huang, Shih-Ying; Packard, Nathan J.; Boone, John M.

    2008-01-01

    The noise power properties of a cone-beam computed tomography (CT) system dedicated for breast cancer detection were investigated. Uniform polyethylene cylinders of various diameters were scanned under different system acquisition conditions. Noise power spectra were calculated from difference data generated by subtraction between two identical scans. Multidimensional noise power spectra (NPS) were used as the metric to evaluate the noise properties of the breast CT (bCT) under different syst...

  7. Enhancing Supportive-Educative Nursing Systems to Reduce Risk of Post-Breast Cancer Lymphedema

    OpenAIRE

    Jane M Armer; Shook, Robin P.; Schneider, Melanie K; Brooks, Constance W.; Peterson, Julie; Stewart, Bob R.

    2009-01-01

    This study describes the use of data regarding self-care agency to enhance a supportive-educative nursing system for breast cancer survivors to reduce the risk of developing lymphedema post surgery. Impetus for this study came from the analysis of participant feedback from a parent study (Lance Armstrong Foundation pilot study) that sought to plan an educational program for nurses that will improve their supportive-educative nursing system when working with breast cancer survivors. The goal i...

  8. Shape analysis of simulated breast anatomical structures

    Science.gov (United States)

    Contijoch, Francisco; Lynch, Jennifer M.; Pokrajac, David D.; Maidment, Andrew D. A.; Bakic, Predrag R.

    2012-03-01

    Recent advances in high-resolution 3D breast imaging, namely, digital breast tomosynthesis and dedicated breast CT, have enabled detailed analysis of the shape and distribution of anatomical structures in the breast. Such analysis is critically important, since the projections of breast anatomical structures make up the parenchymal pattern in clinical images which can mask the existing abnormalities or introduce false alarms; the parenchymal pattern is also correlated with the risk of cancer. As a first step towards the shape analysis of anatomical structures in the breast, we have analyzed an anthropomorphic software breast phantom. The phantom generation is based upon the recursive splitting of the phantom volume using octrees, which produces irregularly shaped tissue compartments, qualitatively mimicking the breast anatomy. The shape analysis was performed by fitting ellipsoids to the simulated tissue compartments. The ellipsoidal semi-axes were calculated by matching the moments of inertia of each individual compartment and of an ellipsoid. The distribution of Dice coefficients, measuring volumetric overlap between the compartment and the corresponding ellipsoid, as well as the distribution of aspect ratios, measuring relative orientations of the ellipsoids, were used to characterize various classes of phantoms with qualitatively distinctive appearance. A comparison between input parameters for phantom generation and the properties of fitted ellipsoids indicated the high level of user control in the design of software breast phantoms. The proposed shape analysis could be extended to clinical breast images, and used to inform the selection of simulation parameters for improved realism.

  9. Targeting Notch degradation system provides promise for breast cancer therapeutics.

    Science.gov (United States)

    Liu, Jing; Shen, Jia-Xin; Wen, Xiao-Fen; Guo, Yu-Xian; Zhang, Guo-Jun

    2016-08-01

    Notch receptor signaling pathways play an important role, not only in normal breast development but also in breast cancer development and progression. As a group of ligand-induced proteins, different subtypes of mammalian Notch (Notch1-4) are sensitive to subtle changes in protein levels. Thus, a clear understanding of mechanisms of Notch protein turnover is essential for understanding normal and pathological mechanisms of Notch functions. It has been suggested that there is a close relationship between the carcinogenesis and the dysregulation of Notch degradation. However, this relationship remains mostly undefined in the context of breast cancer, as protein degradation is mediated by numerous signaling pathways as well as certain molecule modulators (activators/inhibitors). In this review, we summarize the published data regarding the regulation of Notch family member degradation in breast cancer, while emphasizing areas that are likely to provide new therapeutic modalities for mechanism-based anti-cancer drugs. PMID:27263934

  10. Tomosynthesis for the early detection of pulmonary emphysema: diagnostic performance compared with chest radiography, using multidetector computed tomography as reference

    Energy Technology Data Exchange (ETDEWEB)

    Yamada, Yoshitake [Keio University School of Medicine, Department of Diagnostic Radiology, Tokyo (Japan); Nippon Koukan Hospital, Department of Radiology, Kawasaki-shi, Kanagawa (Japan); Jinzaki, Masahiro; Hashimoto, Masahiro; Shiomi, Eisuke; Kuribayashi, Sachio [Keio University School of Medicine, Department of Diagnostic Radiology, Tokyo (Japan); Abe, Takayuki [Keio University School of Medicine, Center for Clinical Research, Tokyo (Japan); Ogawa, Kenji [Nippon Koukan Hospital, Department of Radiology, Kawasaki-shi, Kanagawa (Japan)

    2013-08-15

    To compare the diagnostic performance of tomosynthesis with that of chest radiography for the detection of pulmonary emphysema, using multidetector computed tomography (MDCT) as reference. Forty-eight patients with and 63 without pulmonary emphysema underwent chest MDCT, tomosynthesis and radiography on the same day. Two blinded radiologists independently evaluated the tomosynthesis images and radiographs for the presence of pulmonary emphysema. Axial and coronal MDCT images served as the reference standard and the percentage lung volume with attenuation values of -950 HU or lower (LAA{sub -950}) was evaluated to determine the extent of emphysema. Receiver-operating characteristic (ROC) analysis and generalised estimating equations model were used. ROC analysis revealed significantly better performance (P < 0.0001) of tomosynthesis than radiography for the detection of pulmonary emphysema. The average sensitivity, specificity, positive predictive value and negative predictive value of tomosynthesis were 0.875, 0.968, 0.955 and 0.910, respectively, whereas the values for radiography were 0.479, 0.913, 0.815 and 0.697, respectively. For both tomosynthesis and radiography, the sensitivity increased with increasing LAA{sub -950}. The diagnostic performance of tomosynthesis was significantly superior to that of radiography for the detection of pulmonary emphysema. In both tomosynthesis and radiography, the sensitivity was affected by the LAA{sub -950}. (orig.)

  11. Mechanized weld inspection for detection of planar defects and depth measurements by tomosynthesis and planartomography

    International Nuclear Information System (INIS)

    A digital radiography (DR) system was developed featuring a high sensitivity line camera, a custom manipulator, and a 225 kV x-ray tube. This system is designed to scan circumferential pipe welds. The pixel resolution is 50 μm with 2048 pixels per line. The camera and tube are supported 180 deg. apart and rotate together around the pipe to acquire DR images line by line. The technique of line scanning yields several advantages in comparison to film radiography. The radiation direction corresponds to the central projection technique which always employs radial penetration and avoids long tangential paths. Thus radial flaws are detected with maximum available contrast. The slit collimator of the camera significantly reduces the proportion of scattered radiation in the image. This DR system thus provides image quality superior to film when properly aligned. The mechanism of this system allows the adjustment of the radiation direction for inspection of side wall flaws by a second translational manipulator. Scanning the weld at different angles provides multiple projections which improve the probability of detection for laminar flaws such as cracks and lack of fusion. Results employing tomosynthesis and planar tomography algorithms are presented that demonstrate improved image interpretation

  12. Mechanized weld inspection for detection of planar defects and depth measurements by tomosynthesis and planartomography

    Science.gov (United States)

    Ewert, Uwe; Redmer, Bernhard; Müller, Jürgen

    2000-05-01

    A digital radiography (DR) system was developed featuring a high sensitivity line camera, a custom manipulator, and a 225 kV x-ray tube. This system is designed to scan circumferential pipe welds. The pixel resolution is 50 μm with 2048 pixels per line. The camera and tube are supported 180° apart and rotate together around the pipe to acquire DR images line by line. The technique of line scanning yields several advantages in comparison to film radiography. The radiation direction corresponds to the central projection technique which always employs radial penetration and avoids long tangential paths. Thus radial flaws are detected with maximum available contrast. The slit collimator of the camera significantly reduces the proportion of scattered radiation in the image. This DR system thus provides image quality superior to film when properly aligned. The mechanism of this system allows the adjustment of the radiation direction for inspection of side wall flaws by a second translational manipulator. Scanning the weld at different angles provides multiple projections which improve the probability of detection for laminar flaws such as cracks and lack of fusion. Results employing tomosynthesis and planar tomography algorithms are presented that demonstrate improved image interpretation.

  13. Tomosynthesis for the early detection of pulmonary emphysema: diagnostic performance compared with chest radiography, using multidetector computed tomography as reference

    International Nuclear Information System (INIS)

    To compare the diagnostic performance of tomosynthesis with that of chest radiography for the detection of pulmonary emphysema, using multidetector computed tomography (MDCT) as reference. Forty-eight patients with and 63 without pulmonary emphysema underwent chest MDCT, tomosynthesis and radiography on the same day. Two blinded radiologists independently evaluated the tomosynthesis images and radiographs for the presence of pulmonary emphysema. Axial and coronal MDCT images served as the reference standard and the percentage lung volume with attenuation values of -950 HU or lower (LAA-950) was evaluated to determine the extent of emphysema. Receiver-operating characteristic (ROC) analysis and generalised estimating equations model were used. ROC analysis revealed significantly better performance (P -950. The diagnostic performance of tomosynthesis was significantly superior to that of radiography for the detection of pulmonary emphysema. In both tomosynthesis and radiography, the sensitivity was affected by the LAA-950. (orig.)

  14. Immediate systemic allergic reaction in an infant to fish allergen ingested through breast milk

    Science.gov (United States)

    Arima, Takayasu; Campos-Alberto, Eduardo; Funakoshi, Hiraku; Inoue, Yuzaburo; Tomiita, Minako; Kohno, Yoichi

    2016-01-01

    This is a rare case report of systemic allergic reaction to fish allergen ingested through breast milk. Mother ate raw fish more than 3 times a week. Her consumption of fish was associated with urticaria and wheeze in an infant via breast-feeding. Fish-specific IgE antibodies were detected by skin prick test but not by in vitro IgE test. This case demonstrates that fish protein ingested by mother can cause an immediate systemic allergic reaction in offspring through breast-feeding. Although fish intake is generally recommended for prevention of allergy, one should be aware that frequent intake of fish by a lactating mother may sensitize the baby and induce an allergic reaction through breast-feeding. PMID:27803887

  15. Iterative reconstruction using a Monte Carlo based system transfer matrix for dedicated breast positron emission tomography.

    Science.gov (United States)

    Saha, Krishnendu; Straus, Kenneth J; Chen, Yu; Glick, Stephen J

    2014-08-28

    To maximize sensitivity, it is desirable that ring Positron Emission Tomography (PET) systems dedicated for imaging the breast have a small bore. Unfortunately, due to parallax error this causes substantial degradation in spatial resolution for objects near the periphery of the breast. In this work, a framework for computing and incorporating an accurate system matrix into iterative reconstruction is presented in an effort to reduce spatial resolution degradation towards the periphery of the breast. The GATE Monte Carlo Simulation software was utilized to accurately model the system matrix for a breast PET system. A strategy for increasing the count statistics in the system matrix computation and for reducing the system element storage space was used by calculating only a subset of matrix elements and then estimating the rest of the elements by using the geometric symmetry of the cylindrical scanner. To implement this strategy, polar voxel basis functions were used to represent the object, resulting in a block-circulant system matrix. Simulation studies using a breast PET scanner model with ring geometry demonstrated improved contrast at 45% reduced noise level and 1.5 to 3 times resolution performance improvement when compared to MLEM reconstruction using a simple line-integral model. The GATE based system matrix reconstruction technique promises to improve resolution and noise performance and reduce image distortion at FOV periphery compared to line-integral based system matrix reconstruction.

  16. Decision Support System for Histopathological Diagnosis of Breast Diseases in Women

    OpenAIRE

    Aderonke A. Kayode; Babajide S.Afolabi; Bernard I. Akhigbe; Ifiok J. Udo; A Ominiyi

    2011-01-01

    This paper presents a representation of histological features for histopathological diagnosis of breast diseases in women. Hence, a Decision Support System (DSS) for histopathological interpretation and diagnosis of breast diseases was implemented and evaluated. The Expert knowledge used was elicited through interview and literature search. The needed diagnostic knowledge was represented using diseases' profile in the form of frame. UML, JAVA and MYSQL were used for the design and implementat...

  17. Mammaglobin-A Immunohistochemistry in Primary Central Nervous System Neoplasms and Intracranial Metastatic Breast Carcinoma

    OpenAIRE

    Cimino, Patrick J.; Perrin, Richard J.

    2014-01-01

    Metastases represent the most common type of intracranial neoplasm. In women, 30% of such tumors derive from breast carcinoma. In neurosurgical cases with ambiguous cellular morphology and/or limited biopsy material, immunohistochemistry (IHC) is often performed to distinguish metastases from primary central nervous system (CNS) neoplasms. IHC for mammaglobin-A (MGA), a protein expressed in a majority of breast carcinomas, is commonly applied in this setting, but its utility for distinguishin...

  18. Challenges in the Design of Microwave Imaging Systems for Breast Cancer Detection

    DEFF Research Database (Denmark)

    Zhurbenko, Vitaliy

    2011-01-01

    Among the various breast imaging modalities for breast cancer detection, microwave imaging is attractive due to the high contrast in dielectric properties between the cancerous and normal tissue. Due to this reason, this modality has received a significant interest and attention from the microwav...... and disadvantages of the implemented imaging techniques are discussed. The fundamental tradeoffs between the various system requirements are indicated. Some strategies to overcome these limitations are outlined....

  19. Systems consequences of amplicon formation in human breast cancer.

    Science.gov (United States)

    Inaki, Koichiro; Menghi, Francesca; Woo, Xing Yi; Wagner, Joel P; Jacques, Pierre-Étienne; Lee, Yi Fang; Shreckengast, Phung Trang; Soon, Wendy WeiJia; Malhotra, Ankit; Teo, Audrey S M; Hillmer, Axel M; Khng, Alexis Jiaying; Ruan, Xiaoan; Ong, Swee Hoe; Bertrand, Denis; Nagarajan, Niranjan; Karuturi, R Krishna Murthy; Miranda, Alfredo Hidalgo; Liu, Edison T

    2014-10-01

    Chromosomal structural variations play an important role in determining the transcriptional landscape of human breast cancers. To assess the nature of these structural variations, we analyzed eight breast tumor samples with a focus on regions of gene amplification using mate-pair sequencing of long-insert genomic DNA with matched transcriptome profiling. We found that tandem duplications appear to be early events in tumor evolution, especially in the genesis of amplicons. In a detailed reconstruction of events on chromosome 17, we found large unpaired inversions and deletions connect a tandemly duplicated ERBB2 with neighboring 17q21.3 amplicons while simultaneously deleting the intervening BRCA1 tumor suppressor locus. This series of events appeared to be unusually common when examined in larger genomic data sets of breast cancers albeit using approaches with lesser resolution. Using siRNAs in breast cancer cell lines, we showed that the 17q21.3 amplicon harbored a significant number of weak oncogenes that appeared consistently coamplified in primary tumors. Down-regulation of BRCA1 expression augmented the cell proliferation in ERBB2-transfected human normal mammary epithelial cells. Coamplification of other functionally tested oncogenic elements in other breast tumors examined, such as RIPK2 and MYC on chromosome 8, also parallel these findings. Our analyses suggest that structural variations efficiently orchestrate the gain and loss of cancer gene cassettes that engage many oncogenic pathways simultaneously and that such oncogenic cassettes are favored during the evolution of a cancer. PMID:25186909

  20. Breast dosimetry system in screen/film mammography

    OpenAIRE

    Goto, Sachiko; Azuma, Yoshiharu; Toshinori MARUYAMA; Nakagiri, Yoshitada; TAKEDA, Yoshihiro; Sugita, Katsuhiko; Kadohisa, Shigefumi

    2000-01-01

    The average glandular dose to glandular tissue m mammography is generally assumed to be a function of beam quality (HVL), x-ray tube target material, tube voltage, breast thickness, breast composition and, to a lesser extent, x-ray tube voltage waveform. The average glandular dose is generally determined from published tables with knowledge of the above function. Tables for a high frequency x-ray generator are not yet published. In our study, the lookup tables for the average glandular dose w...

  1. Technical innovation: digital tomosynthesis of the hip following intra-articular administration of contrast

    Energy Technology Data Exchange (ETDEWEB)

    Gazaille, Roland E.; Flynn, Michael J.; Page, Walter; Finley, Sonia; Holsbeeck, Marnix van [Henry Ford Hospital, Department of Musculoskeletal Radiology, Detroit, MI (United States)

    2011-11-15

    To demonstrate the clinical use of digital tomosynthesis in the depiction of labral and chondral pathology in the setting of post-operative CAM-type impingement of the hip following intra-articular administration of dilute iodinated contrast. We present images from a 46 year-old African American female with suspected CAM-type femoroacetabular impingement (FAI) following percutaneous pinning of the right hip for slipped capital femoral epiphysis (SCFE). A partial tear of the labrum and clinically significant acetabular chondral abnormalities were demonstrated with the use of digital tomosynthesis with superb anatomic detail. Digital tomosynthesis can be of great clinical utility and can depict pathology in superb anatomic detail, particularly in situations in which MRI is not available as well as under circumstances in which artifact due to orthopedic hardware is of concern as shown in this case. (orig.)

  2. The Impact of Acquisition Dose on Quantitative Breast Density Estimation with Digital Mammography: Results from ACRIN PA 4006.

    Science.gov (United States)

    Chen, Lin; Ray, Shonket; Keller, Brad M; Pertuz, Said; McDonald, Elizabeth S; Conant, Emily F; Kontos, Despina

    2016-09-01

    Purpose To investigate the impact of radiation dose on breast density estimation in digital mammography. Materials and Methods With institutional review board approval and Health Insurance Portability and Accountability Act compliance under waiver of consent, a cohort of women from the American College of Radiology Imaging Network Pennsylvania 4006 trial was retrospectively analyzed. All patients underwent breast screening with a combination of dose protocols, including standard full-field digital mammography, low-dose digital mammography, and digital breast tomosynthesis. A total of 5832 images from 486 women were analyzed with previously validated, fully automated software for quantitative estimation of density. Clinical Breast Imaging Reporting and Data System (BI-RADS) density assessment results were also available from the trial reports. The influence of image acquisition radiation dose on quantitative breast density estimation was investigated with analysis of variance and linear regression. Pairwise comparisons of density estimations at different dose levels were performed with Student t test. Agreement of estimation was evaluated with quartile-weighted Cohen kappa values and Bland-Altman limits of agreement. Results Radiation dose of image acquisition did not significantly affect quantitative density measurements (analysis of variance, P = .37 to P = .75), with percent density demonstrating a high overall correlation between protocols (r = 0.88-0.95; weighted κ = 0.83-0.90). However, differences in breast percent density (1.04% and 3.84%, P digital mammography are not substantially affected by variations in radiation dose; thus, the use of low-dose techniques for the purpose of density estimation may be feasible. (©) RSNA, 2016 Online supplemental material is available for this article. PMID:27002418

  3. Application of digital tomosynthesis (DTS) of optimal deblurring filters for dental X-ray imaging

    Energy Technology Data Exchange (ETDEWEB)

    Oh, J. E.; Cho, H. S.; Kim, D. S.; Choi, S. I.; Je, U. K. [Yonsei University, Wonju (Korea, Republic of)

    2012-04-15

    Digital tomosynthesis (DTS) is a limited-angle tomographic technique that provides some of the tomographic benefits of computed tomography (CT) but at reduced dose and cost. Thus, the potential for application of DTS to dental X-ray imaging seems promising. As a continuation of our dental radiography R and D, we developed an effective DTS reconstruction algorithm and implemented it in conjunction with a commercial dental CT system for potential use in dental implant placement. The reconstruction algorithm employed a backprojection filtering (BPF) method based upon optimal deblurring filters to suppress effectively both the blur artifacts originating from the out-focus planes and the high-frequency noise. To verify the usefulness of the reconstruction algorithm, we performed systematic simulation works and evaluated the image characteristics. We also performed experimental works in which DTS images of enhanced anatomical resolution were successfully obtained by using the algorithm and were promising to our ongoing applications to dental X-ray imaging. In this paper, our approach to the development of the DTS reconstruction algorithm and the results are described in detail.

  4. Refractive-index based tomosynthesis using dark-field imaging optics

    International Nuclear Information System (INIS)

    Tomosynthesis (TS) is a pseudo-3-dimensional image reconstruction method to recover depth-resolved information using restricted number of projections. In this research, refraction index based TS imaging using dark-field imaging (DFI) optics is proposed and biomedical soft tissues were imaged in low dose exposure. By a single exposure of an object, two projected images are obtained from a Laue-case analyzer of DFI. Calculating the both images refraction component is deduced, while two exposures are needed in DEI (diffraction enhanced imaging). Thus the measurement time and the radiation dose in DFI are half of DEI. In addition, the proposed reconstruction algorithm, derived from the quantitative relationship in measurement process, allows high contrast tomographic imaging in spite of one order smaller number of projections for CT (computed tomography). To demonstrate the proposed imaging protocol efficacy, an ex-vivo excised tissue of human lung were imaged using a system constructed at the vertical wiggler beamline at PF-BL14C at KEK. TS image is successfully delineated high quality soft tissue structures comparable to CT.

  5. Application of digital tomosynthesis (DTS) of optimal deblurring filters for dental X-ray imaging

    Science.gov (United States)

    Oh, J. E.; Cho, H. S.; Kim, D. S.; Choi, S. I.; Je, U. K.

    2012-04-01

    Digital tomosynthesis (DTS) is a limited-angle tomographic technique that provides some of the tomographic benefits of computed tomography (CT) but at reduced dose and cost. Thus, the potential for application of DTS to dental X-ray imaging seems promising. As a continuation of our dental radiography R&D, we developed an effective DTS reconstruction algorithm and implemented it in conjunction with a commercial dental CT system for potential use in dental implant placement. The reconstruction algorithm employed a backprojection filtering (BPF) method based upon optimal deblurring filters to suppress effectively both the blur artifacts originating from the out-focus planes and the high-frequency noise. To verify the usefulness of the reconstruction algorithm, we performed systematic simulation works and evaluated the image characteristics. We also performed experimental works in which DTS images of enhanced anatomical resolution were successfully obtained by using the algorithm and were promising to our ongoing applications to dental X-ray imaging. In this paper, our approach to the development of the DTS reconstruction algorithm and the results are described in detail.

