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Digital Tomosynthesis:: Advanced Breast Cancer Imaging Technique

Digital tomosynthesis is an imaging technique that reconstructs 3D images from multiple 2D X-ray scans taken at different angles. It has advantages over conventional mammography such as increased comfort for patients, lower radiation dosage, and better imaging of dense breast tissue. While approved in the EU, it has not yet received FDA approval in the US but is being studied as a potential replacement for mammography.

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83 views22 pages

Digital Tomosynthesis:: Advanced Breast Cancer Imaging Technique

Digital tomosynthesis is an imaging technique that reconstructs 3D images from multiple 2D X-ray scans taken at different angles. It has advantages over conventional mammography such as increased comfort for patients, lower radiation dosage, and better imaging of dense breast tissue. While approved in the EU, it has not yet received FDA approval in the US but is being studied as a potential replacement for mammography.

Uploaded by

Sanda Gherasim
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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Digital Tomosynthesis:

Advanced Breast Cancer 


Imaging Technique

Max Wiedmann
Digital Tomosynthesis
•  An imaging technique in which
multiple X-rays of one object
are take from a discrete number
angles.
•  These cross-sectional images
are used to reconstruct 3-D
images of the object being
scanned.
•  Tomosynthesis differs from
computed tomography because
the range of angles used is less
than 360˚, which is used in CT.
Breast Cancer
•  The leading Cause of
death for women ages
40-55.
•  Is only behind lung and
bronchus cancer in terms
of number of deaths in
US.
•  Early detection of breast
cancer is believed to save
thousands of lives
Mammography
•  A method for detecting growths
in breasts using a dedicated
machine.
•  Achieved by compressing the
breast tissue to both spread it
out and reduce motion blur,
followed by X-ray exposure.
•  X-rays will be absorbed to
different degrees with different
tissue.
•  Bone absorbs the most while
soft tissue allows the rays to
pass through.
Mammography part