  6. Assembling a prototype resonance electrical impedance spectroscopy system for breast tissue signal detection: preliminary assessment

    Science.gov (United States)

    Sumkin, Jules; Zheng, Bin; Gruss, Michelle; Drescher, John; Leader, Joseph; Good, Walter; Lu, Amy; Cohen, Cathy; Shah, Ratan; Zuley, Margarita; Gur, David

    2008-03-01

    Using electrical impedance spectroscopy (EIS) technology to detect breast abnormalities in general and cancer in particular has been attracting research interests for decades. Large clinical tests suggest that current EIS systems can achieve high specificity (>= 90%) at a relatively low sensitivity ranging from 15% to 35%. In this study, we explore a new resonance frequency based electrical impedance spectroscopy (REIS) technology to measure breast tissue EIS signals in vivo, which aims to be more sensitive to small tissue changes. Through collaboration between our imaging research group and a commercial company, a unique prototype REIS system has been assembled and preliminary signal acquisition has commenced. This REIS system has two detection probes mounted in the two ends of a Y-shape support device with probe separation of 60 mm. During REIS measurement, one probe touches the nipple and the other touches to an outer point of the breast. The electronic system continuously generates sweeps of multi-frequency electrical pulses ranging from 100 to 4100 kHz. The maximum electric voltage and the current applied to the probes are 1.5V and 30mA, respectively. Once a "record" command is entered, multi-frequency sweeps are recorded every 12 seconds until the program receives a "stop recording" command. In our imaging center, we have collected REIS measurements from 150 women under an IRB approved protocol. The database includes 58 biopsy cases, 78 screening negative cases, and other "recalled" cases (for additional imaging procedures). We measured eight signal features from the effective REIS sweep of each breast. We applied a multi-feature based artificial neural network (ANN) to classify between "biopsy" and normal "non-biopsy" breasts. The ANN performance is evaluated using a leave-one-out validation method and ROC analysis. We conducted two experiments. The first experiment attempted to classify 58 "biopsy" breasts and 58 "non-biopsy" breasts acquired on 58 women

  7. Estimation of the average glandular dose on a team of tomosynthesis

    International Nuclear Information System (INIS)

    Seeking to improve the information that gives us an image of mammography the manufacturers have implemented tomosynthesis. With this method of acquisition and reconstruction of image we went from having a 2D to a 3D image image, in such a way that it reduces or eliminates the effect of overlap of tissues. The estimate of the dose, which is always a fundamental parameter in the control of quality of radiology equipment, is more in the case of mammography by the radiosensitivity of this body and the frequency of their use. The objective of this work is the determination of the mean in a team glandular dose of with tomosynthesis mammography. (Author)

  8. Phantom experiments with a microwave imaging system for breast-cancer screening

    DEFF Research Database (Denmark)

    Rubæk, Tonny; Zhurbenko, Vitaliy

    2009-01-01

    Microwave imaging is emerging as a promising technique for breast-cancer detection. In this paper, the microwave imaging system currently being developed at the Technical University of Denmark is introduced. This system consists of 32 antennas positioned in a cylindrical setup, each equipped...

  9. Developing and testing a multi-probe resonance electrical impedance spectroscopy system for detecting breast abnormalities

    Science.gov (United States)

    Gur, David; Zheng, Bin; Dhurjaty, Sreeram; Wolfe, Gene; Fradin, Mary; Weil, Richard; Sumkin, Jules; Zuley, Margarita

    2009-02-01

    In our previous study, we reported on the development and preliminary testing of a prototype resonance electrical impedance spectroscopy (REIS) system with a pair of probes. Although our pilot study on 150 young women ranging from 30 to 50 years old indicated the feasibility of using REIS output sweep signals to classify between the women who had negative examinations and those who would ultimately be recommended for biopsy, the detection sensitivity was relatively low. To improve performance when using REIS technology, we recently developed a new multi-probe based REIS system. The system consists of a sensor module box that can be easily lifted along a vertical support device to fit women of different height. Two user selectable breast placement "cups" with different curvatures are included in the system. Seven probes are mounted on each of the cups on opposing sides of the sensor box. By rotating the sensor box, the technologist can select the detection sensor cup that better fits the breast size of the woman being examined. One probe is mounted in the cup center for direct contact with the nipple and the other six probes are uniformly distributed along an outside circle to enable contact with six points on the outer and inner breast skin surfaces. The outer probes are located at a distance of 60mm away from the center (nipple) probe. The system automatically monitors the quality of the contact between the breast surface and each of the seven probes and data acquisition can only be initiated when adequate contact is confirmed. The measurement time for each breast is approximately 15 seconds during which time the system records 121 REIS signal sweep outputs generated from 200 KHz to 800 KHz at 5 KHz increments for all preselected probe pairs. Currently we are measuring 6 pairs between the center probe and each of six probes located on the outer circle as well as two pairs between probe pairs on the outer circle. This new REIS system has been installed in our

  10. Evaluation of breast microcalcifications according to breast imaging reporting and data system criteria and Le Gal's classification

    Energy Technology Data Exchange (ETDEWEB)

    Guelsuen, Meltem; Demirkazik, Figen Basaran E-mail: fdemirka@hacettepe.edu.com; Ariyuerek, Macit

    2003-09-01

    Introduction/objective: Our aim was to evaluate the positive predictive value (PPV) of the analysis of breast microcalcifications according to Breast Imaging Reporting and Data System (BI-RADS) and Le Gal's classification in identification of malignancy, and to assess the interobserver agreement using these criteria. Methods and material: Eighty-two patients with breast microcalcifications on their screening mammograms underwent surgical excision after a needle localization at our institution between July 1993 and June 2000. The mammograms were examined by two experienced mammographers retrospectively and independently. Each observer noted the morphology, distribution, associated findings, final assessment categories of microcalcifications according to BI-RADS criteria and the morphologic type of microcalcifications according to Le Gal's classification. The PPVs for each radiologist and the interobserver agreement were determined by using these data and histologic findings. Results: Histopathologic results yielded malignancy in 25 (30%) cases. The evaluation of microcalcifications according to BI-RADS criteria revealed PPVs of 17% and 25% for category 4 lesions, and 68% and 44% for categoy 5 lesions. In the assessment of microcalcifications according to Le Gal's classification, the PPV of type 4 lesions was 45% (for both observers), whereas the PPVs of type 5 lesions were 70% and 50%. The interobserver agreement was fair in evaluation of morphology of microcalcifications ({kappa}: 0.31), distribution of microcalcifications ({kappa}: 0.29), final assessment categories ({kappa}: 0.27), and moderate in evaluation of associated findings ({kappa}: 0.48) by using BI-RADS lexicon. It was higher for the assessment of milk of calcium and round microcalcifications than other typically benign microcalcifications, and for fine linear or fine linear branching microcalifications than other probably malignant calcifications. There was a fair interobserver agreement

  11. Breast cancer cells: Modulation by melatonin and the ubiquitin-proteasome system--a review.

    Science.gov (United States)

    Vriend, Jerry; Reiter, Russel J

    2015-12-01

    Melatonin inhibits human breast cancer cells stimulated with estrogen. This antiproliferative action depends on the presence of the estrogen receptor alpha (ERα) in the human MCF-7 cell line and is strictly dose-dependent. Since researchers concerned with melatonin and breast cancer have not considered the relevance of the ubiquitin-proteasome system to this research in this review we do so. The fact that the first breast cancer susceptibility gene to be identified, Brca1, functions as a ubiquitin ligase indicates that the ubiquitin-proteasome system has a role in regulating susceptibility to breast cancer. While mutations of this gene increase the incidence of breast cancer, the wild type gene suppresses estrogen-dependent transcriptional events relying on the estrogen receptor ERα. Three other ubiquitin ligases, SCF(Skp2), E6AP and APC, interact directly with ERα at the ERE and AP-1 promoters of ERα target genes. Melatonin, like proteasome inhibitors, decreases estrogen-induced gene transcription. Indeed, it has been reported that melatonin specifically inhibits estrogen-induced transcription mediated by ERα at the ERE and AP1 gene promoters. Herein, we present a model in which the inhibitory action of melatonin on MCF-7 cells is mediated, directly or indirectly, by the ubiquitin-proteasome system. In this model ERα, apoptotic proteins, and cell cycle proteins, all influenced by melatonin, are substrates of key ubiquitin ligases including SCF(Skp2), E6AP, and SCF(B-TrCP). Since dysfunction of the ubiquitin-proteasome system is a risk factor for breast cancer, this model provides a context in which to test the clinical potential, and limitations, of melatonin and proteasome inhibitors. PMID:26363225

  12. Mammaglobin-A immunohistochemistry in primary central nervous system neoplasms and intracranial metastatic breast carcinoma.

    Science.gov (United States)

    Cimino, Patrick J; Perrin, Richard J

    2014-07-01

    Metastases represent the most common type of intracranial neoplasm. In women, 30% of such tumors derive from breast carcinoma. In neurosurgical cases with ambiguous cellular morphology and/or limited biopsy material, immunohistochemistry (IHC) is often performed to distinguish metastases from primary central nervous system (CNS) neoplasms. IHC for mammaglobin-A (MGA), a protein expressed in a majority of breast carcinomas, is commonly applied in this setting, but its utility for distinguishing primary CNS neoplasms from metastatic breast carcinoma is unknown; the reactivity of MGA in primary and metastatic CNS neoplasms has never been described. Here, we describe the frequency and patterns of IHC reactivity for MGA in metastatic and primary CNS neoplasms from patients with well-documented histories of breast carcinoma. Following a published protocol previously applied to non-CNS neoplasms, MGA staining of moderate to strong intensity within 5% or more of a neoplasm was considered positive. On the basis of these criteria, 3 of 12 (25.0%) glioblastomas, 1 of 10 (10.0%) meningiomas, and 47 of 95 (49.5%) metastases were positive. Importantly, the cytoarchitectural staining characteristics among all 4 MGA-positive primary CNS neoplasms (cytoplasmic and nuclear) differed from those of the metastases (cytoplasmic and membranous). These findings suggest that MGA IHC staining intensity and distribution can distinguish metastases from primary CNS neoplasms (P=0.0086) in women with a history of breast carcinoma but also indicate that cytologic staining patterns must be interpreted for more accurate tumor classification. PMID:23958549

  13. Monte Carlo simulation of glandular dose in a dedicated breast CT system

    Institute of Scientific and Technical Information of China (English)

    TANG Xiao; WEI Long; ZHAO Wei; WANG Yan-Fang; SHU Hang; SUN Cui-Li; WEI Cun-Feng; CAO Da-Quan; QUE Jie-Min; SHI Rong-Jian

    2012-01-01

    A dedicated breast CT system (DBCT) is a new method for breast cancer detection proposed in recent years.In this paper,the glandular dose in the DBCT is simulated using the Monte Carlo method.The phantom shape is half ellipsoid,and a series of phantoms with different sizes,shapes and compositions were constructed. In order to optimize the spectra,monoenergy X-ray beams of 5-80 keV were used in simulation.The dose distribution of a breast phantom was studied:a higher energy beam generated more uniform distribution,and the outer parts got more dose than the inner parts.For polyenergtic spectra,four spectra of Al filters with different thicknesses were simulated,and the polyenergtic glandular dose was calculated as a spectral weighted combination of the monoenergetic dose.

  14. Conceptual detector development and Monte Carlo simulation of a novel 3D breast computed tomography system

    Science.gov (United States)

    Ziegle, Jens; Müller, Bernhard H.; Neumann, Bernd; Hoeschen, Christoph

    2016-03-01

    A new 3D breast computed tomography (CT) system is under development enabling imaging of microcalcifications in a fully uncompressed breast including posterior chest wall tissue. The system setup uses a steered electron beam impinging on small tungsten targets surrounding the breast to emit X-rays. A realization of the corresponding detector concept is presented in this work and it is modeled through Monte Carlo simulations in order to quantify first characteristics of transmission and secondary photons. The modeled system comprises a vertical alignment of linear detectors hold by a case that also hosts the breast. Detectors are separated by gaps to allow the passage of X-rays towards the breast volume. The detectors located directly on the opposite side of the gaps detect incident X-rays. Mechanically moving parts in an imaging system increase the duration of image acquisition and thus can cause motion artifacts. So, a major advantage of the presented system design is the combination of the fixed detectors and the fast steering electron beam which enable a greatly reduced scan time. Thereby potential motion artifacts are reduced so that the visualization of small structures such as microcalcifications is improved. The result of the simulation of a single projection shows high attenuation by parts of the detector electronics causing low count levels at the opposing detectors which would require a flat field correction, but it also shows a secondary to transmission ratio of all counted X-rays of less than 1 percent. Additionally, a single slice with details of various sizes was reconstructed using filtered backprojection. The smallest detail which was still visible in the reconstructed image has a size of 0.2mm.

  15. Systemic chemotherapy induces microsatellite instability in the peripheral blood mononuclear cells of breast cancer patients

    International Nuclear Information System (INIS)

    Systemic chemotherapy is an important part of treatment for breast cancer. We conducted the present study to evaluate whether systemic chemotherapy could produce microsatellite instability (MSI) in the peripheral blood mononuclear cell fraction of breast cancer patients. We studied 119 sequential blood samples from 30 previously untreated breast cancer patients before, during and after chemotherapy. For comparison, we also evaluated 20 women who had no relevant medical history (control group). In 27 out of 30 patients we observed MSI in at least one sample, and six patients had loss of heterozygosity. We found a significant correlation between the number of MSI events per sample and chemotherapy with alkylating agents (P < 0.0001). We also observed an inverse correlation between the percentage of cells positive for hMSH2 and the number of MSI events per sample (P = 0.00019) and use of alkylating agents (P = 0.019). We conclude that systemic chemotherapy may induce MSI and loss of heterozygosity in peripheral blood mononuclear cells from breast cancer patients receiving alkylating agents, possibly mediated by a chemotherapy-induced decrease in the expression of hMSH2. These effects may be related to the generation of secondary leukaemia in some patients, and may also intensify the genetic instability of tumours and increase resistance to treatment

  16. Decision Support System for Histopathological Diagnosis of Breast Diseases in Women

    Directory of Open Access Journals (Sweden)

    Aderonke A Kayode

    2011-03-01

    Full Text Available This paper presents a representation of histological features for histopathological diagnosis of breast diseases in women. Hence, a Decision Support System (DSS for histopathological interpretation and diagnosis of breast diseases was implemented and evaluated. The Expert knowledge used was elicited through interview and literature search. The needed diagnostic knowledge was represented using diseases' profile in the form of frame. UML, JAVA and MYSQL were used for the design and implementation of the system. 150 samples of retrospective cases were used for the system's implementation, while a Consultant Pathologist's interpretation was used to evaluate the system. Results for Sensitivity, Specificity, Positive Prediction Value and the Negative Prediction Value are 97.7%, 95.0%, 99.2% and 86.3% respectively. Thus, the result showed that the system is capable of assisting an inexperience pathologist in making accurate, consistent and timely diagnoses, also in the study of diagnostic protocol, education, self-assessment, and quality control.

  17. Classification System for Identifying Women at Risk for Altered Partial Breast Irradiation Recommendations After Breast Magnetic Resonance Imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kowalchik, Kristin V. [Department of Radiation Oncology, Mayo Clinic, Jacksonville, Florida (United States); Vallow, Laura A., E-mail: vallow.laura@mayo.edu [Department of Radiation Oncology, Mayo Clinic, Jacksonville, Florida (United States); McDonough, Michelle [Department of Radiology, Mayo Clinic, Jacksonville, Florida (United States); Thomas, Colleen S.; Heckman, Michael G. [Section of Biostatistics, Mayo Clinic, Jacksonville, Florida (United States); Peterson, Jennifer L. [Department of Radiation Oncology, Mayo Clinic, Jacksonville, Florida (United States); Adkisson, Cameron D. [Department of General Surgery, Mayo Clinic, Jacksonville, Florida (United States); Serago, Christopher [Department of Radiation Oncology, Mayo Clinic, Jacksonville, Florida (United States); McLaughlin, Sarah A. [Department of General Surgery, Mayo Clinic, Jacksonville, Florida (United States)

    2013-09-01

    Purpose: To study the utility of preoperative breast MRI for partial breast irradiation (PBI) patient selection, using multivariable analysis of significant risk factors to create a classification rule. Methods and Materials: Between 2002 and 2009, 712 women with newly diagnosed breast cancer underwent preoperative bilateral breast MRI at Mayo Clinic Florida. Of this cohort, 566 were retrospectively deemed eligible for PBI according to the National Surgical Adjuvant Breast and Bowel Project Protocol B-39 inclusion criteria using physical examination, mammogram, and/or ultrasound. Magnetic resonance images were then reviewed to determine their impact on patient eligibility. The patient and tumor characteristics were evaluated to determine risk factors for altered PBI eligibility after MRI and to create a classification rule. Results: Of the 566 patients initially eligible for PBI, 141 (25%) were found ineligible because of pathologically proven MRI findings. Magnetic resonance imaging detected additional ipsilateral breast cancer in 118 (21%). Of these, 62 (11%) had more extensive disease than originally noted before MRI, and 64 (11%) had multicentric disease. Contralateral breast cancer was detected in 28 (5%). Four characteristics were found to be significantly associated with PBI ineligibility after MRI on multivariable analysis: premenopausal status (P=.021), detection by palpation (P<.001), first-degree relative with a history of breast cancer (P=.033), and lobular histology (P=.002). Risk factors were assigned a score of 0-2. The risk of altered PBI eligibility from MRI based on number of risk factors was 0:18%; 1:22%; 2:42%; 3:65%. Conclusions: Preoperative bilateral breast MRI altered the PBI recommendations for 25% of women. Women who may undergo PBI should be considered for breast MRI, especially those with lobular histology or with 2 or more of the following risk factors: premenopausal, detection by palpation, and first-degree relative with a history of

  18. Classification System for Identifying Women at Risk for Altered Partial Breast Irradiation Recommendations After Breast Magnetic Resonance Imaging

    International Nuclear Information System (INIS)

    Purpose: To study the utility of preoperative breast MRI for partial breast irradiation (PBI) patient selection, using multivariable analysis of significant risk factors to create a classification rule. Methods and Materials: Between 2002 and 2009, 712 women with newly diagnosed breast cancer underwent preoperative bilateral breast MRI at Mayo Clinic Florida. Of this cohort, 566 were retrospectively deemed eligible for PBI according to the National Surgical Adjuvant Breast and Bowel Project Protocol B-39 inclusion criteria using physical examination, mammogram, and/or ultrasound. Magnetic resonance images were then reviewed to determine their impact on patient eligibility. The patient and tumor characteristics were evaluated to determine risk factors for altered PBI eligibility after MRI and to create a classification rule. Results: Of the 566 patients initially eligible for PBI, 141 (25%) were found ineligible because of pathologically proven MRI findings. Magnetic resonance imaging detected additional ipsilateral breast cancer in 118 (21%). Of these, 62 (11%) had more extensive disease than originally noted before MRI, and 64 (11%) had multicentric disease. Contralateral breast cancer was detected in 28 (5%). Four characteristics were found to be significantly associated with PBI ineligibility after MRI on multivariable analysis: premenopausal status (P=.021), detection by palpation (P<.001), first-degree relative with a history of breast cancer (P=.033), and lobular histology (P=.002). Risk factors were assigned a score of 0-2. The risk of altered PBI eligibility from MRI based on number of risk factors was 0:18%; 1:22%; 2:42%; 3:65%. Conclusions: Preoperative bilateral breast MRI altered the PBI recommendations for 25% of women. Women who may undergo PBI should be considered for breast MRI, especially those with lobular histology or with 2 or more of the following risk factors: premenopausal, detection by palpation, and first-degree relative with a history of

  19. The effect of menopause and hysterectomy on systemic vascular endothelial growth factor in women undergoing surgery for breast cancer

    International Nuclear Information System (INIS)

    Vascular endothelial growth factor (VEGF) is a potent angiogenic cytokine produced physiologically by the uterus. Pathological secretion by tumours promotes growth and metastasis. High circulating VEGF levels potentially have a deleterious effect on breast cancer by promoting disease progression. The aims of this study were to investigate circulating VEGF levels in breast cancer patients and assess the effect of menopause or hysterectomy on systemic VEGF. Patients undergoing primary surgery for breast cancer and controls matched for age, menopausal and hysterectomy status were prospectively recruited. Serum VEGF, FSH, LH, estrogen, progesterone and platelet levels were measured. Serum VEGF was corrected for platelet load (sVEGFp) to provide a biologically relevant measurement of circulating VEGF. SVEGFp levels were analyzed with respect to tumor characteristics, menopausal status and hysterectomy status. Two hundred women were included in the study; 89 breast cancer patients and 111 controls. SVEGFp levels were significantly higher in breast cancer patients compared to controls (p = 0.0001), but were not associated with clinico-pathological tumor characteristics. Systemic VEGF levels reduced significantly in the breast cancer patients following tumor excision (p = 0.018). The highest systemic VEGF levels were observed in postmenopausal breast cancer patients. Postmenopausal women who had had a previous hysterectomy had significantly higher VEGF levels than those with an intact postmenopausal uterus (p = 0.001). This study identifies an intact postmenopausal uterus as a potential means of reducing circulating levels of VEGF which could confer a protective effect against breast cancer metastatic potential

  20. An Integrated Knowledge Base System Architecture for Histopathological Diagnosis of Breast Diseases

    Directory of Open Access Journals (Sweden)

    Aderonke A. Kayode

    2012-12-01

    Full Text Available The histopathological diagnosis of breast diseases requires highly trained and experienced experts, and often strains pathologists’ cognitive capabilities. Accurate and timely diagnosis of breast diseases is essential for the appropriate management of the patients. The paper presents a knowledge base system that uses a combination of rule-based and case-based techniques to achieve the diagnosis. Rule-based systems handle problems with well-defined knowledge bases this limits the flexibility of such system. Case-based reasoning has been adopted to overcome this inherent weakness of rule-based systems by incorporating previous cases in the generation of new cases to improve the performance of the system. The result of this research shows that the system is capable of assisting pathologists in making accurate, consistent and timely diagnoses. The system also aid in eliminating errors of omission that have been viewed as a prominent cause of medical errors. In conclusion this paper investigated the histological features used in the diagnosis of breast diseases and proposed an integrated knowledge base system based on the features.

  1. Stereo-vision system for finger tracking in breast self-examination

    Science.gov (United States)

    Zeng, Jianchao; Wang, Yue J.; Freedman, Matthew T.; Mun, Seong K.

    1997-05-01

    Early detection of breast cancer, one of the leading causes of death by cancer for women in the US is key to any strategy designed to reduce breast cancer mortality. Breast self-examination (BSE) is considered as the most cost- effective approach available for early breast cancer detection because it is simple and non-invasive, and a large fraction of breast cancers are actually found by patients using this technique today. In BSE, the patient should use a proper search strategy to cover the whole breast region in order to detect al possible tumors. At present there is no objective approach or clinical data to evaluate the effectiveness of a particular BSE strategy. Even if a particular strategy is determined to be the most effective, training women to use it is still difficult because there is no objective way for them to know whether they are doing it correctly. We have developed a system using vision-based motion tracking technology to gather quantitative data about the breast palpation process for analysis of the BSE technique. By tracking position of the fingers, the system can provide the first objective quantitative data about the BSE process, and thus can improve our knowledge of the technique and help analyze its effectiveness. By visually displaying all the touched position information to the patient as the BSE is being conducted, the system can provide interactive feedback to the patient and create a prototype for a computer-based BSE training system. We propose to use color features, put them on the finger nails and track these features, because in breast palpation the background is the breast itself which is similar to the hand in color. This situation can hinder the ability/efficiency of other features if real time performance is required. To simplify feature extraction process, color transform is utilized instead of RGB values. Although the clinical environment will be well illuminated, normalization of color attributes is applied to compensate for

  2. Cloud-Based Service Information System for Evaluating Quality of Life after Breast Cancer Surgery.

    Directory of Open Access Journals (Sweden)

    Hao-Yun Kao

    Full Text Available Although recent studies have improved understanding of quality of life (QOL outcomes of breast conserving surgery, few have used longitudinal data for more than two time points, and few have examined predictors of QOL over two years. Additionally, the longitudinal data analyses in such studies rarely apply the appropriate statistical methodology to control for censoring and inter-correlations arising from repeated measures obtained from the same patient pool. This study evaluated an internet-based system for measuring longitudinal changes in QOL and developed a cloud-based system for managing patients after breast conserving surgery.This prospective study analyzed 657 breast cancer patients treated at three tertiary academic hospitals. Related hospital personnel such as surgeons and other healthcare professionals were also interviewed to determine the requirements for an effective cloud-based system for surveying QOL in breast cancer patients. All patients completed the SF-36, Quality of Life Questionnaire (QLQ-C30 and its supplementary breast cancer measure (QLQ-BR23 at baseline, 6 months, 1 year, and 2 years postoperatively. The 95% confidence intervals for differences in responsiveness estimates were derived by bootstrap estimation. Scores derived by these instruments were interpreted by generalized estimating equation before and after surgery.All breast cancer surgery patients had significantly improved QLQ-C30 and QLQ-BR23 subscale scores throughout the 2-year follow-up period (p<0.05. During the study period, QOL generally had a negative association with advanced age, high Charlson comorbidity index score, tumor stage III or IV, previous chemotherapy, and long post-operative LOS. Conversely, QOL was positively associated with previous radiotherapy and hormone therapy. Additionally, patients with high scores for preoperative QOL tended to have high scores for QLQ-C30, QLQ-BR23 and SF-36 subscales. Based on the results of usability testing

  3. Breast imaging reporting and data system (BI-RADS) lexicon for breast MRI: Interobserver variability in the description and assignment of BI-RADS category

    Energy Technology Data Exchange (ETDEWEB)

    El Khoury, Mona, E-mail: monelkhoury@gmail.com [Centre Hospitalier Universitaire de Montréal, Breast Centre, Radiology Department, 3840 Rue Saint Urbain, Montréal, QC H2W1T8 (Canada); Lalonde, Lucie; David, Julie; Labelle, Maude [Centre Hospitalier Universitaire de Montréal, Breast Centre, Radiology Department, 3840 Rue Saint Urbain, Montréal, QC H2W1T8 (Canada); Mesurolle, Benoit [Centre Hospitalier Universitaire de McGill, Cedar Breast Centre, Radiology Department, 687 Pine Avenue West, Montreal, QC H3A1A1 (Canada); Trop, Isabelle [Centre Hospitalier Universitaire de Montréal, Breast Centre, Radiology Department, 3840 Rue Saint Urbain, Montréal, QC H2W1T8 (Canada)

    2015-01-15

    Highlights: • The use of BI-RADS lexicon in interpreting breast MRI examinations is beneficial. • Our study shows: (a) moderate to substantial agreement between observers and (b) better agreement in interpreting mass than non-mass enhancement (NME). • Careful analysis of the NME should be done to help detect cancer as early as possible. - Abstract: Purpose: To retrospectively evaluate interobserver variability between breast radiologists when describing abnormal enhancement on breast MR examinations and assigning a BI-RADS category using the Breast Imaging Reporting and Data System (BI-RADS) terminology. Materials and methods: Five breast radiologists blinded to patients’ medical history and pathologic results retrospectively and independently reviewed 257 abnormal areas of enhancement on breast MRI performed in 173 women. Each radiologist described the focal enhancement using BI-RADS terminology and assigned a final BI-RADS category. Krippendorff's α coefficient of agreement was used to asses interobserver variability. Results: All radiologists agreed on the morphology of enhancement in 183/257 (71%) lesions, yielding a substantial agreement (Krippendorff's α = 0.71). Moderate agreement was obtained for mass descriptors – shape, margins and internal enhancement – (α = 0.55, 0.51 and 0.45 respectively) and NME (non-mass enhancement) descriptors – distribution and internal enhancement – (α = 0.54 and 0.43). Overall substantial agreement was obtained for BI-RADS category assignment (α = 0.71). It was however only moderate (α = 0.38) for NME compared to mass (α = 0.80). Conclusion: Our study shows good agreement in describing mass and NME on a breast MR examination but a better agreement in predicting malignancy for mass than NME.

  4. Predictive model for contrast-enhanced ultrasound of the breast: Is it feasible in malignant risk assessment of breast imaging reporting and data system 4 lesions?

    Science.gov (United States)

    Luo, Jun; Chen, Ji-Dong; Chen, Qing; Yue, Lin-Xian; Zhou, Guo; Lan, Cheng; Li, Yi; Wu, Chi-Hua; Lu, Jing-Qiao

    2016-01-01

    AIM: To build and evaluate predictive models for contrast-enhanced ultrasound (CEUS) of the breast to distinguish between benign and malignant lesions. METHODS: A total of 235 breast imaging reporting and data system (BI-RADS) 4 solid breast lesions were imaged via CEUS before core needle biopsy or surgical resection. CEUS results were analyzed on 10 enhancing patterns to evaluate diagnostic performance of three benign and three malignant CEUS models, with pathological results used as the gold standard. A logistic regression model was developed basing on the CEUS results, and then evaluated with receiver operating curve (ROC). RESULTS: Except in cases of enhanced homogeneity, the rest of the 9 enhancement appearances were statistically significant (P biopsy, and provide accurate BI-RADS classification. PMID:27358688

  5. Characterization of materials for optimal near-infrared and x-ray imaging of the breast.

    Science.gov (United States)

    Michaelsen, Kelly; Krishnaswamy, Venkataramanan; Pogue, Brian W; Brooks, Ken; Defreitas, Ken; Shaw, Ian; Poplack, Steven P; Paulsen, Keith D

    2012-09-01

    Development of a detector case for complete co-registration of images in a non-fiber-based combined near-infrared spectral tomography and digital breast tomosynthesis, required analysis to find materials that could support a breast under full mammographic compression without affecting the x-ray images or the quality of the near infrared measurements. Several possible solutions were considered, and many types of plastics were tested in the development of the detector case. Light channeling within the detector case changed the data obtained in resin and agarose phantoms, lowering recovered absorption values. Additional developments focusing on blocking stray light were successful and permitted a normal subject imaging exam.

  6. Animal testing using 3D microwave tomography system for breast cancer detection.

    Science.gov (United States)

    Lee, Jong Moon; Son, Sung Ho; Kim, Hyuk Je; Kim, Bo Ra; Choi, Heyng Do; Jeon, Soon Ik

    2014-01-01

    The three dimensional microwave tomography (3D MT) system of the Electronics and Telecommunications Research Institute (ETRI) comprises an antenna array, transmitting receiving module, switch matrix module and a signal processing component. This system also includes a patient interface bed as well as a 3D reconstruction algorithm. Here, we perform a comparative analysis of image reconstruction results using the assembled system and MRI results, which is used to image the breasts of dogs. Microwave imaging reconstruction results (at 1,500 MHz) obtained using the ETRI 3D MT system are presented. The system provides computationally reliable diagnosis results from the reconstructed MT Image. PMID:25160233

  7. Mammary renin-angiotensin system-regulating aminopeptidase activities are modified in rats with breast cancer.

    Science.gov (United States)

    del Pilar Carrera, Maria; Ramírez-Expósito, Maria Jesus; Mayas, Maria Dolores; García, Maria Jesus; Martínez-Martos, Jose Manuel

    2010-12-01

    Angiotensin II in particular and/or the local renin-angiotensin system in general could have an important role in epithelial tissue growth and modelling; therefore, it is possible that it may be involved in breast cancer. In this sense, previous works of our group showed a predominating role of angiotensin II in tumoral tissue obtained from women with breast cancer. However, although classically angiotensin II has been considered the main effector peptide of the renin-angiotensin system cascade, several of its catabolism products such as angiotensin III and angiotensin IV also possess biological functions. These peptides are formed through the activity of several proteolytic regulatory enzymes of the aminopeptidase type, also called angiotensinases. The aim of this work was to analyse several specific angiotensinase activities involved in the renin-angiotensin system cascade in mammary tissue from control rats and from rats with mammary tumours induced by N-methyl-nitrosourea (NMU), which may reflect the functional status of their target peptides under the specific conditions brought about by the tumoural process. The results show that soluble and membrane-bound specific aspartyl aminopeptidase activities and membrane-bound glutamyl aminopeptidase activity increased in mammary tissue from NMU-treated animals and soluble aminopeptidase N and aminopeptidase B activities significantly decreased in mammary tissue from NMU-treated rats. These changes support the existence of a local mammary renin-angiotensin system and that this system and its putative functions in breast tissue could be altered by the tumour process, in which we suggest a predominant role of angiotensin III. All described data about the renin-angiotensin system in mammary tissue support the idea that it must be involved in normal breast tissue functions, and its disruption could be involved in one or more steps of the carcinogenesis process.

  8. Fuzzy-probabilistic multi agent system for breast cancer risk assessment and insurance premium assignment.

    Science.gov (United States)

    Tatari, Farzaneh; Akbarzadeh-T, Mohammad-R; Sabahi, Ahmad

    2012-12-01

    In this paper, we present an agent-based system for distributed risk assessment of breast cancer development employing fuzzy and probabilistic computing. The proposed fuzzy multi agent system consists of multiple fuzzy agents that benefit from fuzzy set theory to demonstrate their soft information (linguistic information). Fuzzy risk assessment is quantified by two linguistic variables of high and low. Through fuzzy computations, the multi agent system computes the fuzzy probabilities of breast cancer development based on various risk factors. By such ranking of high risk and low risk fuzzy probabilities, the multi agent system (MAS) decides whether the risk of breast cancer development is high or low. This information is then fed into an insurance premium adjuster in order to provide preventive decision making as well as to make appropriate adjustment of insurance premium and risk. This final step of insurance analysis also provides a numeric measure to demonstrate the utility of the approach. Furthermore, actual data are gathered from two hospitals in Mashhad during 1 year. The results are then compared with a fuzzy distributed approach.

  9. Systemic Delivery of an Oncolytic Adenovirus Expressing Decorin for the Treatment of Breast Cancer Bone Metastases.

    Science.gov (United States)

    Yang, Yuefeng; Xu, Weidong; Neill, Thomas; Hu, Zebin; Wang, Chi-Hsiung; Xiao, Xianghui; Stock, Stuart R; Guise, Theresa; Yun, Chae-Ok; Brendler, Charles B; Iozzo, Renato V; Seth, Prem

    2015-12-01

    The development of novel therapies for breast cancer bone metastasis is a major unmet medical need. Toward that end, we have constructed an oncolytic adenovirus, Ad.dcn, and a nonreplicating adenovirus, Ad(E1-).dcn, both containing the human decorin gene. Our in vitro studies showed that Ad.dcn produced high levels of viral replication and the decorin protein in the breast tumor cells. Ad(E1-).dcn-mediated decorin expression in MDA-MB-231 cells downregulated the expression of Met, β-catenin, and vascular endothelial growth factor A, all of which are recognized decorin targets and play pivotal roles in the progression of breast tumor growth and metastasis. Adenoviral-mediated decorin expression inhibited cell migration and induced mitochondrial autophagy in MDA-MB-231 cells. Mice bearing MDA-MB-231-luc skeletal metastases were systemically administered with the viral vectors, and skeletal tumor growth was monitored over time. The results of bioluminescence imaging and X-ray radiography indicated that Ad.dcn and Ad(E1-).dcn significantly inhibited the progression of bone metastases. At the terminal time point, histomorphometric analysis, micro-computed tomography, and bone destruction biomarkers showed that Ad.dcn and Ad(E1-).dcn reduced tumor burden and inhibited bone destruction. A nonreplicating adenovirus Ad(E1-).luc expressing the luciferase 2 gene had no significant effect on inhibiting bone metastases, and in several assays, Ad.dcn and Ad(E1-).dcn were better than Ad.luc, a replicating virus expressing the luciferase 2 gene. Our data suggest that adenoviral replication coupled with decorin expression could produce effective antitumor responses in a MDA-MB-231 bone metastasis model of breast cancer. Thus, Ad.dcn could potentially be developed as a candidate gene therapy vector for treating breast cancer bone metastases.

  10. Validity of breast-specific gamma imaging for Breast Imaging Reporting and Data System 4 lesions on mammography and/or ultrasound

    Science.gov (United States)

    Cho, Min Jeng; Yu, Yeong Beom; Park, Kyoung Sik; Chung, Hyun Woo; So, Young; Choi, Nami; Kim, Mi Young

    2016-01-01

    Purpose The purpose of this study was to assess the breast-specific gamma imaging (BSGI) in Breast Imaging Reporting and Data System (BI-RADS) 4 lesions on mammography and/or ultrasound. Methods We performed a retrospective review of 162 patients who underwent BSGI in BI-RADS 4 lesions on mammography and/or ultrasound. Results Of the 162 breast lesions, 66 were malignant tumors and 96 were benign tumors. Sensitivity and specificity of BSGI were 90.9% and 78.1%, and positive predictive value and negative predictive value were 74.1% and 92.6%. The sensitivity or specificity of mammography and ultrasound were 74.2% and 56.3% and 87.9% and 19.8%, respectively. The sensitivity and specificity of BSGI for breast lesions ≤1 cm were 88.0% and 86.8%, while the values of beast lesions >1 cm were 92.7% and 61.5%. The sensitivity or specificity of BSGI and mammography for patients with dense breasts were 92.0% and 81.3% and 72.0% and 50.0%, respectively. 26 patients showed neither a nodule nor microcalcification on ultrasound, but showed suspicious calcification on mammography. The sensitivity and specificity of BSGI with microcalcification only lesion were 75.0% and 94.4%. Conclusion This study demonstrated that BSGI had shown high sensitivity and specificity, as well as positive and negative predictive values in BI-RADS 4 lesions on ultrasound and/or mammography. BSGI showed excellent results in dense breasts, in lesions that are less than 1 cm in size and lesions with suspicious microcalcification only. PMID:27073789

  11. kV x-ray dual digital tomosynthesis for image guided lung SBRT

    Science.gov (United States)

    Partain, Larry; Boyd, Douglas; Kim, Namho; Hernandez, Andrew; Daly, Megan; Boone, John

    2016-03-01

    Two simulated sets of digital tomosynthesis images of the lungs, each acquired at a 90 degree angle from the other, with 19 projection images used for each set and SART iterative reconstructed, gives dual tomosynthesis slice image quality approaching that of spiral CT, and with a data acquisition time that is 3% of that of cone beam CT. This fast kV acquisition, should allow near real time tracking of lung tumors in patients receiving SBRT, based on a novel TumoTrakTM multi-source X-ray tube design. Until this TumoTrakTM prototype is completed over the next year, its projected performance was simulated from the DRR images created from a spiral CT data set from a lung cancer patient. The resulting dual digital tomosynthesis reconstructed images of the lung tumor were exceptional and approached that of the gold standard Feldkamp CT reconstruction of breath hold, diagnostic, spiral, multirow, CT data. The relative dose at 46 mAs was less than 10% of what it would have been if the digital tomosynthesis had been done at the 472 mAs of the CT data set. This is for a 0.77 fps imaging rate sufficient to resolve respiratory motion in many free breathing patients during SBRT. Such image guidance could decrease the magnitudes of targeting error margins by as much as 20 mm or more in the craniocaudal direction for lower lobe lesions while markedly reducing dose to normal lung, heart and other critical structures. These initial results suggest a wide range of topics for future work.

  12. Assessment of three different software systems in the evaluation of dynamic MRI of the breast

    Energy Technology Data Exchange (ETDEWEB)

    Kurz, K.D. [Department of Radiology, Stavanger University Hospital, Postbox 8100, Stavanger (Norway)], E-mail: kurk@sus.no; Steinhaus, D. [Institute of Daignostic Radiology, Duesseldorf University Hospital, Moorenstr. 5, 40225 Duesseldorf (Germany)], E-mail: Daniele.Steinhaus@med.uni-duesseldorf.de; Klar, V. [Institute of Daignostic Radiology, Duesseldorf University Hospital, Moorenstr. 5, 40225 Duesseldorf (Germany)], E-mail: verena.klar@uni-duesseldorf.de; Cohnen, M. [Institute of Daignostic Radiology, Duesseldorf University Hospital, Moorenstr. 5, 40225 Duesseldorf (Germany)], E-mail: cohnen@med.uni-duesseldorf.de; Wittsack, H.J. [Institute of Daignostic Radiology, Duesseldorf University Hospital, Moorenstr. 5, 40225 Duesseldorf (Germany)], E-mail: wittsack@uni-duesseldorf.de; Saleh, A. [Institute of Daignostic Radiology, Duesseldorf University Hospital, Moorenstr. 5, 40225 Duesseldorf (Germany)], E-mail: saleh@uni-duesseldorf.de; Moedder, U. [Institute of Daignostic Radiology, Duesseldorf University Hospital, Moorenstr. 5, 40225 Duesseldorf (Germany)], E-mail: moedder@med.uni-duesseldorf.de; Blondin, D. [Institute of Daignostic Radiology, Duesseldorf University Hospital, Moorenstr. 5, 40225 Duesseldorf (Germany)], E-mail: blondin@med.uni-duesseldorf.de

    2009-02-15

    Objective: The aim was to compare the diagnostic performance and handling of dynamic contrast-enhanced MRI of the breast with two commercial software solutions ('CADstream' and '3TP') and one self-developed software system ('Mammatool'). Materials and methods: Identical data sets of dynamic breast MRI from 21 patients were evaluated retrospectively with all three software systems. The exams were classified according to the BI-RADS classification. The number of lesions in the parametric mapping was compared to histology or follow-up of more than 2 years. In addition, 25 quality criteria were judged by 3 independent investigators with a score from 0 to 5. Statistical analysis was performed to document the quality ranking of the different software systems. Results: There were 9 invasive carcinomas, one pure DCIS, one papilloma, one radial scar, three histologically proven changes due to mastopathy, one adenosis and two fibroadenomas. Additionally two patients with enhancing parenchyma followed with MRI for more than 3 years and one scar after breast conserving therapy were included. All malignant lesions were classified as BI-RADS 4 or 5 using all software systems and showed significant enhancement in the parametric mapping. 'CADstream' showed the best score on subjective quality criteria. '3TP' showed the lowest number of false-positive results. 'Mammatool' produced the lowest number of benign tissues indicated with parametric overlay. Conclusion: All three software programs tested were adequate for sensitive and efficient assessment of dynamic MRI of the breast. Improvements in specificity may be achievable.

  13. Preservation of biomolecules in breast cancer tissue by a formalin-free histology system

    Directory of Open Access Journals (Sweden)

    Morales Azorides R

    2008-01-01

    Full Text Available Abstract Background The potential problems associated with the use of formalin in histology, such as health hazards, degradation of RNA and cross-linking of proteins are well recognized. We describe the utilization of a formalin-free fixation and processing system for tissue detection of two important biopredictors in breast cancer – estrogen receptor and HER2 – at the RNA and protein levels. Methods Parallel sections of 62 cases of breast cancer were fixed in an alcohol-based molecular fixative and in formalin. Molecular fixative samples were processed by a novel formalin-free microwave-assisted processing system that preserves DNA, RNA and proteins. Formalin-fixed samples were processed using the conventional method. Estrogen receptor was assessed by immunohistochemistry and real-time PCR. HER2 was assessed by immunohistochemistry, FISH, CISH and real-time PCR. Results The immunohistochemical reaction for estrogen receptor was similar in molecular- and formalin-fixed samples (Spearman Rank R = 0.83, p Conclusion The formalin-free tissue fixation and processing system is a practical platform for evaluation of biomolecular markers in breast cancer and it allows reliable DNA and RNA and protein studies.

  14. A Comparison of Behavioral Inhibition/ Activation System, Type D and Optimism in the Breast Cancer Patients and Healthy Controls

    Directory of Open Access Journals (Sweden)

    A Alipoor

    2015-04-01

    Full Text Available Background & aim: Nowadays, the role and importance of psychosocial factors on physical health, as well as the influence of personality characteristics in having psychosomatic diseases such as cancer are of interest to many researchers. In spite of increase in breast cancer in Iran, very few studies have been carried out on risk factors of breast cancer. The aim of this study was to evaluate the comparative Behavioral inhibition / Activation System, type D and optimism in the breast cancer patients and healthy individuals. Methods: In the present casual-comparative study, 190 people (95 Patients and 95 Normal Subjects were selected in Rasht, Iran. Moreover, the groups were matched for demographic characteristics (age, gender and education. All individuals diagnosed with Breast Cancer and Normal Subjects received a Gary-Wilson Personality Questionnaire, Life Orientation Test and Type D Personality Scale. Collected data were analyzed using multivariate analysis of variance and regression. Results: The findings revealed that there were significant differences between cancer and normal groups in behavioral inhibition/activation system, type D Personality and optimism. In this regard, the Breast Cancer group had higher scores subscales of negative affect, social inhibition, passive avoidance, extinction and fight-flight than normal group. In addition, subscales of approach, active avoidance and optimism in the normal group were more than the Breast Cancer group. Conclusion: The present study supported the role of psychological variables in breast cancer patients which is essential for improving patients’ health and quality of life.

  15. Clear-PEM: A PET imaging system dedicated to breast cancer diagnostics

    CERN Document Server

    Abreu, M C; Albuquerque, E; Almeida, F G; Almeida, P; Amaral, P; Auffray, Etiennette; Bento, P; Bruyndonckx, P; Bugalho, R; Carriço, B; Cordeiro, H; Ferreira, M; Ferreira, N C; Gonçalves, F; Lecoq, Paul; Leong, C; Lopes, F; Lousã, P; Luyten, J; Martins, M V; Matela, N; Rato-Mendes, P; Moura, R; Nobre, J; Oliveira, N; Ortigão, C; Peralta, L; Rego, J; Ribeiro, R; Rodrigues, P; Santos, A I; Silva, J C; Silva, M M; Tavernier, Stefaan; Teixeira, I C; Texeira, J P; Trindade, A; Trummer, Julia; Varela, J

    2007-01-01

    The Clear-PEM scanner for positron emission mammography under development is described. The detector is based on pixelized LYSO crystals optically coupled to avalanche photodiodes and readout by a fast low-noise electronic system. A dedicated digital trigger (TGR) and data acquisition (DAQ) system is used for on-line selection of coincidence events with high efficiency, large bandwidth and small dead-time. A specialized gantry allows to perform exams of the breast and of the axilla. In this paper we present results of the measurement of detector modules that integrate the system under construction as well as the imaging performance estimated from Monte Carlo simulated data.

  16. Generation of 3D synthetic breast tissue

    Science.gov (United States)

    Elangovan, Premkumar; Dance, David R.; Young, Kenneth C.; Wells, Kevin

    2016-03-01

    Virtual clinical trials are an emergent approach for the rapid evaluation and comparison of various breast imaging technologies and techniques using computer-based modeling tools. A fundamental requirement of this approach for mammography is the use of realistic looking breast anatomy in the studies to produce clinically relevant results. In this work, a biologically inspired approach has been used to simulate realistic synthetic breast phantom blocks for use in virtual clinical trials. A variety of high and low frequency features (including Cooper's ligaments, blood vessels and glandular tissue) have been extracted from clinical digital breast tomosynthesis images and used to simulate synthetic breast blocks. The appearance of the phantom blocks was validated by presenting a selection of simulated 2D and DBT images interleaved with real images to a team of experienced readers for rating using an ROC paradigm. The average areas under the curve for 2D and DBT images were 0.53+/-.04 and 0.55+/-.07 respectively; errors are the standard errors of the mean. The values indicate that the observers had difficulty in differentiating the real images from simulated images. The statistical properties of simulated images of the phantom blocks were evaluated by means of power spectrum analysis. The power spectrum curves for real and simulated images closely match and overlap indicating good agreement.

  17. Clinical effect of percutaneous radiofrequency ablation for residual lung metastases from breast cancer after systemic chemotherapy

    International Nuclear Information System (INIS)

    Objective: To determine the clinical effect of Radiofrequency Ablation (RFA) for residual lung metastases from breast cancer after systemic chemotherapy. Study Design: An experimental study. Place and Duration of Study: The Second Affiliated Hospital of Soochow University, Suzhou, Fudan University Shanghai Cancer Center, Shanghai, China, from January 2008 to October 2014. Methodology: Thirty-five breast cancer patients with 67 pulmonary metastases were involved in this study. All lesions were treated by RFA and followed by CT-scan. Primary endpoint of this clinical study was local control; secondary endpoints were overall survival and treatment-related toxicities. Results: Complete Response (CR) was observed in 59 lesions, with Partial Response (PR) in 4 lesions, Stable Disease (SD) in 1 lesion and Progression Disease (PD) in 3 lesions. The lesion diameter > 2 cm was related to poor local control (p=0.04). The median Overall Survival (OS) was 33 months (95%CI: 21.6 - 44.4). One, 2-, and 3-year OS rates were 88.6%, 59.3% and 42.8% respectively. The mumber of pulmonary metastases (2), the diameter of lesion (> 2 cm) and coexisting with liver metastases were significantly correlated to poor OS by multivariate analysis. Log-rank test showed statistically significant difference of OS in diameter of lesion and coexisting with other metastases. Conclusion: RFA is a promising treatment option for patients with residual lung metastases from breast cancer after systemic chemotherapy in selected patients. (author)

  18. Defining the Survival Benchmark for Breast Cancer Patients with Systemic Relapse

    Science.gov (United States)

    Zeichner, Simon B; Ambros, Tadeu; Zaravinos, John; Montero, Alberto J; Mahtani, Reshma L; Ahn, Eugene R; Mani, Aruna; Markward, Nathan J; Vogel, Charles L

    2015-01-01

    BACKGROUND Our original paper, published in 1992, reported a median overall survival after first relapse in breast cancer of 26 months. The current retrospective review concentrates more specifically on patients with first systemic relapse, recognizing that subsets of patients with local recurrence are potentially curable. METHODS Records of 5,168 patients from a largely breast-cancer-specific oncology practice were reviewed to identify breast cancer patients with their first relapse between 1996 and 2006 after primary treatment. There were 189 patients diagnosed with metastatic disease within 2 months of being seen by our therapeutic team and 101 patients diagnosed with metastatic disease greater than 2 months. The patients were divided in order to account for lead-time bias than could potentially confound the analysis of the latter 101 patients. RESULTS Median survival for our primary study population of 189 patients was 33 months. As expected, the median survival from first systemic relapse (MSFSR) for the 101 patients excluded because of the potential for lead-time bias was better at 46 months. Factors influencing prognosis included estrogen receptor (ER) status, disease-free interval (DFI), and dominant site of metastasis. Compared with our original series, even with elimination of local-regional recurrences in our present series, the median survival from first relapse has improved by 7 months over the past two decades. CONCLUSION The new benchmark for MSFSR approaches 3 years. PMID:25922577

  19. Optimal systemic therapy for early breast cancer in women: a clinical practice guideline.

    Science.gov (United States)

    Eisen, A; Fletcher, G G; Gandhi, S; Mates, M; Freedman, O C; Dent, S F; Trudeau, M E

    2015-03-01

    The Breast Cancer Disease Site Group of Cancer Care Ontario identified the need for new guidelines for the adjuvant systemic therapy of early-stage breast cancer. The specific question to be addressed was "What is the optimal adjuvant systemic therapy for female patients with early-stage operable breast cancer, when patient and disease factors are considered?" A systematic review was prepared based on literature searches conducted using the medline and embase databases for the period January 2008 to March 5, 2012, and updated to May 12, 2014. Guidelines were located from that search, from the Standards and Guidelines Evidence directory of cancer guidelines, and from the Web sites of major guideline organizations. The literature located was subdivided into the broad categories of chemotherapy, hormonal therapy, and therapy targeted to her2 (human epidermal growth factor receptor 2). Although several of the systemic therapies discussed in this guideline can be considered in the neoadjuvant setting, the review focused on trials with rates of disease-free and overall survival as endpoints and thus excluded several trials that used pathologic complete response as a primary endpoint. Based on the systematic review, the working group drafted recommendations on the use of chemotherapy, hormonal therapy, and targeted therapy; based on their professional experience, they also drafted recommendations on patient and disease characteristics and recurrence risk. The literature review and draft recommendations were circulated to a consensus panel of medical oncologists who had expertise in breast cancer and who represented the regions of Ontario. Items without initial consensus were discussed at an in-person consensus meeting held in Toronto, November 23, 2012. The final recommendations are those for which consensus was reached before or at the meeting. Some of the key evidence was revised after the updated literature search. Evidence reviews for systemic chemotherapy, endocrine

  20. Evaluation of an Automated Information Extraction Tool for Imaging Data Elements to Populate a Breast Cancer Screening Registry.

    Science.gov (United States)

    Lacson, Ronilda; Harris, Kimberly; Brawarsky, Phyllis; Tosteson, Tor D; Onega, Tracy; Tosteson, Anna N A; Kaye, Abby; Gonzalez, Irina; Birdwell, Robyn; Haas, Jennifer S

    2015-10-01

    Breast cancer screening is central to early breast cancer detection. Identifying and monitoring process measures for screening is a focus of the National Cancer Institute's Population-based Research Optimizing Screening through Personalized Regimens (PROSPR) initiative, which requires participating centers to report structured data across the cancer screening continuum. We evaluate the accuracy of automated information extraction of imaging findings from radiology reports, which are available as unstructured text. We present prevalence estimates of imaging findings for breast imaging received by women who obtained care in a primary care network participating in PROSPR (n = 139,953 radiology reports) and compared automatically extracted data elements to a "gold standard" based on manual review for a validation sample of 941 randomly selected radiology reports, including mammograms, digital breast tomosynthesis, ultrasound, and magnetic resonance imaging (MRI). The prevalence of imaging findings vary by data element and modality (e.g., suspicious calcification noted in 2.6% of screening mammograms, 12.1% of diagnostic mammograms, and 9.4% of tomosynthesis exams). In the validation sample, the accuracy of identifying imaging findings, including suspicious calcifications, masses, and architectural distortion (on mammogram and tomosynthesis); masses, cysts, non-mass enhancement, and enhancing foci (on MRI); and masses and cysts (on ultrasound), range from 0.8 to1.0 for recall, precision, and F-measure. Information extraction tools can be used for accurate documentation of imaging findings as structured data elements from text reports for a variety of breast imaging modalities. These data can be used to populate screening registries to help elucidate more effective breast cancer screening processes. PMID:25561069

  1. Systemic Sclerosis and Silicone Breast Implant: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Antonios Psarras

    2014-01-01

    Full Text Available Environmentally induced systemic sclerosis is a well-recognized condition, which is correlated with exposure to various chemical compounds or drugs. However, development of scleroderma-like disease after exposure to silicone has always been a controversial issue and, over time, it has triggered spirited debate whether there is a certain association or not. Herein, we report the case of a 35-year-old female who developed Raynaud’s phenomenon and, finally, systemic sclerosis shortly after silicone breast implantation surgery.

  2. Predicting the continuous values of breast cancer relapse time by type-2 fuzzy logic system.

    Science.gov (United States)

    Mahmoodian, Hamid

    2012-06-01

    Microarray analysis and gene expression profile have been widely used in tumor classification, survival analysis and ER statues of breast cancer. Sample discrimination as well as identification of significant genes have been the focus of most previous studies. The aim of this research is to propose a fuzzy model to predict the relapse time of breast cancer by using breast cancer dataset published by van't Veer. Fuzzy rule mining based on support vector machine has been used in a hybrid method with rule pruning and shown its ability to divide the samples in many subgroups. To handle the existence of uncertainties in linguistic variables and fuzzy sets, the TSK model of Interval type-2 fuzzy logic system has been used and a new simple method is also developed to consider the uncertainties of the rules which have been optimized by genetic algorithm. B632 validation method is applied to estimate the error of the model. The results with 95 % confidence interval show a reasonable accuracy in prediction.

  3. A systems analysis of the chemosensitivity of breast cancer cells to the polyamine analogue PG-11047

    Energy Technology Data Exchange (ETDEWEB)

    Kuo, Wen-Lin; Das, Debopriya; Ziyad, Safiyyah; Bhattacharya, Sanchita; Gibb, William J.; Heiser, Laura M.; Sadanandam, Anguraj; Fontenay, Gerald V.; Hu, Zhi; Wang, Nicholas J.; Bayani, Nora; Feiler, Heidi S.; Neve, Richard M.; Wyrobek, Andrew J.; Spellman, Paul T.; Marton, Laurence J.; Gray, Joe W.

    2009-11-14

    Polyamines regulate important cellular functions and polyamine dysregulation frequently occurs in cancer. The objective of this study was to use a systems approach to study the relative effects of PG-11047, a polyamine analogue, across breast cancer cells derived from different patients and to identify genetic markers associated with differential cytotoxicity. A panel of 48 breast cell lines that mirror many transcriptional and genomic features present in primary human breast tumours were used to study the antiproliferative activity of PG-11047. Sensitive cell lines were further examined for cell cycle distribution and apoptotic response. Cell line responses, quantified by the GI50 (dose required for 50% relative growth inhibition) were correlated with the omic profiles of the cell lines to identify markers that predict response and cellular functions associated with drug sensitivity. The concentrations of PG-11047 needed to inhibit growth of members of the panel of breast cell lines varied over a wide range, with basal-like cell lines being inhibited at lower concentrations than the luminal cell lines. Sensitive cell lines showed a significant decrease in S phase fraction at doses that produced little apoptosis. Correlation of the GI50 values with the omic profiles of the cell lines identified genomic, transcriptional and proteomic variables associated with response. A 13-gene transcriptional marker set was developed as a predictor of response to PG-11047 that warrants clinical evaluation. Analyses of the pathways, networks and genes associated with response to PG-11047 suggest that response may be influenced by interferon signaling and differential inhibition of aspects of motility and epithelial to mesenchymal transition.

  4. Breast cancer brain metastases responding to lapatinib plus capecitabine as second-line primary systemic therapy.

    Science.gov (United States)

    Bergen, Elisabeth S; Berghoff, Anna S; Rudas, Margaretha; Preusser, Matthias; Bartsch, Rupert

    2015-06-01

    Brain metastases (BM) are diagnosed in up to 40% of HER2-positive breast cancer patients. Standard treatment includes local approaches such as whole-brain radiotherapy (WBRT), radiosurgery, and neurosurgery. The landscape trial established primary systemic therapy as an effective and safe alternative to WBRT in selected patients with Her2-positive BM. We aim to further focus on the role of systemic therapy in oligosymptomatic patients by presenting this case report. We report on a 50-year-old patient diagnosed with multiple BM 5 years after early breast cancer diagnosis. As the patient was asymptomatic and had a favorable diagnosis-specific GPA score, she received primary systemic treatment with T-DM1. She achieved partial remission within the brain for eight treatment cycles and then progressed despite stable extracranial disease. As the patient remained asymptomatic and refused WBRT, we decided upon trastuzumab, lapatinib plus capecitabine as second-line therapy. Another partial remission of BM was observed; to date, she has received 11 treatment cycles without any sign of disease progression. In this case, WBRT was delayed by at least 14 months, again indicating the activity of systemic treatment in BM. Apparently, in selected patients, BM can be controlled with multiple lines of systemic therapy similar to extracranial disease. Further investigation of systemic treatment approaches is therefore warranted.

  5. Initial evaluation of a full breast digital system

    International Nuclear Information System (INIS)

    Full-field digital mammography systems have been developed for overcoming the limitations of the screen-film mammography. This work is focused on the system from GE Medical Systems (Senographe 2000) which has been recently installed in our institution. The imager consists of a thin Ics:Tl scintillator which is in narrow contact with an array of amorphous silicon detectors mounted in a single panel. The flat-panel detector is integrated in a x-ray system with a high-frequency generator Senographe DM and dual track anode of Mo and Rh with Mo and Rh filtration. The aim of this work is to analyse the defaults exposure factors set at the installation of the x-ray unit. The image quality has been evaluated by using one of the two phantoms recommended in the ACR Accreditation Program. Phantom images were obtained at each of the three available imaging modes: contrast (CNT), standard (STD) and DOSE. While maintaining the defaults of kilovoltage and anode/filter combination, phantom images were obtained at lower dose vales. The contrast noise ratio (CNR) was calculated for each of the low contrast objects (masses) of the phantom images and the detail visibility was also evaluated. The results obtained for both parameters reveal that similar image quality can be obtained with significant reductions of the average glandular dose. (author)

  6. Effect of adjuvant systemic treatment on cosmetic outcome and late normal-tissue reactions after breast conservation

    DEFF Research Database (Denmark)

    Johansen, Jørgen; Overgaard, Jens; Overgaard, Marie

    2007-01-01

    To investigate whether adjuvant treatment with CMF or tamoxifen predisposes to an unfavorable cosmetic outcome or increased breast morbidity after radiotherapy in breast conservation. Data from 266 patients who entered a randomized breast conservation trial (DBCG-82TM protocol) was analyzed......-risk patients: premenopausal patients (n = 67) received eight cycles of CMF intravenously (600/40/600 mg per m(2)) every fourth week; postmenopausal patients (n = 27) received 30 mg of tamoxifen daily for one year. Clinical assessments included cosmetic outcome, breast fibrosis, skin telangiectasia....... In premenopausal patients, systemic treatment with CMF independently predicted a fair/poor cosmetic outcome, RR = 2.2 (95% CI 1.2-4.2), as well as increased skin telangiectasia, RR = 3.3 (1.4-8.2). There was no impact of tamoxifen treatment on cosmetic outcome in postmenopausal patients (p = 0.32). However...

  7. Collimator design for a dedicated molecular breast imaging-guided biopsy system: Proof-of-concept

    Energy Technology Data Exchange (ETDEWEB)

    Weinmann, Amanda L.; Hruska, Carrie B.; Conners, Amy L.; O' Connor, Michael K. [Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, Minnesota 55905 (United States)

    2013-01-15

    Purpose: Molecular breast imaging (MBI) is a dedicated nuclear medicine breast imaging modality that employs dual-head cadmium zinc telluride (CZT) gamma cameras to functionally detect breast cancer. MBI has been shown to detect breast cancers otherwise occult on mammography and ultrasound. Currently, a MBI-guided biopsy system does not exist to biopsy such lesions. Our objective was to consider the utility of a novel conical slant-hole (CSH) collimator for rapid (<1 min) and accurate monitoring of lesion position to serve as part of a MBI-guided biopsy system. Methods: An initial CSH collimator design was derived from the dimensions of a parallel-hole collimator optimized for MBI performed with dual-head CZT gamma cameras. The parameters of the CSH collimator included the collimator height, cone slant angle, thickness of septa and cones of the collimator, and the annular areas exposed at the base of the cones. These parameters were varied within the geometric constraints of the MBI system to create several potential CSH collimator designs. The CSH collimator designs were evaluated using Monte Carlo simulations. The model included a breast compressed to a thickness of 6 cm with a 1-cm diameter lesion located 3 cm from the collimator face. The number of particles simulated was chosen to represent the count density of a low-dose, screening MBI study acquired with the parallel-hole collimator for 10 min after a {approx}150 MBq (4 mCi) injection of Tc-99m sestamibi. The same number of particles was used for the CSH collimator simulations. In the resulting simulated images, the count sensitivity, spatial resolution, and accuracy of the lesion depth determined from the lesion profile width were evaluated. Results: The CSH collimator design with default parameters derived from the optimal parallel-hole collimator provided 1-min images with error in the lesion depth estimation of 1.1 {+-} 0.7 mm and over 21 times the lesion count sensitivity relative to 1-min images

  8. Validating a Prognostic Scoring System for Postmastectomy Locoregional Recurrence in Breast Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Cheng, Skye Hung-Chun, E-mail: skye@kfsyscc.org [Department of Radiation Oncology, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan (China); Clinical Research Office, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan (China); Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Tsai, Stella Y. [Department of Radiation Oncology, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan (China); Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Yu, Ben-Long [Department of Surgery, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan (China); Horng, Cheng-Fang [Clinical Research Office, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan (China); Chen, Chii-Ming [Department of Surgery, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan (China); Jian, James J. [Department of Radiation Oncology, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan (China); Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Chu, Nan-Min [Department of Medical Oncology, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan (China); Tsou, Mei-Hua [Department of Pathology, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan (China); Liu, Mei-Ching [Department of Medical Oncology, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan (China); Huang, Andrew T. [Department of Medical Oncology, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan (China); Department of Medicine, Duke University Medical Center, Durham, North Carolina (United States); Prosnitz, Leonard R. [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States)

    2013-03-15

    Purpose: This study is designed to validate a previously developed locoregional recurrence risk (LRR) scoring system and further define which groups of patients with breast cancer would benefit from postmastectomy radiation therapy (PMRT). Methods and Materials: An LRR risk scoring system was developed previously at our institution using breast cancer patients initially treated with modified radical mastectomy between 1990 and 2001. The LRR score comprised 4 factors: patient age, lymphovascular invasion, estrogen receptor negativity, and number of involved lymph nodes. We sought to validate the original study by examining a new dataset of 1545 patients treated between 2002 and 2007. Results: The 1545 patients were scored according to the previously developed criteria: 920 (59.6%) were low risk (score 0-1), 493 (31.9%) intermediate risk (score 2-3), and 132 (8.5%) were high risk (score ≥4). The 5-year locoregional control rates with and without PMRT in low-risk, intermediate-risk, and high-risk groups were 98% versus 97% (P=.41), 97% versus 91% (P=.0005), and 89% versus 50% (P=.0002) respectively. Conclusions: This analysis of an additional 1545 patients treated between 2002 and 2007 validates our previously reported LRR scoring system and suggests appropriate patients for whom PMRT will be beneficial. Independent validation of this scoring system by other institutions is recommended.

  9. How to improve your breast cancer program: Standardized reporting using the new American College of Radiology Breast Imaging-Reporting and Data System

    International Nuclear Information System (INIS)

    In the USA, the use of the American College of Radiology Breast Imaging-Reporting and Data System (ACR BI-RADS) has served not only as a quality assurance tool and guide to standardizing breast imaging reports but has also improved communication between referring physicians, researchers, and patients. In fact, in the USA, the Mammography Quality Standards Act of 1997 requires that all mammograms be assigned a BI-RADS category based on the finding of most concern. In this manuscript, we aim to review the recommendations provided in the 4th edition of the ACR BI-RADS for mammography, USG, and MRI. We also review the major controversies surrounding the use of ACR BI-RADS

  10. Taking the lymphatic system into consideration in nursing : How lymphedema impacts the breast cancer patients’ quality of life

    OpenAIRE

    Haapiainen, Tiina

    2015-01-01

    The lymphatic system has several vital functions to maintain a healthy immune system. Breast cancer-related lymphedema is a non-curable condition that refers to post-surgical chronic and painful swelling of the upper limb. The aim of this study was to review existing literature to see what information is available for nurses about the importance of the lymphatic system. The study focused on breast cancer related lymphedema patients and two research questions were asked 1) What are some of the...

  11. CHESS (Comprehensive Health Enhancement Support System): an interactive computer system for women with breast cancer piloted with an underserved population.

    Science.gov (United States)

    McTavish, F M; Gustafson, D H; Owens, B H; Hawkins, R P; Pingree, S; Wise, M; Taylor, J O; Apantaku, F M

    1995-07-01

    The Comprehensive Health Enhancement Support System (CHESS) is an interactive computer system containing information, social support, and problem-solving tools. It was developed with intensive input from potential users through needs-assessment surveys and field testing. CHESS had previously been used by women in the middle and upper socioeconomic classes with high school and college education. This article reports on the results of a pilot study involving eight African-American women with breast cancer from impoverished neighborhoods in Chicago. CHESS was very well received; was extensively used; and produced feelings of acceptance, motivation, understanding, and relief. PMID:10143478

  12. Real-time 3-dimensional virtual reality navigation system with open MRI for breast-conserving surgery

    International Nuclear Information System (INIS)

    We report here the early experiences using a real-time three-dimensional (3D) virtual reality navigation system with open magnetic resonance imaging (MRI) for breast-conserving surgery (BCS). Two patients with a non-palpable MRI-detected breast tumor underwent BCS under the guidance of the navigation system. An initial MRI for the breast tumor using skin-affixed markers was performed immediately prior to excision. A percutaneous intramammary dye marker was applied to delineate an excision line, and the computer software '3D Slicer' generated a real-time 3D virtual reality model of the tumor and the puncture needle in the breast. Under guidance by the navigation system, marking procedures were performed without any difficulties. Fiducial registration errors were 3.00 mm for patient no.1, and 4.07 mm for patient no.2. The real-time 3D virtual reality navigation system with open MRI is feasible for safe and accurate excision of non-palpable MRI-detected breast tumors. (author)

  13. Weighted simultaneous algebraic reconstruction technique for tomosynthesis imaging of objects with high-attenuation features

    Energy Technology Data Exchange (ETDEWEB)

    Levakhina, Y. M. [Institute of Medical Engineering, University of Luebeck, Luebeck 23562, Germany and Graduate School for Computing in Medicine and Life Sciences, Luebeck 23562 (Germany); Mueller, J.; Buzug, T. M. [Institute of Medical Engineering, University of Luebeck, Luebeck 23562 (Germany); Duschka, R. L.; Vogt, F.; Barkhausen, J. [Clinic for Radiology, University Clinics Schleswig-Holstein, Luebeck 23562 (Germany)

    2013-03-15

    Purpose: This paper introduces a nonlinear weighting scheme into the backprojection operation within the simultaneous algebraic reconstruction technique (SART). It is designed for tomosynthesis imaging of objects with high-attenuation features in order to reduce limited angle artifacts. Methods: The algorithm estimates which projections potentially produce artifacts in a voxel. The contribution of those projections into the updating term is reduced. In order to identify those projections automatically, a four-dimensional backprojected space representation is used. Weighting coefficients are calculated based on a dissimilarity measure, evaluated in this space. For each combination of an angular view direction and a voxel position an individual weighting coefficient for the updating term is calculated. Results: The feasibility of the proposed approach is shown based on reconstructions of the following real three-dimensional tomosynthesis datasets: a mammography quality phantom, an apple with metal needles, a dried finger bone in water, and a human hand. Datasets have been acquired with a Siemens Mammomat Inspiration tomosynthesis device and reconstructed using SART with and without suggested weighting. Out-of-focus artifacts are described using line profiles and measured using standard deviation (STD) in the plane and below the plane which contains artifact-causing features. Artifacts distribution in axial direction is measured using an artifact spread function (ASF). The volumes reconstructed with the weighting scheme demonstrate the reduction of out-of-focus artifacts, lower STD (meaning reduction of artifacts), and narrower ASF compared to nonweighted SART reconstruction. It is achieved successfully for different kinds of structures: point-like structures such as phantom features, long structures such as metal needles, and fine structures such as trabecular bone structures. Conclusions: Results indicate the feasibility of the proposed algorithm to reduce typical

  14. Weighted simultaneous algebraic reconstruction technique for tomosynthesis imaging of objects with high-attenuation features

    International Nuclear Information System (INIS)

    Purpose: This paper introduces a nonlinear weighting scheme into the backprojection operation within the simultaneous algebraic reconstruction technique (SART). It is designed for tomosynthesis imaging of objects with high-attenuation features in order to reduce limited angle artifacts. Methods: The algorithm estimates which projections potentially produce artifacts in a voxel. The contribution of those projections into the updating term is reduced. In order to identify those projections automatically, a four-dimensional backprojected space representation is used. Weighting coefficients are calculated based on a dissimilarity measure, evaluated in this space. For each combination of an angular view direction and a voxel position an individual weighting coefficient for the updating term is calculated. Results: The feasibility of the proposed approach is shown based on reconstructions of the following real three-dimensional tomosynthesis datasets: a mammography quality phantom, an apple with metal needles, a dried finger bone in water, and a human hand. Datasets have been acquired with a Siemens Mammomat Inspiration tomosynthesis device and reconstructed using SART with and without suggested weighting. Out-of-focus artifacts are described using line profiles and measured using standard deviation (STD) in the plane and below the plane which contains artifact-causing features. Artifacts distribution in axial direction is measured using an artifact spread function (ASF). The volumes reconstructed with the weighting scheme demonstrate the reduction of out-of-focus artifacts, lower STD (meaning reduction of artifacts), and narrower ASF compared to nonweighted SART reconstruction. It is achieved successfully for different kinds of structures: point-like structures such as phantom features, long structures such as metal needles, and fine structures such as trabecular bone structures. Conclusions: Results indicate the feasibility of the proposed algorithm to reduce typical

  15. The Breast Imaging Reporting and Data System (BI-RADS) in the Dutch breast cancer screening programme: its role as an assessment and stratification tool

    International Nuclear Information System (INIS)

    To assess the suitability of the Breast Imaging Reporting and Data System (BI-RADS) as a quality assessment tool in the Dutch breast cancer screening programme. The data of 93,793 screened women in the Amsterdam screening region (November 2005-July 2006) were reviewed. BI-RADS categories, work-up, age, final diagnosis and final TNM classification were available from the screening registry. Interval cancers were obtained through linkage with the cancer registry. BI-RADS was introduced as a pilot in the Amsterdam region before the nationwide introduction of digital mammography (2009-2010). A total of 1,559 women were referred to hospital (referral rate 1.7 %). Breast cancer was diagnosed in 485 women (detection rate 0.52 %); 253 interval cancers were reported, yielding a programme sensitivity of 66 % and specificity of 99 %. BI-RADS 0 had a lower positive predictive value (PPV, 14.1 %) than BI-RADS 4 (39.1 %) and BI-RADS 5 (92.9 %; P < 0.0001). The number of invasive procedures and tumour size also differed significantly between BI-RADS categories (P < 0.0001). The significant differences in PPV, invasive procedures and tumour size match with stratification into BI-RADS categories. It revealed inter-observer variability between screening radiologists and can thus be used as a quality assessment tool in screening and as a stratification tool in diagnostic work-up. (orig.)

  16. Comparative performance of modern digital mammography systems in a large breast screening program

    Energy Technology Data Exchange (ETDEWEB)

    Yaffe, Martin J., E-mail: martin.yaffe@sri.utoronto.ca; Bloomquist, Aili K.; Hunter, David M.; Mawdsley, Gordon E. [Physical Sciences Division, Sunnybrook Research Institute, Departments of Medical Biophysics and Medical Imaging, University of Toronto, Ontario M4N 3M5 (Canada); Chiarelli, Anna M. [Prevention and Cancer Control, Cancer Care Ontario, Dalla Lana School of Public Health, University of Toronto, Ontario M4N 3M5, Canada and Ontario Breast Screening Program, Cancer Care Ontario, Toronto, Ontario M5G 1X3 (Canada); Muradali, Derek [Ontario Breast Screening Program, Cancer Care Ontario, Toronto, Ontario M5G 1X3 (Canada); Mainprize, James G. [Physical Sciences Division, Sunnybrook Research Institute, Toronto, Ontario M4N 3M5 (Canada)

    2013-12-15

    Purpose: To compare physical measures pertaining to image quality among digital mammography systems utilized in a large breast screening program. To examine qualitatively differences in these measures and differences in clinical cancer detection rates between CR and DR among sites within that program. Methods: As part of the routine quality assurance program for screening, field measurements are made of several variables considered to correlate with the diagnostic quality of medical images including: modulation transfer function, noise equivalent quanta, d′ (an index of lesion detectability) and air kerma to allow estimation of mean glandular dose. In addition, images of the mammography accreditation phantom are evaluated. Results: It was found that overall there were marked differences between the performance measures of DR and CR mammography systems. In particular, the modulation transfer functions obtained with the DR systems were found to be higher, even for larger detector element sizes. Similarly, the noise equivalent quanta, d′, and the phantom scores were higher, while the failure rates associated with low signal-to-noise ratio and high dose were lower with DR. These results were consistent with previous findings in the authors’ program that the breast cancer detection rates at sites employing CR technology were, on average, 30.6% lower than those that used DR mammography. Conclusions: While the clinical study was not large enough to allow a statistically powered system-by-system assessment of cancer detection accuracy, the physical measures expressing spatial resolution, and signal-to-noise ratio are consistent with the published finding that sites employing CR systems had lower cancer detection rates than those using DR systems for screening mammography.

  17. Comparative performance of modern digital mammography systems in a large breast screening program

    International Nuclear Information System (INIS)

    Purpose: To compare physical measures pertaining to image quality among digital mammography systems utilized in a large breast screening program. To examine qualitatively differences in these measures and differences in clinical cancer detection rates between CR and DR among sites within that program. Methods: As part of the routine quality assurance program for screening, field measurements are made of several variables considered to correlate with the diagnostic quality of medical images including: modulation transfer function, noise equivalent quanta, d′ (an index of lesion detectability) and air kerma to allow estimation of mean glandular dose. In addition, images of the mammography accreditation phantom are evaluated. Results: It was found that overall there were marked differences between the performance measures of DR and CR mammography systems. In particular, the modulation transfer functions obtained with the DR systems were found to be higher, even for larger detector element sizes. Similarly, the noise equivalent quanta, d′, and the phantom scores were higher, while the failure rates associated with low signal-to-noise ratio and high dose were lower with DR. These results were consistent with previous findings in the authors’ program that the breast cancer detection rates at sites employing CR technology were, on average, 30.6% lower than those that used DR mammography. Conclusions: While the clinical study was not large enough to allow a statistically powered system-by-system assessment of cancer detection accuracy, the physical measures expressing spatial resolution, and signal-to-noise ratio are consistent with the published finding that sites employing CR systems had lower cancer detection rates than those using DR systems for screening mammography

  18. Breast pain

    Science.gov (United States)

    Pain - breast; Mastalgia; Mastodynia; Breast tenderness ... There are many possible causes for breast pain. For example, hormone level changes from menstruation or pregnancy often cause breast tenderness. Some swelling and tenderness just before your period ...

  19. Inhibiting metastasis of breast cancer cells in vitro using gold nanorod-siRNA delivery system

    Science.gov (United States)

    Zhang, Weiqi; Meng, Jie; Ji, Yinglu; Li, Xiaojin; Kong, Hua; Wu, Xiaochun; Xu, Haiyan

    2011-09-01

    Breast cancer is the most common malignant disease in women, and it is not the primary tumor but its metastasis kills most patients with breast cancer. Anti-metastasis therapy based on RNA interference (RNAi) is emerging as one of promising strategies in tumor therapy. However, construction of an efficient delivery system for siRNA is still one of the major challenges. In this work, siRNA against protease-activated receptor-1 (PAR-1) which is a pivotal gene involved in tumor metastasis was conjugated to gold nanorods (AuNRs) via electrostatic interaction and delivered to highly metastatic human breast cancer cells. It was demonstrated that the siRNA oligos were successfully delivered into the cancer cells and mainly located in vesicle-like structures including lysosome. After transfected with the complex of AuNRs and PAR-1 siRNA (AuNRs@PAR-1 siRNA), expression of PAR-1 at both mRNA and protein levels were efficiently down regulated, as evidenced by quantitative real time PCR and flow cytometry analysis, respectively. Transwell migration assay confirmed the decrease in metastatic ability of the cancer cells. The silencing efficiency of the complex was in-between that of TurboFect and Lipofectamine, however, the cytotoxicity of the AuNRs was lower than that of the latter two. Taken together, AuNRs with PAR-1 siRNA are suited for RNAi based anti-metastasis therapy.Breast cancer is the most common malignant disease in women, and it is not the primary tumor but its metastasis kills most patients with breast cancer. Anti-metastasis therapy based on RNA interference (RNAi) is emerging as one of promising strategies in tumor therapy. However, construction of an efficient delivery system for siRNA is still one of the major challenges. In this work, siRNA against protease-activated receptor-1 (PAR-1) which is a pivotal gene involved in tumor metastasis was conjugated to gold nanorods (AuNRs) via electrostatic interaction and delivered to highly metastatic human breast cancer

  20. Timing of Chemotherapy After MammoSite Radiation Therapy System Breast Brachytherapy: Analysis of the American Society of Breast Surgeons MammoSite Breast Brachytherapy Registry Trial

    International Nuclear Information System (INIS)

    Purpose: To evaluate cosmetic outcome and radiation recall in the American Society of Breast Surgeons registry trial, as a function of the interval between accelerated partial breast irradiation (APBI) and initiation of chemotherapy (CTX). Methods and Materials: A total of 1440 patients at 97 institutions participated in this trial. After lumpectomy for early-stage breast cancer, patients received APBI (34 Gy in 10 fractions) with MammoSite RTS brachytherapy. A total of 148 patients received CTX within 90 days of APBI. Cosmetic outcome was evaluated at each follow-up visit and dichotomized as excellent/good or fair/poor. Results: Chemotherapy was initiated at a mean of 3.9 weeks after the final MammoSite procedure and was administered ≤3 weeks after APBI in 54 patients (36%) and >3 weeks after APBI in 94 patients (64%). The early and delayed groups were well balanced with respect to multiple factors that may impact on cosmetic outcome. There was a superior cosmetic outcome in those receiving chemotherapy >3 weeks after APBI (excellent/good in 72.2% at ≤3 weeks vs. excellent/good in 93.8% at >3 weeks; p = 0.01). Radiation recall in those receiving CTX at ≤3 weeks was 9 of 50 (18%), compared with 6 of 81(7.4%) in those receiving chemotherapy at >3 weeks (p = 0.09). Conclusion: The majority of patients receiving CTX after APBI have excellent/good cosmetic outcomes, with a low rate of radiation recall. Chemotherapy initiated >3 weeks after the final MammoSite procedure seems to be associated with a better cosmetic outcome and lower rate of radiation recall. An excellent/good cosmetic outcome in patients receiving CTX after 3 weeks was similar to the cosmetic outcome of the overall patient population who did not receive CTX

  1. Brain metastases as site of first and isolated recurrence of breast cancer: the role of systemic therapy after local treatment.

    Science.gov (United States)

    Niwińska, Anna

    2016-10-01

    The role of systemic treatment was assessed after local therapy for breast cancer patients who developed central nervous system (CNS) metastases as a first and isolated recurrence. Subjects were 128 breast cancer patients with brain metastases as the first and isolated site of recurrence that were selected from 673 consecutive breast cancer patients with brain metastases treated at the same institution. Median survival from brain metastases in patients with and without systemic treatment after local therapy was respectively 15 and 4 months (p systemic treatment after local therapy, was respectively 22 and 7 months (p = 0.003). Cox multivariate analysis demonstrated that good performance status, solitary brain metastasis and systemic therapy undertaken after local treatment were factors which prolonged survival. However patient survival was adversely affected by those having leptomeningeal metastasis associated with brain parenchymal lesions. Systemic therapy, undertaken after local treatment improved survival in those patients with breast cancer and brain metastases as the site of first and isolated recurrence. Further study is required in order to fully establish the role of systemic treatment for this patient group.

  2. Ultrasound characterization of breast masses

    International Nuclear Information System (INIS)

    A lump in the breast is a cause of great concern. High frequency, high-resolution USG helps in its evaluation. This is exemplified in women with dense breast tissue where USG is useful in detecting small breast cancers that are not seen on mammography. Several studies in the past have addressed the issue of differentiating benign from malignant lesions in the breast. The American College of Radiology has also brought out a BIRADS-US classification system for categorizing focal breast lesions

  3. Follow-up of endovascular aortic aneurysm repair: Preliminary validation of digital tomosynthesis and contrast enhanced ultrasound in detection of medium- to long-term complications

    OpenAIRE

    Mazzei, Maria Antonietta; Guerrini, Susanna; Mazzei, Francesco Giuseppe; Cioffi Squitieri, Nevada; Notaro, Dario; de Donato, Gianmarco; Galzerano, Giuseppe; Sacco, Palmino; Setacci, Francesco; Volterrani, Luca; Setacci, Carlo

    2016-01-01

    AIM: To validate the feasibility of digital tomosynthesis of the abdomen (DTA) combined with contrast enhanced ultrasound (CEUS) in assessing complications after endovascular aortic aneurysm repair (EVAR) by using computed tomography angiography (CTA) as the gold standard.

  4. Imaging-Assisted Large-Format Breast Pathology: Program Rationale and Development in a Nonprofit Health System in the United States

    Directory of Open Access Journals (Sweden)

    F. Lee Tucker

    2012-01-01

    Full Text Available Modern breast imaging, including magnetic resonance imaging, provides an increasingly clear depiction of breast cancer extent, often with suboptimal pathologic confirmation. Pathologic findings guide management decisions, and small increments in reported tumor characteristics may rationalize significant changes in therapy and staging. Pathologic techniques to grossly examine resected breast tissue have changed little during this era of improved breast imaging and still rely primarily on the techniques of gross inspection and specimen palpation. Only limited imaging information is typically conveyed to pathologists, typically in the form of wire-localization images from breast-conserving procedures. Conventional techniques of specimen dissection and section submission destroy the three-dimensional integrity of the breast anatomy and tumor distribution. These traditional methods of breast specimen examination impose unnecessary limitations on correlation with imaging studies, measurement of cancer extent, multifocality, and margin distance. Improvements in pathologic diagnosis, reporting, and correlation of breast cancer characteristics can be achieved by integrating breast imagers into the specimen examination process and the use of large-format sections which preserve local anatomy. This paper describes the successful creation of a large-format pathology program to routinely serve all patients in a busy interdisciplinary breast center associated with a community-based nonprofit health system in the United States.

  5. Design and analysis of a conformal patch antenna for a wearable breast hyperthermia treatment system

    Science.gov (United States)

    Curto, Sergio; Ramasamy, Manoshika; Suh, Minyoung; Prakash, Punit

    2015-03-01

    To overcome the limitations of currently available clinical hyperthermia systems which are based on rigid waveguide antennas, a wearable microwave hyperthermia system is presented. A light wearable system can improve patient comfort and be located in close proximity to the breast, thereby enhancing energy deposition and reducing power requirements. The objective of this work was to design and assess the feasibility of a conformal patch antenna element of an array system to be integrated into a wearable hyperthermia bra. The feasibility of implementing antennas with silver printed ink technology on flexible substrates was evaluated. A coupled electromagnetic-bioheat transfer solver and a hemispheric heterogeneous numerical breast phantom were used to design and optimize a 915 MHz patch antenna. The optimization goals were device miniaturization, operating bandwidth, enhanced energy deposition pattern in targets, and reduced Efield back radiation. The antenna performance was evaluated for devices incorporating a hemispheric conformal groundplane and a rectangular groundplane configuration. Simulated results indicated a stable -10 dB return loss bandwidth of 88 MHz for both the conformal and rectangular groundplane configurations. Considering applied power levels restricted to 15 W, treatment volumes (T>410C) and depth from the skin surface were 11.32 cm3 and 27.94 mm, respectively, for the conformal groundplane configuration, and 2.79 cm3 and 19.72 mm, respectively, for the rectangular groundplane configuration. E-field back-radiation reduced by 85.06% for the conformal groundplane compared to the rectangular groundplane configuration. A prototype antenna with rectangular groundplane was fabricatd and experimentally evaluated. The groundplane was created by printing silver ink (Metalon JS-B25P) on polyethylene terephthalate (PET) film surface. Experiments revealed stable antenna performance for power levels up to 15.3 W. In conclusion, the proposed patch antenna with

  6. The systematic and random errors determination using realtime 3D surface tracking system in breast cancer

    Science.gov (United States)

    Kanphet, J.; Suriyapee, S.; Dumrongkijudom, N.; Sanghangthum, T.; Kumkhwao, J.; Wisetrintong, M.

    2016-03-01

    The purpose of this study to determine the patient setup uncertainties in deep inspiration breath-hold (DIBH) radiation therapy for left breast cancer patients using real-time 3D surface tracking system. The six breast cancer patients treated by 6 MV photon beams from TrueBeam linear accelerator were selected. The patient setup errors and motion during treatment were observed and calculated for interfraction and intrafraction motions. The systematic and random errors were calculated in vertical, longitudinal and lateral directions. From 180 images tracking before and during treatment, the maximum systematic error of interfraction and intrafraction motions were 0.56 mm and 0.23 mm, the maximum random error of interfraction and intrafraction motions were 1.18 mm and 0.53 mm, respectively. The interfraction was more pronounce than the intrafraction, while the systematic error was less impact than random error. In conclusion the intrafraction motion error from patient setup uncertainty is about half of interfraction motion error, which is less impact due to the stability in organ movement from DIBH. The systematic reproducibility is also half of random error because of the high efficiency of modern linac machine that can reduce the systematic uncertainty effectively, while the random errors is uncontrollable.

  7. Imaging results of multi-modal ultrasound computerized tomography system designed for breast diagnosis.

    Science.gov (United States)

    Opieliński, Krzysztof J; Pruchnicki, Piotr; Gudra, Tadeusz; Podgórski, Przemysław; Kurcz, Jacek; Kraśnicki, Tomasz; Sąsiadek, Marek; Majewski, Jarosław

    2015-12-01

    Nowadays, in the era of common computerization, transmission and reflection methods are intensively developed in addition to improving classical ultrasound methods (US) for imaging of tissue structure, in particular ultrasound transmission tomography UTT (analogous to computed tomography CT which uses X-rays) and reflection tomography URT (based on the synthetic aperture method used in radar imaging techniques). This paper presents and analyses the results of ultrasound transmission tomography imaging of the internal structure of the female breast biopsy phantom CIRS Model 052A and the results of the ultrasound reflection tomography imaging of a wire sample. Imaging was performed using a multi-modal ultrasound computerized tomography system developed with the participation of a private investor. The results were compared with the results of imaging obtained using dual energy CT, MR mammography and conventional US method. The obtained results indicate that the developed UTT and URT methods, after the acceleration of the scanning process, thus enabling in vivo examination, may be successfully used for detection and detailed characterization of breast lesions in women. PMID:25759234

  8. Chloroquine Engages the Immune System to Eradicate Irradiated Breast Tumors in Mice

    International Nuclear Information System (INIS)

    Purpose: This study used chloroquine to direct radiation-induced tumor cell death pathways to harness the antitumor activity of the immune system. Methods and Materials: Chloroquine given immediately after tumor irradiation increased the cure rate of MCaK breast cancer in C3H mice. Chloroquine blocked radiation-induced autophagy and drove MCaK cells into a more rapid apoptotic and more immunogenic form of cell death. Results: Chloroquine treatment made irradiated tumor vaccines superior at inducing strong interferon gamma-associated immune responses in vivo and protecting mice from further tumor challenge. In vitro, chloroquine slowed antigen uptake and degradation by dendritic cells, although T-cell stimulation was unaffected. Conclusions: This study illustrates a novel approach to improve the efficacy of breast cancer radiation therapy by blocking endosomal pathways, which enhances radiation-induced cell death within the field and drives antitumor immunity to assist therapeutic cure. The study illuminates and merges seemingly disparate concepts regarding the importance of autophagy in cancer therapy

  9. Chloroquine Engages the Immune System to Eradicate Irradiated Breast Tumors in Mice

    Energy Technology Data Exchange (ETDEWEB)

    Ratikan, Josephine Anna [Department of Radiation Oncology, David Geffen School of Medicine at UCLA, Los Angeles, California (United States); Sayre, James William [Public Health Biostatistics/Radiology at UCLA, David Geffen School of Medicine at UCLA, Los Angeles, California (United States); Schaue, Dörthe, E-mail: dschaue@mednet.ucla.edu [Department of Radiation Oncology, David Geffen School of Medicine at UCLA, Los Angeles, California (United States)

    2013-11-15

    Purpose: This study used chloroquine to direct radiation-induced tumor cell death pathways to harness the antitumor activity of the immune system. Methods and Materials: Chloroquine given immediately after tumor irradiation increased the cure rate of MCaK breast cancer in C3H mice. Chloroquine blocked radiation-induced autophagy and drove MCaK cells into a more rapid apoptotic and more immunogenic form of cell death. Results: Chloroquine treatment made irradiated tumor vaccines superior at inducing strong interferon gamma-associated immune responses in vivo and protecting mice from further tumor challenge. In vitro, chloroquine slowed antigen uptake and degradation by dendritic cells, although T-cell stimulation was unaffected. Conclusions: This study illustrates a novel approach to improve the efficacy of breast cancer radiation therapy by blocking endosomal pathways, which enhances radiation-induced cell death within the field and drives antitumor immunity to assist therapeutic cure. The study illuminates and merges seemingly disparate concepts regarding the importance of autophagy in cancer therapy.

  10. Activity-based costing via an information system: an application created for a breast imaging center.

    Science.gov (United States)

    Hawkins, H; Langer, J; Padua, E; Reaves, J

    2001-06-01

    Activity-based costing (ABC) is a process that enables the estimation of the cost of producing a product or service. More accurate than traditional charge-based approaches, it emphasizes analysis of processes, and more specific identification of both direct and indirect costs. This accuracy is essential in today's healthcare environment, in which managed care organizations necessitate responsible and accountable costing. However, to be successfully utilized, it requires time, effort, expertise, and support. Data collection can be tedious and expensive. By integrating ABC with information management (IM) and systems (IS), organizations can take advantage of the process orientation of both, extend and improve ABC, and decrease resource utilization for ABC projects. In our case study, we have examined the process of a multidisciplinary breast center. We have mapped the constituent activities and established cost drivers. This information has been structured and included in our information system database for subsequent analysis.

  11. Activity-based costing via an information system: an application created for a breast imaging center.

    Science.gov (United States)

    Hawkins, H; Langer, J; Padua, E; Reaves, J

    2001-06-01

    Activity-based costing (ABC) is a process that enables the estimation of the cost of producing a product or service. More accurate than traditional charge-based approaches, it emphasizes analysis of processes, and more specific identification of both direct and indirect costs. This accuracy is essential in today's healthcare environment, in which managed care organizations necessitate responsible and accountable costing. However, to be successfully utilized, it requires time, effort, expertise, and support. Data collection can be tedious and expensive. By integrating ABC with information management (IM) and systems (IS), organizations can take advantage of the process orientation of both, extend and improve ABC, and decrease resource utilization for ABC projects. In our case study, we have examined the process of a multidisciplinary breast center. We have mapped the constituent activities and established cost drivers. This information has been structured and included in our information system database for subsequent analysis. PMID:11442093

  12. 女性胸部形态美的评价标准研究%Study on Evaluation Standard System of Female Breast Shape Beauty

    Institute of Scientific and Technical Information of China (English)

    方方; 赵想瑞

    2012-01-01

    Researching status of female breast shape beauty at home and abroad was introduced from three aspects, such as breast shape parameters, breast shape classification, breast shape beauty and so on. The existing standards of breast shape beauty were ana- lyzed and united to establish the evaluation standard system of breast shape beauty was proposed combining subjective and objective methods.%从胸部形态参数、胸部形态分类、胸部形态美研究等方面入手,介绍了国内外关于女性胸部形态关的研究现状,对现有胸部形态美标准进行了剖析,提出以主客结合的方式统一建立胸部形态美评价标准体系。

  13. Sensory profiles of breast meat from broilers reared in an organic niche production system and conventional standard broilers

    DEFF Research Database (Denmark)

    Horsted, Klaus; Allesen-Holm, Bodil Helene; Hermansen, John E.;

    2012-01-01

    for the niche products. The meat was more `tender', `short' and `crumbly' and less `hard' and `stringy' in the standard products than in one or more of the niche products. Product `I 657' was less `juicy' than the rest. Products `I 657' and `L 40' were more `cohesive' and tasted more `sourish' and less...... `tenderness' for the overall liking of broiler meat.......BACKGROUND: Breast meat from broilers produced in very different production systems may vary considerable in sensory profile, which may affect consumer interests. In this study the aim was to evaluate differences in the sensory profiles of breast meat from five broiler products: two conventional...

  14. Breast dosimetry in transverse and longitudinal field MRI-Linac radiotherapy systems

    International Nuclear Information System (INIS)

    Purpose: In the framework of developing the integration of a MRI-Linac system, configurations of MRI-Linac units were simulated in order to improve the dose distribution in tangential breast radiotherapy using transverse and longitudinal magnetic field geometries of Lorentz force for both medial and lateral tangential fields. Methods: In this work, the GEANT4 Monte Carlo (MC) code was utilized to compare dose distributions in breast radiotherapy for Linac-MR systems in the transverse and longitudinal geometries within humanoid phantoms across a range of magnetic field strengths of 0.5 and 1.5 T. The dose increment due to scattering from the coils was investigated for both geometries as well. Computed tomography images of two patients were used for MC simulations. One patient had intact breast while the other was mastectomized. In the simulations, planning and methods of chest wall irradiation were similar to the actual clinical planning. Results: In a longitudinal geometry, the magnetic field is shown to restrict the lateral spread of secondary electrons to the lung, heart, and contralateral organs, which reduced the mean dose of the ipsilateral lung and heart by means of 17.2% and 6% at 1.5 T, respectively. The transverse configuration exhibits a significant increase in tissue interface effects, which increased dose buildup in the entrance regions of the lateral and medial tangent beams to the planning target volume (PTV) and improved dose homogeneity within the PTV. The improved relative average homogeneity index for two patients to the PTV at magnetic field strength of 1.5 T with respect to no magnetic field case evaluated was 11.79% and 34.45% in the LRBP and TRBP geometries, respectively. In both geometries, the simulations show significant mean dose reductions in the contralateral breast and chest wall skin, respectively, by a mean of 16.6% and 24.9% at 0.5 T and 17.2% and 28.1% at 1.5 T in the transverse geometry, and 10.56% and 14.6% at 0.5 T and 11.3% and

  15. Evaluation of scoring system in cytological diagnosis and management of breast lesion with review of literature

    Directory of Open Access Journals (Sweden)

    N M Nandini

    2011-01-01

    Full Text Available Background: Fine needle aspiration cytology (FNAC breast is generally considered as a rapid, reliable, and safe diagnostic tool to distinguish non-neoplastic from neoplastic breast lesions. Masood′s Scoring Index has been proposed to help in sub-grouping of breast lesions so as to help in surgical management. Aims: To assess the accuracy of Modified Masood′s Scoring Index (MMSI in the diagnosis of benign and malignant breast lesions in patients with palpable breast lump, and review of literature. Settings and Design: A prospective study from a tertiary care center. Material and Methods: This prospective study included a total of 100 cases, both females and males, with palpable breast lump, in the age range of 10-80 years, over a period of 2 years from January 2007 to 2009, who underwent FNAC. They were cytologically grouped into five categories as suggested by Masood et al, and confirmed by histopathology. Results: Evaluation of Masood Scoring Index led to modification (Modified Masood Scoring Index; MMSI by shifting score 9 from Group I to Group II, thus increasing the diagnostic accuracy of the breast lesions. Conclusions: MMSI was found to be a useful, easily reproducible scoring method of breast lesions to improve diagnostic accuracy of nonproliferative breast disease and proliferative breast disease without atypia cases, as the prognosis and treatment of these cases varies.

  16. Impact of high energy resolution detectors on the performance of a PET system dedicated to breast cancer imaging.

    Science.gov (United States)

    Levin, Craig S; Foudray, Angela M K; Habte, Frezghi

    2006-01-01

    We are developing a high resolution, high sensitivity PET camera dedicated to breast cancer imaging. We are studying two novel detector technologies for this imaging system: a scintillation detector comprising layers of small lutetium oxyorthosilicate (LSO) crystals coupled to new position sensitive avalanche photodiodes (PSAPDs), and a pure semiconductor detector comprising cadmium zinc telluride (CZT) crystal slabs with thin anode and cathode strips deposited in orthogonal directions on either side of each slab. Both detectors achieve 1 mm spatial resolution with 3-5 mm directly measured photon interaction depth resolution, which promotes uniform reconstructed spatial resolution throughout a compact, breast-size field of view. Both detector types also achieve outstanding energy resolution (4 kcps for 200 microCi in a simulated breast phantom. PMID:17645990

  17. Treatment of Breast Cancer Cells by IGF1R Tyrosine Kinase Inhibitor Combined with Conventional Systemic Drugs

    NARCIS (Netherlands)

    Hartog, H.; Van der Graaf, W. T. A.; Boezen, H. M.; Wesseling, J.

    2012-01-01

    Aim: Insulin-like growth factor-1 receptor (IGF1R) is a tyrosine kinase receptor mediating cell growth and survival of cancer cells. We studied responses to IGF1R tyrosine kinase inhibitor NVP-AEW541 combined with conventional systemic drugs in breast cancer cell lines of different clinical subtype.

  18. Treatment of breast cancer cells by IGF1R tyrosine kinase inhibitor combined with conventional systemic drugs.

    NARCIS (Netherlands)

    Hartog, H.; Graaf, W.T.A. van der; Boezen, H.M.; Wesseling, J.

    2012-01-01

    AIM: Insulin-like growth factor-1 receptor (IGF1R) is a tyrosine kinase receptor mediating cell growth and survival of cancer cells. We studied responses to IGF1R tyrosine kinase inhibitor NVP-AEW541 combined with conventional systemic drugs in breast cancer cell lines of different clinical subtype.

  19. Design and realisation of a microwave three-dimensional imaging system with application to breast-cancer detection

    DEFF Research Database (Denmark)

    Zhurbenko, Vitaliy; Rubæk, T.; Krozer, V.;

    2010-01-01

    An active microwave-imaging system for non-invasive detection of breast cancer based on dedicated hardware is described. Thirty-two transceiving channels are used to measure the amplitude and phase of the scattered fields in the three-dimensional (3D) imaging domain using electronic scanning. The...

  20. Slow gantry rotation acquisition technique for on-board four-dimensional digital tomosynthesis

    International Nuclear Information System (INIS)

    Purpose: Four-dimensional cone-beam computed tomography (4D CBCT) has been investigated for motion imaging in the radiotherapy treatment room. The drawbacks of 4D CBCT are long scan times and high imaging doses. The aims of this study were to develop and investigate a slow gantry rotation acquisition protocol for four-dimensional digital tomosynthesis (4D DTS) as a faster, lower dose alternative to 4D CBCT. Methods: This technique was implemented using an On-Board Imager kV imaging system (Varian Medical Systems, Palo Alto, CA) mounted on the gantry of a linear accelerator. The general procedure for 4D DTS imaging using slow gantry rotation acquisition consists of the following steps: (1) acquire projections over a limited gantry rotation angle in a single motion with constant frame rate and gantry rotation speed; (2) generate a respiratory signal and temporally match projection images with appropriate points from the respiratory signal; (3) use the respiratory signal to assign phases to each of the projection images; (4) sort projection images into phase bins; and (5) reconstruct phase images. Phantom studies were conducted to validate theoretically derived relationships between acquisition and respiratory parameters. Optimization of acquisition parameters was then conducted by simulating lung scans using patient data. Lung tumors with approximate volumes ranging from 0.12 to 1.53 cm3 were studied. Results: A protocol for slow gantry rotation 4D DTS was presented. Equations were derived to express relationships between acquisition parameters (frame rate, phase window, and angular intervals between projections), respiratory cycle durations, and resulting acquisition times and numbers of projections. The phantom studies validated the relationships, and the patient studies resulted in determinations of appropriate acquisition parameters. The phase window must be set according to clinical goals. For 10% phase windows, we found that appropriate frame rates ranging from

  1. What Is Breast Cancer?

    Science.gov (United States)

    ... Next Topic Types of breast cancers What is breast cancer? Breast cancer starts when cells in the breast ... breast cancer? ” and Non-cancerous Breast Conditions . How Breast Cancer Spreads Breast cancer can spread through the lymph ...

  2. An issue tracking system to facilitate the enhancement of clinical data quality in the clinical breast care project.

    Science.gov (United States)

    Zhang, Yonghong; Sun, Weihong; Gutchell, Emily M; Hu, Hai; Liebman, Michael N; Shriver, Craig D; Mural, Richard J

    2007-10-11

    An online issue tracking (QAIT) system was developed to support the QA of questionnaire-based clinical data and tissue banking in the Clinical Breast Care Project (CBCP). The web-based system provides a centralized storage and management of QA issues and role-based access to related information and functions via internet. The QAIT system greatly improved the QA process for the CBCP clinical data and tissue banking and can be easily adapted to other applications.

  3. Breast-feeding and Vitamin D Supplementation Rates in the Ochsner Health System

    OpenAIRE

    Ponnapakkam, Tulasi; Ravichandran, Anisha; Bradford, Elease; Tobin, Gregory; Gensure, Robert

    2008-01-01

    Breast-feeding imparts many benefits to both mothers and infants. Because of these numerous recognized benefits, there has been an effort to increase breast-feeding rates nationwide; increasing breast-feeding rates was one of the goals of the U.S. Department of Health and Human Services' Healthy People 2010 initiative. This study examined the breast-feeding rate at the Ochsner Clinic Foundation by conducting a retrospective chart review of patients aged 0–12 months who visited any branch of t...

  4. Computerized Ultrasound Risk Evaluation (CURE) System: Development of Combined Transmission and Reflection Ultrasound with New Reconstruction Algorithms for Breast Imaging

    Energy Technology Data Exchange (ETDEWEB)

    Littrup, P J; Duric, N; Azevedo, S; Chambers, D; Candy, J V; Johnson, S; Auner, G; Rather, J; Holsapple, E T

    2001-09-07

    Our Computerized Ultrasound Risk Evaluation (CURE) system has been developed to the engineering prototype stage and generated unique data sets of both transmission and reflection ultrasound (US). This paper will help define the clinical underpinnings of the developmental process and interpret the imaging results from a similar perspective. The CURE project was designed to incorporate numerous diagnostic parameters to improve upon two major areas of early breast cancer detection. CURE may provide improved tissue characterization of breast masses and reliable detection of abnormal microcalcifications found in some breast cancers and ductal carcinoma in situ (DCIS). Current breast US is limited to mass evaluation, whereas mammography also detects and guides biopsy of malignant calcifications. Screening with CURE remains a distant goal, but improved follow-up of mammographic abnormalities may represent a feasible breakthrough. Improved tissue characterization could result in reduction of the estimated one million benign biopsies each year in the United States, costing up to several billion dollars. Most breast calcifications are benign and comprise-80% of stereotactic biopsies guided by mammography. Ultrasound has the capability of finding some groups of calcifications, but further improvements in resolution should also address tissue characterization to define the soft tissue filling of ducts by DCIS. In this manner, CURE may be able to more accurately identify the malignant calcifications associated with progression of DCIS or early cancers. Currently, high-resolution US images of the breast are performed in the reflection mode at higher frequencies, which also limits depth of penetration. Reconstruction of reflection ultrasound images relies upon acoustic impedance differences in the tissue and includes only direct backscatter of the ultrasound signal. Resolution and tissue contrast of current US continues to improve with denser transducer arrays and image

  5. Whole brain radiotherapy for brain metastases from breast cancer: estimation of survival using two stratification systems

    International Nuclear Information System (INIS)

    Brain metastases (BM) are the most common form of intracranial cancer. The incidence of BM seems to have increased over the past decade. Recursive partitioning analysis (RPA) of data from three Radiation Therapy Oncology Group (RTOG) trials (1200 patients) has allowed three prognostic groups to be identified. More recently a simplified stratification system that uses the evaluation of three main prognostics factors for radiosurgery in BM was developed. To analyze the overall survival rate (OS), prognostic factors affecting outcomes and to estimate the potential improvement in OS for patients with BM from breast cancer, stratified by RPA class and brain metastases score (BS-BM). From January 1996 to December 2004, 174 medical records of patients with diagnosis of BM from breast cancer, who received WBRT were analyzed. The surgery followed by WBRT was used in 15.5% of patients and 84.5% of others patients were submitted at WBRT alone; 108 patients (62.1%) received the fractionation schedule of 30 Gy in 10 fractions. Solitary BM was present in 37.9 % of patients. The prognostic factors evaluated for OS were: age, Karnofsky Performance Status (KPS), number of lesions, localization of lesions, neurosurgery, chemotherapy, absence extracranial disease, RPA class, BS-BM and radiation doses and fractionation. The OS in 1, 2 and 3 years was 33.4 %, 16.7%, and 8.8 %, respectively. The RPA class analysis showed strong relation with OS (p < 0.0001). The median survival time by RPA class in months was: class I 11.7, class II 6.2 and class III 3.0. The significant prognostic factors associated with better OS were: higher KPS (p < 0.0001), neurosurgery (P < 0.0001), single metastases (p = 0.003), BS-BM (p < 0.0001), control primary tumor (p = 0.002) and absence of extracranial metastases (p = 0.001). In multivariate analysis, the factors associated positively with OS were: neurosurgery (p < 0.0001), absence of extracranial metastases (p <0.0001) and RPA class I (p < 0.0001). Our

  6. Investigation of optimal parameters for penalized maximum-likelihood reconstruction applied to iodinated contrast-enhanced breast CT

    Science.gov (United States)

    Makeev, Andrey; Ikejimba, Lynda; Lo, Joseph Y.; Glick, Stephen J.

    2016-03-01

    Although digital mammography has reduced breast cancer mortality by approximately 30%, sensitivity and specificity are still far from perfect. In particular, the performance of mammography is especially limited for women with dense breast tissue. Two out of every three biopsies performed in the U.S. are unnecessary, thereby resulting in increased patient anxiety, pain, and possible complications. One promising tomographic breast imaging method that has recently been approved by the FDA is dedicated breast computed tomography (BCT). However, visualizing lesions with BCT can still be challenging for women with dense breast tissue due to the minimal contrast for lesions surrounded by fibroglandular tissue. In recent years there has been renewed interest in improving lesion conspicuity in x-ray breast imaging by administration of an iodinated contrast agent. Due to the fully 3-D imaging nature of BCT, as well as sub-optimal contrast enhancement while the breast is under compression with mammography and breast tomosynthesis, dedicated BCT of the uncompressed breast is likely to offer the best solution for injected contrast-enhanced x-ray breast imaging. It is well known that use of statistically-based iterative reconstruction in CT results in improved image quality at lower radiation dose. Here we investigate possible improvements in image reconstruction for BCT, by optimizing free regularization parameter in method of maximum likelihood and comparing its performance with clinical cone-beam filtered backprojection (FBP) algorithm.

  7. Microwave Breast Imaging Techniques

    DEFF Research Database (Denmark)

    Zhurbenko, Vitaliy; Rubæk, Tonny

    2010-01-01

    This paper outlines the applicability of microwave radiation for breast cancer detection. Microwave imaging systems are categorized based on their hardware architecture. The advantages and disadvantages of various imaging techniques are discussed. The fundamental tradeoffs are indicated between...... various requirements to be fulfilled in the design of an imaging system for breast cancer detection and some strategies to overcome these limitations....

  8. Design and characterization of a digital image acquisition system for whole-specimen breast histopathology

    Science.gov (United States)

    Clarke, Gina M.; Peressotti, Chris; Mawdsley, Gordon E.; Yaffe, Martin J.

    2006-10-01

    We have developed a digital histopathology imaging system capable of producing a three-dimensional (3D) representation of histopathology from an entire lumpectomy specimen. The system has the potential to improve the accuracy of surgical margin assessment in the treatment of breast cancer by providing finer sampling and 3D visualization. A scanning light microscope was modified to allow digital photomicrography of a stack of large (up to 120 × 170 mm2) histology slides cut serially through the entire specimen. The images are registered and displayed in 2D and 3D. The design of the system, which reduces or eliminates the appearance of 'tiling' and 'seam' artefacts inherent in the scanning method, is described and its resolution, contrast/noise and coverage properties are characterized through measurements of the modulation transfer function (MTF), depth of field (DOF) and signal difference to noise ratio (SDNR). The imaging task requires a lateral resolution of 5 µm, an SDNR of 5 between relevant features, 'tiling artefact' at a level below the detectability threshold of the eye, and 'seam artefact' of less than 5-10 µm. The tests demonstrate that the system is largely adequate for the imaging task, although further optimizations are required to reduce the degradation of coverage incurred by seam artefact.

  9. Design and characterization of a digital image acquisition system for whole-specimen breast histopathology

    Energy Technology Data Exchange (ETDEWEB)

    Clarke, Gina M [Imaging Research Program, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario, M4N 3M5 (Canada); Peressotti, Chris [Imaging Research Program, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario, M4N 3M5 (Canada); Mawdsley, Gordon E [Imaging Research Program, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario, M4N 3M5 (Canada); Yaffe, Martin J [Imaging Research Program, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario, M4N 3M5 (Canada)

    2006-10-21

    We have developed a digital histopathology imaging system capable of producing a three-dimensional (3D) representation of histopathology from an entire lumpectomy specimen. The system has the potential to improve the accuracy of surgical margin assessment in the treatment of breast cancer by providing finer sampling and 3D visualization. A scanning light microscope was modified to allow digital photomicrography of a stack of large (up to 120 x 170 mm{sup 2}) histology slides cut serially through the entire specimen. The images are registered and displayed in 2D and 3D. The design of the system, which reduces or eliminates the appearance of 'tiling' and 'seam' artefacts inherent in the scanning method, is described and its resolution, contrast/noise and coverage properties are characterized through measurements of the modulation transfer function (MTF), depth of field (DOF) and signal difference to noise ratio (SDNR). The imaging task requires a lateral resolution of 5 {mu}m, an SDNR of 5 between relevant features, 'tiling artefact' at a level below the detectability threshold of the eye, and 'seam artefact' of less than 5-10 {mu}m. The tests demonstrate that the system is largely adequate for the imaging task, although further optimizations are required to reduce the degradation of coverage incurred by seam artefact.

  10. Breast cancer risk in elderly women with systemic autoimmune rheumatic diseases: a population-based case–control study

    OpenAIRE

    Gadalla, S M; Amr, S; LANGENBERG P.; Baumgarten, M.; Davidson, W F; Schairer, C; Engels, E A; Pfeiffer, R M; Goedert, J J

    2009-01-01

    Systemic autoimmune rheumatic diseases (SARDs) are chronic inflammatory and immuno-modulatory conditions that have been suggested to affect cancer risk. Using the Surveillance, Epidemiology and End Results–Medicare-linked database, women aged 67–99 years and diagnosed with incident breast cancer in 1993–2002 (n=84 778) were compared with an equal number of age-matched cancer-free female controls. Diagnoses of SARDs, including rheumatoid arthritis (RA, n=5238), systemic lupus erythematosus (SL...

  11. SUBMIT: Systemic therapy with or without up front surgery of the primary tumor in breast cancer patients with distant metastases at initial presentation

    Directory of Open Access Journals (Sweden)

    Ruiterkamp Jetske

    2012-04-01

    Full Text Available Abstract Background Five percent of all patients with breast cancer have distant metastatic disease at initial presentation. Because metastatic breast cancer is considered to be an incurable disease, it is generally treated with a palliative intent. Recent non-randomized studies have demonstrated that (complete resection of the primary tumor is associated with a significant improvement of the survival of patients with primary metastatic breast cancer. However, other studies have suggested that the claimed survival benefit by surgery may be caused by selection bias. Therefore, a randomized controlled trial will be performed to assess whether breast surgery in patients with primary distant metastatic breast cancer will improve the prognosis. Design Randomization will take place after the diagnosis of primary distant metastatic breast cancer. Patients will either be randomized to up front surgery of the breast tumor followed by systemic therapy or to systemic therapy, followed by delayed local treatment of the breast tumor if clinically indicated. Patients with primary distant metastatic breast cancer, with no prior treatment of the breast cancer, who are 18 years or older and fit enough to undergo surgery and systemic therapy are eligible. Important exclusion criteria are: prior invasive breast cancer, surgical treatment or radiotherapy of this breast tumor before randomization, irresectable T4 tumor and synchronous bilateral breast cancer. The primary endpoint is 2-year survival. Quality of life and local tumor control are among the secondary endpoints. Based on the results of prior research it was calculated that 258 patients are needed in each treatment arm, assuming a power of 80%. Total accrual time is expected to take 60 months. An interim analysis will be performed to assess any clinically significant safety concerns and to determine whether there is evidence that up front surgery is clinically or statistically inferior to systemic therapy

  12. The "Win-Win" initiative: a global, scientifically based approach to resource sparing treatment for systemic breast cancer therapy

    Directory of Open Access Journals (Sweden)

    Elzawawy Ahmed

    2009-05-01

    Full Text Available Abstract Background Worldwide, breast cancer is the most frequent malignancy among females. Its incidence shows a trend towards an increase in the next decade, particularly in developing countries where less than of 5% of resources for cancer management are available. In most breast cancer cases systemic cancer treatment remains a primary management strategy. With the increasing costs of novel drugs, amidst the growing breast cancer rate, it can be safely assumed that in the next decade, newly developed cancer drugs will become less affordable and therefore will be available to fewer patients in low and middle income countries. In light of this potentially tragic situation, a pressing need emerges for science-based innovative solutions. Methods In this article, we cite examples of recently published researches and case management approaches that have been shown to lower overall treatment costs without compromising patient outcomes. The cited approaches are not presented as wholly inclusive or definitive solutions but are offered as effective examples that we hope will inspire the development of additional evidence-based management approaches that provide both efficient and effective breast cancer treatment Results We propose a "win-win" initiative, borne in the year of 2008 of strategic information sharing through preparatory communications, publications and our conference presentations. In the year 2009, ideas developed through these mechanisms can be refined through focused small pilot meetings with interested stakeholders, including the clinical, patient advocate, and pharmaceutical communities, and as appropriate (as proposed plans emerge, governmental representatives. The objective is to draw a realistic road map for feasible and innovative scientific strategies and collaborative actions that could lead to resource sparing; i.e. cost effective and tailored breast cancer systemic treatment for low and middle income countries. Conclusion The

  13. Effect of adjuvant systemic treatment on cosmetic outcome and late normal-tissue reactions after breast conservation

    Energy Technology Data Exchange (ETDEWEB)

    Johansen, Joergen [Dept. of Oncology, Odense Univ. Hospital, Odense (Denmark); Overgaard, Jens [Dept. of Experimental Clinical Oncology, Danish Cancer Society, Aarhus (Denmark); Overgaard, Marie [Dept. of Oncology, Aarhus Univ. Hospital, Aarhus (Denmark)

    2007-05-15

    To investigate whether adjuvant treatment with CMF or tamoxifen predisposes to an unfavorable cosmetic outcome or increased breast morbidity after radiotherapy in breast conservation. Data from 266 patients who entered a randomized breast conservation trial (DBCG-82TM protocol) was analyzed. The patients were treated with lumpectomy and axillary dissection followed by external beam radiotherapy to the residual breast. High-risk patients (n 94), as well as 31 low-risk patients, received additional radiation to the regional lymph nodes. Adjuvant systemic treatment was given to all high-risk patients: premenopausal patients (n = 67) received eight cycles of CMF intravenously (600/40/600 mg/m{sup 2}) every fourth week; postmenopausal patients (n = 27) received 30 mg of tamoxifen daily for one year. Clinical assessments included cosmetic outcome, breast fibrosis, skin telangiectasia, and dyspigmentation which were scored on a 4-point categorical scale after median 6.6 years. The observations were analyzed in multivariate logistic regression analysis which included potential risk factors on outcome related to systemic treatment, surgery, radiation technique, tumor, and patient characteristics. In premenopausal patients, systemic treatment with CMF independently predicted a fair/poor cosmetic outcome, RR = 2.2 (95% CI 1.2-4.2), as well as increased skin telangiectasia, RR = 3.3 (1.4-8.2). There was no impact of tamoxifen treatment on cosmetic outcome in postmenopausal patients (p 0.32). However, univariate analysis showed that tamoxifen was significantly associated with breast fibrosis (p <0.004), as was radiation to the regional lymph nodes (p <0.0001). A strong interaction between axillary irradiation and tamoxifen treatment occurred since 26 of 27 high-risk postmenopausal patients had received both tamoxifen and axillary irradiation. In multivariate regression analysis, axillary irradiation independently predicted moderate/severe breast fibrosis with a relative risk of

  14. Effect of adjuvant systemic treatment on cosmetic outcome and late normal-tissue reactions after breast conservation

    International Nuclear Information System (INIS)

    To investigate whether adjuvant treatment with CMF or tamoxifen predisposes to an unfavorable cosmetic outcome or increased breast morbidity after radiotherapy in breast conservation. Data from 266 patients who entered a randomized breast conservation trial (DBCG-82TM protocol) was analyzed. The patients were treated with lumpectomy and axillary dissection followed by external beam radiotherapy to the residual breast. High-risk patients (n 94), as well as 31 low-risk patients, received additional radiation to the regional lymph nodes. Adjuvant systemic treatment was given to all high-risk patients: premenopausal patients (n = 67) received eight cycles of CMF intravenously (600/40/600 mg/m2) every fourth week; postmenopausal patients (n = 27) received 30 mg of tamoxifen daily for one year. Clinical assessments included cosmetic outcome, breast fibrosis, skin telangiectasia, and dyspigmentation which were scored on a 4-point categorical scale after median 6.6 years. The observations were analyzed in multivariate logistic regression analysis which included potential risk factors on outcome related to systemic treatment, surgery, radiation technique, tumor, and patient characteristics. In premenopausal patients, systemic treatment with CMF independently predicted a fair/poor cosmetic outcome, RR = 2.2 (95% CI 1.2-4.2), as well as increased skin telangiectasia, RR = 3.3 (1.4-8.2). There was no impact of tamoxifen treatment on cosmetic outcome in postmenopausal patients (p 0.32). However, univariate analysis showed that tamoxifen was significantly associated with breast fibrosis (p <0.004), as was radiation to the regional lymph nodes (p <0.0001). A strong interaction between axillary irradiation and tamoxifen treatment occurred since 26 of 27 high-risk postmenopausal patients had received both tamoxifen and axillary irradiation. In multivariate regression analysis, axillary irradiation independently predicted moderate/severe breast fibrosis with a relative risk of 5

  15. Breast lump

    Science.gov (United States)

    Breast mass ... males and females of all ages have normal breast tissue. This tissue responds to hormone changes. Because of this, lumps can come and go. Breast lumps may appear at any age: Both male ...

  16. Breast Diseases

    Science.gov (United States)

    Most women experience breast changes at some time. Your age, hormone levels, and medicines you take may cause lumps, bumps, and discharges (fluids that are not breast milk). If you have a breast lump, pain, ...

  17. The utilization of an ultrasound-guided 8-gauge vacuum-assisted breast biopsy system as an innovative approach to accomplishing complete eradication of multiple bilateral breast fibroadenomas

    Directory of Open Access Journals (Sweden)

    Povoski Stephen P

    2007-10-01

    Full Text Available Abstract Background Ultrasound-guided vacuum-assisted breast biopsy technology is extremely useful for diagnostic biopsy of suspicious breast lesions and for attempted complete excision of appropriately selected presumed benign breast lesions. Case presentation A female patient presented with 16 breast lesions (eight within each breast, documented on ultrasound and all presumed to be fibroadenomas. Over a ten and one-half month period of time, 14 of these 16 breast lesions were removed under ultrasound guidance during a total of 11 separate 8-gauge Mammotome® excision procedures performed during seven separate sessions. Additionally, two of these 16 breast lesions were removed by open surgical excision. A histopathologic diagnosis of fibroadenoma and/or fibroadenomatous changes was confirmed at all lesion excision sites. Interval follow-up ultrasound imaging revealed no evidence of a residual lesion at the site of any of the 16 original breast lesions. Conclusion This report describes an innovative approach of utilizing ultrasound-guided 8-gauge vacuum-assisted breast biopsy technology for assisting in achieving complete eradication of multiple bilateral fibroadenomas in a patient who presented with 16 documented breast lesions. As such, this innovative approach is highly recommended in similar appropriately selected patients.

  18. Evaluation of the efficiency of biofield diagnostic system in breast cancer detection using clinical study results and classifiers.

    Science.gov (United States)

    Subbhuraam, Vinitha Sree; Ng, E Y K; Kaw, G; Acharya U, Rajendra; Chong, B K

    2012-02-01

    The division of breast cancer cells results in regions of electrical depolarisation within the breast. These regions extend to the skin surface from where diagnostic information can be obtained through measurements of the skin surface electropotentials using sensors. This technique is used by the Biofield Diagnostic System (BDS) to detect the presence of malignancy. This paper evaluates the efficiency of BDS in breast cancer detection and also evaluates the use of classifiers for improving the accuracy of BDS. 182 women scheduled for either mammography or ultrasound or both tests participated in the BDS clinical study conducted at Tan Tock Seng hospital, Singapore. Using the BDS index obtained from the BDS examination and the level of suspicion score obtained from mammography/ultrasound results, the final BDS result was deciphered. BDS demonstrated high values for sensitivity (96.23%), specificity (93.80%), and accuracy (94.51%). Also, we have studied the performance of five supervised learning based classifiers (back propagation network, probabilistic neural network, linear discriminant analysis, support vector machines, and a fuzzy classifier), by feeding selected features from the collected dataset. The clinical study results show that BDS can help physicians to differentiate benign and malignant breast lesions, and thereby, aid in making better biopsy recommendations.

  19. Renin angiotensin system-regulating aminopeptidase activities in serum of pre- and postmenopausal women with breast cancer.

    Science.gov (United States)

    Martínez-Martos, José Manuel; del Pilar Carrera-González, María; Dueñas, Basilio; Mayas, María Dolores; García, María Jesús; Ramírez-Expósito, María Jesús

    2011-10-01

    Angiotensin peptides regulate vascular tone and natriohydric balance through the renin angiotensin system (RAS) and are related with the angiogenesis which plays an important role in the metastatic pathway. Estrogen influences the aminopeptidases (APs) involved in the metabolism of bioactive peptides of RAS through several pathways. We analyze RAS-regulating AP activities in serum of pre- and postmenopausal women with breast cancer to evaluate the putative value of these activities as biological markers of the development of breast cancer. We observed an increase in aminopeptidase N (APN) and aminopeptidase B (APB) activities in women with breast cancer; however, a decrease in aspartyl-aminopeptidase (AspAP) activity in premenopausal women. These results suggest a slow metabolism of angiotensin II (Ang II) to angiotensin III (Ang III) in premenopausal women and a rapid metabolism of Ang III to angiotensin IV (Ang IV) in pre- and postmenopausal women with breast cancer. An imbalance in the signals activated by Ang II may produce abnormal vascular growth with different response between pre- and postmenopausal women depending on the hormonal profile and the development of the disease.

  20. Evaluation of the efficiency of biofield diagnostic system in breast cancer detection using clinical study results and classifiers.

    Science.gov (United States)

    Subbhuraam, Vinitha Sree; Ng, E Y K; Kaw, G; Acharya U, Rajendra; Chong, B K

    2012-02-01

    The division of breast cancer cells results in regions of electrical depolarisation within the breast. These regions extend to the skin surface from where diagnostic information can be obtained through measurements of the skin surface electropotentials using sensors. This technique is used by the Biofield Diagnostic System (BDS) to detect the presence of malignancy. This paper evaluates the efficiency of BDS in breast cancer detection and also evaluates the use of classifiers for improving the accuracy of BDS. 182 women scheduled for either mammography or ultrasound or both tests participated in the BDS clinical study conducted at Tan Tock Seng hospital, Singapore. Using the BDS index obtained from the BDS examination and the level of suspicion score obtained from mammography/ultrasound results, the final BDS result was deciphered. BDS demonstrated high values for sensitivity (96.23%), specificity (93.80%), and accuracy (94.51%). Also, we have studied the performance of five supervised learning based classifiers (back propagation network, probabilistic neural network, linear discriminant analysis, support vector machines, and a fuzzy classifier), by feeding selected features from the collected dataset. The clinical study results show that BDS can help physicians to differentiate benign and malignant breast lesions, and thereby, aid in making better biopsy recommendations. PMID:20703753

  1. Role of digital tomosynthesis and dual energy subtraction digital radiography in detecting pulmonary nodules

    International Nuclear Information System (INIS)

    Highlights: • Accuracy of digital tomosynthesis for nodule detection is substantially higher. • Improvement in diagnostic accuracy is most pronounced for nodules <10 mm. • There is five times increase in radiation dose compared to DR. - Abstract: Objective: Digital tomosynthesis (DT) and dual-energy subtraction digital radiography (DES-DR) are known to perform better than conventional radiography in the detection of pulmonary nodules. Yet the comparative diagnostic performances of DT, DES-DR and digital radiography (DR) is not known. The present study compares the diagnostic performances of DT, DES-DR and DR in detecting pulmonary nodules. Subjects and methods: The institutional Review Board approved the study and informed written consent was obtained. Fifty-five patients (30 with pulmonary nodules, 25 with non-nodular focal chest pathology) were included in the study. DT and DES-DR were performed within14 days of MDCT. Composite images acquired at high kVp as part of DES-DR were used as DR images. Images were analyzed for presence of nodules and calcification in nodules. Interpretations were assigned confidence levels from 1 to 5 according to Five-Point rating scale. Areas under the receiver operating characteristic curves were compared using Z test. Results: A total of 110 (88 non-calcified, 22 calcified) nodules were identified on MDCT. For detection of nodules, DR showed cumulative sensitivity and specificity of 25.45% and 67.97%, respectively. DT showed a cumulative sensitivity and specificity of 60.9% and 85.07%, respectively. The performance was significantly better than DR (p < 0.003). DES-DR showed sensitivity and specificity of 27.75% and 82.64%, not statistically different from those of DR (p—0.92). In detection of calcification, there was no statistically significant difference between DT, DES-DR and DR. Conclusions: DT performs significantly better than DES-DR and DR at the cost of moderate increase in radiation dose

  2. Role of digital tomosynthesis and dual energy subtraction digital radiography in detecting pulmonary nodules

    Energy Technology Data Exchange (ETDEWEB)

    Kumar, Sarvana G. [Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research (PGIMER), Sector 12, Chandigarh 160012 (India); Garg, Mandeep Kumar, E-mail: gargmandeep01@gmail.com [Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research (PGIMER), Sector 12, Chandigarh 160012 (India); Khandelwal, Niranjan; Gupta, Pankaj [Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research (PGIMER), Sector 12, Chandigarh 160012 (India); Gupta, Dheeraj; Aggarwal, Ashutosh Nath [Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Sector 12, Chandigarh 160012 (India); Bansal, Subash Chand [Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research (PGIMER), Sector 12, Chandigarh 160012 (India)

    2015-07-15

    Highlights: • Accuracy of digital tomosynthesis for nodule detection is substantially higher. • Improvement in diagnostic accuracy is most pronounced for nodules <10 mm. • There is five times increase in radiation dose compared to DR. - Abstract: Objective: Digital tomosynthesis (DT) and dual-energy subtraction digital radiography (DES-DR) are known to perform better than conventional radiography in the detection of pulmonary nodules. Yet the comparative diagnostic performances of DT, DES-DR and digital radiography (DR) is not known. The present study compares the diagnostic performances of DT, DES-DR and DR in detecting pulmonary nodules. Subjects and methods: The institutional Review Board approved the study and informed written consent was obtained. Fifty-five patients (30 with pulmonary nodules, 25 with non-nodular focal chest pathology) were included in the study. DT and DES-DR were performed within14 days of MDCT. Composite images acquired at high kVp as part of DES-DR were used as DR images. Images were analyzed for presence of nodules and calcification in nodules. Interpretations were assigned confidence levels from 1 to 5 according to Five-Point rating scale. Areas under the receiver operating characteristic curves were compared using Z test. Results: A total of 110 (88 non-calcified, 22 calcified) nodules were identified on MDCT. For detection of nodules, DR showed cumulative sensitivity and specificity of 25.45% and 67.97%, respectively. DT showed a cumulative sensitivity and specificity of 60.9% and 85.07%, respectively. The performance was significantly better than DR (p < 0.003). DES-DR showed sensitivity and specificity of 27.75% and 82.64%, not statistically different from those of DR (p—0.92). In detection of calcification, there was no statistically significant difference between DT, DES-DR and DR. Conclusions: DT performs significantly better than DES-DR and DR at the cost of moderate increase in radiation dose.

  3. Dynamic modeling of breast tissue with application of model reference adaptive system identification technique based on clinical robot-assisted palpation.

    Science.gov (United States)

    Keshavarz, M; Mojra, A

    2015-11-01

    Accurate identification of breast tissue's dynamic behavior in physical examination is critical to successful diagnosis and treatment. In this study a model reference adaptive system identification (MRAS) algorithm is utilized to estimate the dynamic behavior of breast tissue from mechanical stress-strain datasets. A robot-assisted device (Robo-Tac-BMI) is going to mimic physical palpation on a 45 year old woman having a benign mass in the left breast. Stress-strain datasets will be collected over 14 regions of both breasts in a specific period of time. Then, a 2nd order linear model is adapted to the experimental datasets. It was confirmed that a unique dynamic model with maximum error about 0.89% is descriptive of the breast tissue behavior meanwhile mass detection may be achieved by 56.1% difference from the normal tissue.

  4. The Evolution of the Local and System Therapy of Breast Cancer Stage I: 27-Years’s Data Analysis

    Directory of Open Access Journals (Sweden)

    Kolyadina I.V.

    2014-03-01

    Full Text Available The aim of the investigation is to study the dynamics of approaches in surgery, adjuvant radiotherapy and systemic therapy for breast cancer stage I over the past 27 years. Materials and Methods. In the study included 1341 women (aged 21–88 years with invasive breast cancer stage I, who had received treatment in N.N. Blokhin Russian Cancer Research Center and Clinic of RMAPE (Moscow from 1985 to 2012. The first stage of treatment for all the patients included radical surgery (43.5% patients — radical mastectomy; and 56.5% — breast-conserving surgery. More than half of the patients (58.9% received adjuvant radiotherapy; adjuvant systemic therapy was used in 821 patients (61.0%, endocrine therapy alone — in the third of patients (432 women, 32.1%, chemotherapy alone — in 124 women (9.2%, and 526 patients (19.7% received a combined systemic therapy (chemotherapy and endocrine therapy. We analyzed the change of approach to the surgical treatment, adjuvant radiotherapy and systemic therapy from 1985 to 2012. A statistical analysis was made by international statistical program SPSS 20.0. Results. Over the past 27 years local treatment structure of stage I breast cancer has changed: radiotherapy has become an indispensible part of breast conserving therapy, and was added by “boost” (radiotherapy with a dose of 14–16 Gy on tumor bed by a half of women (50.3%. The part of patients who received radiotherapy after radical mastectomy has decreased (from 14.6 to 4.5%, p < 0.05. Adjuvant systemic therapy has been used by the majority of women (86.7%: a part of patients receiving endocrine therapy has significantly increased (from 20.7 to 44.3%, chemotherapy (from 2.6 to 13.6%, or chemo-hormone therapy (from 8.4 to 28.8%, p < 0.05. Chemotherapy regimens have been changed: non-anthracycline combinations are used instead of anthracycline regimens, and after 2005 — taxanes. HER2-status detection has been used in clinical practice since 2000, and

  5. SU-E-J-134: An Augmented-Reality Optical Imaging System for Accurate Breast Positioning During Radiotherapy

    International Nuclear Information System (INIS)

    Purpose: Breast radiotherapy, particularly electronic compensation, may involve large dose gradients and difficult patient positioning problems. We have developed a simple self-calibrating augmented-reality system, which assists in accurately and reproducibly positioning the patient, by displaying her live image from a single camera superimposed on the correct perspective projection of her 3D CT data. Our method requires only a standard digital camera capable of live-view mode, installed in the treatment suite at an approximately-known orientation and position (rotation R; translation T). Methods: A 10-sphere calibration jig was constructed and CT imaged to provide a 3D model. The (R,T) relating the camera to the CT coordinate system were determined by acquiring a photograph of the jig and optimizing an objective function, which compares the true image points to points calculated with a given candidate R and T geometry. Using this geometric information, 3D CT patient data, viewed from the camera's perspective, is plotted using a Matlab routine. This image data is superimposed onto the real-time patient image, acquired by the camera, and displayed using standard live-view software. This enables the therapists to view both the patient's current and desired positions, and guide the patient into assuming the correct position. The method was evaluated using an in-house developed bolus-like breast phantom, mounted on a supporting platform, which could be tilted at various angles to simulate treatment-like geometries. Results: Our system allowed breast phantom alignment, with an accuracy of about 0.5 cm and 1 ± 0.5 degree. Better resolution could be possible using a camera with higher-zoom capabilities. Conclusion: We have developed an augmented-reality system, which combines a perspective projection of a CT image with a patient's real-time optical image. This system has the potential to improve patient setup accuracy during breast radiotherapy, and could possibly be

  6. Inhibition of system L (LAT1/CD98hc) reduces the growth of cultured human breast cancer cells.

    Science.gov (United States)

    Shennan, David B; Thomson, Jean

    2008-10-01

    It has been suggested that system L (LAT1/CD98hc) is up-regulated in cancer cells, including breast tumour cells, and is therefore a promising molecular target to inhibit or limit tumour cell growth. In view of this, we have examined the effect of BCH and other inhibitors of system L on the growth of MCF-7, ZR-75-1 and MDA-MB-231 cells. Treating cells with BCH markedly inhibited the metabolism of WST-1 in a dose-dependent fashion. Similarly, melphalan and D-leucine inhibited the growth of cultured breast cancer cells whereas MeAIB, an inhibitor of system A, was without effect. The effects of BCH and melphalan on cell growth were non-additive suggesting that both compounds were acting at a single locus. The results indicate that system L is required to maintain MCF-7, ZR-75-1 and MDA-MB-231 cell growth and support the notion that LAT1/CD98hc may be a suitable target to inhibit breast cancer progression. PMID:18813831

  7. Clinical Report on the First Prototype of a Photoacoustic Tomography System with Dual Illumination for Breast Cancer Imaging.

    Directory of Open Access Journals (Sweden)

    Elham Fakhrejahani

    Full Text Available Photoacoustic tomography is a recently developed imaging modality that can provide high spatial-resolution images of hemoglobin distribution in tissues such as the breast. Because breast cancer is an angiogenesis-dependent type of malignancy, we evaluated the clinical acceptability of breast tissue images produced using our first prototype photoacoustic mammography (PAM system in patients with known cancer. Post-excisionally, histological sections of the tumors were stained immunohistochemically (IHC for CD31 (an endothelial marker and carbonic anhydrase IX (CAIX (a marker of hypoxia. Whole-slide scanning and image analyses were used to evaluate the tumor microvessel distribution pattern and to calculate the total vascular perimeter (TVP/area for each lesion. In this clinical study, 42 lesions were primarily scanned using PAM preoperatively, three of which were reported to be benign and were excluded from statistical analysis. Images were produced for 29 out of 39 cancers (visibility rate = 74.4% at the median depth of 26.5 (3.25-51.2 mm. Age, menopausal status, body mass index, history of neoadjuvant treatment, clinical stage and histological tumor angiogenesis markers did not seem to affect the visibility. The oxygen saturation level in all of the measured lesions was lower than in the subcutaneous counterpart vessels (Wilcoxon test, p value<0.001, as well as in the counterpart contralateral normal breast region of interest (ROI (Wilcoxon test, p value = 0.001. Although the oxygen saturation level was not statistically significant between CAIX-positive vs. -negative cases, lesional TVP/area showed a positive correlation with the oxygen saturation level only in the group that had received therapy before PAM. In conclusion, the vascular and oxygenation data obtained by PAM have great potential for identifying functional features of breast tumors.

  8. Effect of dietary supplementation with Agaricus sylvaticus fungus on the hematology and immunology systems of breast cancer patients undergoing chemotherapy

    OpenAIRE

    Valadares, Fabiana; Novaes, Maria Rita Carvalho Garbi; Roberto Cañete VILLAFRANCA; Marília da Cunha MENEZES; Mariana Campos REIS; Gonçalves, Daniella Rodrigues

    2011-01-01

    Objective: Patients with cancer tend to develop hematological and immunological alterations during the disease process. Medicinal fungi can stimulate the immune and hematopoietic systems, promoting improvements in the prognosis and physiological response. In this trial it is aimed to evaluate changes in hematological and immunological parameters in patients with breast cancer undergoing chemotherapy after dietary supplementation with Agaricus sylvaticus. Method: A randomized, double-blind, pl...

  9. Experimental measurement of radiation dose in a dedicated breast CT system

    CERN Document Server

    Shan-Wei, Shen; Hang, Shu; Xiao, Tang; Cun-Feng, Wei; Yu-Shou, Song; Rong-Jian, Shi; Long, Wei

    2013-01-01

    Radiation dose is an important performance indicator of a dedicated breast CT (DBCT). In this paper, the method of putting thermoluminescent dosimeters (TLD) into a breast shaped PMMA phantom to study the dose distribution in breasts was improved by using smaller TLDs and a new half-ellipsoid PMMA phantom. Then the weighted CT dose index (CTDIw) was introduced to average glandular assessment in DBCT for the first time and two measurement modes were proposed for different sizes of breasts. The dose deviations caused by using cylindrical phantoms were simulated using the Monte Carlo method and a set of correction factors were calculated. The results of the confirmatory measurement with a cylindrical phantom (11cm/8cm) show that CTDIw gives a relatively conservative overestimate of the average glandular dose comparing to the results of Monte Carlo simulation and TLDs measurement. But with better practicability and stability, the CTDIw is suitable for dose evaluations in daily clinical practice. Both of the TLDs ...

  10. Increased concentrations of growth factors and activation of the EGFR system in breast cancer

    DEFF Research Database (Denmark)

    Aalund Olsen, Dorte; Bechmann, Troels; Østergaard, Birthe;

    2012-01-01

    In this study the total and phosphorylated amount of epidermal growth factor receptor 1 (EGFR) and 2 (HER2) were measured together with EGFR ligands in tissue samples of breast cancer patients in order to investigate interrelations and possible prognostic values.......In this study the total and phosphorylated amount of epidermal growth factor receptor 1 (EGFR) and 2 (HER2) were measured together with EGFR ligands in tissue samples of breast cancer patients in order to investigate interrelations and possible prognostic values....

  11. Role of digital tomosynthesis and dual energy subtraction digital radiography in detection of parenchymal lesions in active pulmonary tuberculosis

    International Nuclear Information System (INIS)

    Highlights: • Digital tomosynthesis and dual energy subtraction digital radiography are modifications of digital radiography. • These modalities perform better than digital radiography in detection of parenchymal lesions in active pulmonary tuberculosis. • Digital tomosynthesis has a sensitivity of 100% in detection of cavities. • Centrilobular nodules seen on CT in active pulmonary tuberculosis, were also demonstrated on digital tomosynthesis in our study. • Digital tomosynthesis can be used for diagnosis and follow up of patients in pulmonary tuberculosis, thereby reducing the number of CT examinations. - Abstract: Objective: To assess the role of digital tomosynthesis (DTS) and dual energy subtraction digital radiography (DES-DR) in detection of parenchymal lesions in active pulmonary tuberculosis (TB) and to compare them with digital radiography (DR). Materials and methods: This prospective study was approved by our institutional review committee. DTS and DES-DR were performed in 62 patients with active pulmonary TB within one week of multidetector computed tomography (MDCT) study. Findings of active pulmonary TB, that is consolidation, cavitation and nodules were noted on digital radiography (DR), DTS and DES-DR in all patients. Sensitivity, specificity, positive and negative predictive values of all 3 modalities was calculated with MDCT as reference standard. In addition presence of centrilobular nodules was also noted on DTS. Results: Our study comprised of 62 patients (33 males, 29 females with age range 18–82 years). Sensitivity and specificity of DTS for detection of nodules and cavitation was better than DR and DES-DR. Sensitivity and specificity of DTS for detection of consolidation was comparable to DR and DES-DR. DES-DR performed better than DR in detection of nodules and cavitation. DTS was also able to detect centrilobular nodules with sensitivity and specificity of 57.4% and 86.5% respectively. Conclusion: DTS and DES-DR perform better

  12. Detection of pulmonary nodule growth with dose reduced chest tomosynthesis: a human observer study using simulated nodules

    Science.gov (United States)

    Söderman, Christina; Johnsson, Ã. se; Vikgren, Jenny; Rossi Norrlund, Rauni; Molnar, David; Mirzai, Maral; Svalkvist, Angelica; Mânsson, Lars Gunnar; Bâth, Magnus

    2016-03-01

    Chest tomosynthesis may be a suitable alternative to computed tomography for the clinical task of follow up of pulmonary nodules. The aim of the present study was to investigate the detection of pulmonary nodule growth suggestive of malignancy using chest tomosynthesis. Previous studies have indicated remained levels of detection of pulmonary nodules at dose levels corresponding to that of a conventional lateral radiograph, approximately 0.04 mSv, which motivated to perform the present study this dose level. Pairs of chest tomosynthesis image sets, where the image sets in each pair were acquired of the same patient at two separate occasions, were included in the study. Simulated nodules with original diameters of approximately 8 mm were inserted in the pairs of image sets, simulating situations where the nodule had remained stable in size or increased isotropically in size between the two different imaging occasions. Four different categories of nodule growth were included, corresponding to a volume increase of approximately 21 %, 68 %, 108 % and 250 %. All nodules were centered in the depth direction in the tomosynthesis images. All images were subjected to a simulated dose reduction, resulting in images corresponding to an effective dose of 0.04 mSv. Four observers were given the task of rating their confidence that the nodule was stable in size or not on a five-level rating scale. This was done both before any size measurements were made of the nodule as well as after measurements were performed. Using Receiver operating characteristic analysis, the rating data for the nodules that were stable in size was compared to the rating data for the nodules simulated to have increased in size. Statistically significant differences between the rating distributions for the stable nodules and all of the four nodule growth categories were found. For the three largest nodule growths, nearly perfect detection of nodule growth was seen. In conclusion, the present study

  13. Role of digital tomosynthesis and dual energy subtraction digital radiography in detection of parenchymal lesions in active pulmonary tuberculosis

    Energy Technology Data Exchange (ETDEWEB)

    Sharma, Madhurima, E-mail: madhurimashrm88@gmail.com [Department of Radiodiagnosis and Imaging, PGIMER, Chandigarh 160012 (India); Sandhu, Manavjit Singh, E-mail: manavjitsandhu@yahoo.com [Department of Radiodiagnosis and Imaging, PGIMER, Chandigarh 160012 (India); Gorsi, Ujjwal, E-mail: ujjwalgorsi@gmail.com [Department of Radiodiagnosis and Imaging, PGIMER, Chandigarh 160012 (India); Gupta, Dheeraj, E-mail: dheeraj1910@gmail.com [Department of Pulmonary Medicine, PGIMER, Chandigarh 160012 (India); Khandelwal, Niranjan, E-mail: khandelwaln@hotmail.com [Department of Radiodiagnosis and Imaging, PGIMER, Chandigarh 160012 (India)

    2015-09-15

    Highlights: • Digital tomosynthesis and dual energy subtraction digital radiography are modifications of digital radiography. • These modalities perform better than digital radiography in detection of parenchymal lesions in active pulmonary tuberculosis. • Digital tomosynthesis has a sensitivity of 100% in detection of cavities. • Centrilobular nodules seen on CT in active pulmonary tuberculosis, were also demonstrated on digital tomosynthesis in our study. • Digital tomosynthesis can be used for diagnosis and follow up of patients in pulmonary tuberculosis, thereby reducing the number of CT examinations. - Abstract: Objective: To assess the role of digital tomosynthesis (DTS) and dual energy subtraction digital radiography (DES-DR) in detection of parenchymal lesions in active pulmonary tuberculosis (TB) and to compare them with digital radiography (DR). Materials and methods: This prospective study was approved by our institutional review committee. DTS and DES-DR were performed in 62 patients with active pulmonary TB within one week of multidetector computed tomography (MDCT) study. Findings of active pulmonary TB, that is consolidation, cavitation and nodules were noted on digital radiography (DR), DTS and DES-DR in all patients. Sensitivity, specificity, positive and negative predictive values of all 3 modalities was calculated with MDCT as reference standard. In addition presence of centrilobular nodules was also noted on DTS. Results: Our study comprised of 62 patients (33 males, 29 females with age range 18–82 years). Sensitivity and specificity of DTS for detection of nodules and cavitation was better than DR and DES-DR. Sensitivity and specificity of DTS for detection of consolidation was comparable to DR and DES-DR. DES-DR performed better than DR in detection of nodules and cavitation. DTS was also able to detect centrilobular nodules with sensitivity and specificity of 57.4% and 86.5% respectively. Conclusion: DTS and DES-DR perform better

  14. Breast Cancer

    Science.gov (United States)

    ... I found something when I did my breast self-exam. What should I do now? How often should I have mammograms? I have breast cancer. What are my treatment options? How often should I do breast self-exams? I have breast cancer. Is my daughter ...

  15. Typetesting of physical characteristics of digital mammography systems for screening within the Flemish breast cancer screening programme

    International Nuclear Information System (INIS)

    To investigate compliance with the acceptance criteria of the European guidelines for quality assurance in breast cancer screening, a typetesting programme of the physical characteristics of digital mammography systems based on direct readout (DR) technology or computed radiography (CR) was organised and executed within the Flemish breast cancer screening programme. While in general image quality/dose characteristics of flat panel DR systems passed the acceptance criteria more easily than CR systems, the slit-scanning direct photon counting system included in present study was outstanding in combining a very low dose with a good image quality. The data obtained up to now indicate the necessity of retuning the AEC for DR systems according to constant contrast to noise ratio (CNR) over the whole range of PMMA thicknesses (20-70 mm) to improve image quality in imaging breasts of large thickness at the cost of higher doses. For the two CR systems which passed the typetesting procedure dose levels do not allow a similar improvement of CNR for thick objects for these systems. The obtained results highlight the importance of the use of high Z target/filter combinations in X-ray generating systems for imaging thick objects to meet the image quality/dose criteria. With respect to image display aspects high-quality 3-megapixel LCD monitors succeeded also in the typetesting procedure in addition to 5-megapixel monitors. However, as zooming and scrolling are necessary for 3-megapixel monitors to get the full resolution capabilities of the image capture system, 5-megapixel monitors are preferred in a busy screening environment.

  16. Real-time optoacoustic imaging of breast cancer using an interleaved two laser imaging system coregistered with ultrasound

    Science.gov (United States)

    Ermilov, Sergey A.; Fronheiser, Matthew P.; Nadvoretsky, Vyacheslav; Brecht, Hans-Peter; Su, Richard; Conjusteau, André; Mehta, Ketan; Otto, Pamela; Oraevsky, Alexander A.

    2010-02-01

    We present results from a clinical case study on imaging breast cancer using a real-time interleaved two laser optoacoustic imaging system co-registered with ultrasound. The present version of Laser Optoacoustic Ultrasonic Imaging System (LOUIS) utilizes a commercial linear ultrasonic transducer array, which has been modified to include two parallel rectangular optical bundles, to operate in both ultrasonic (US) and optoacoustic (OA) modes. In OA mode, the images from two optical wavelengths (755 nm and 1064 nm) that provide opposite contrasts for optical absorption of oxygenated vs deoxygenated blood can be displayed simultaneously at a maximum rate of 20 Hz. The real-time aspect of the system permits probe manipulations that can assist in the detection of the lesion. The results show the ability of LOUIS to co-register regions of high absorption seen in OA images with US images collected at the same location with the dual modality probe. The dual wavelength results demonstrate that LOUIS can potentially provide breast cancer diagnostics based on different intensities of OA images of the lesion obtained at 755 nm and 1064 nm. We also present new data processing based on deconvolution of the LOUIS impulse response that helps recover original optoacoustic pressure profiles. Finally, we demonstrate the image analysis tool that provides automatic detection of the tumor boundary and quantitative metrics of the optoacoustic image quality. Using a blood vessel phantom submerged in a tissue-like milky background solution we show that the image contrast is minimally affected by the phantom distance from the LOUIS probe until about 60-65 mm. We suggest using the image contrast for quantitative assessment of an OA image of a breast lesion, as a part of the breast cancer diagnostics procedure.

  17. Late treatment-related morbidity in breast cancer patients randomized to postmastectomy radiotherapy and systemic treatment versus systemic treatment alone

    Energy Technology Data Exchange (ETDEWEB)

    Hoejris, I.; Andersen, J.; Overgaard, M.; Overgaard, J. [Aarhus Univ. Hospital (Denmark). Dept. of Oncology

    2000-07-01

    Late treatment-related morbidity after mastectomy and adjuvant systemic treatment with and without postoperative irradiation was assessed in 84 patients randomized in the Danish Breast Cancer Cooperative Group Trials 82b and c. A structured interview and physical examinatio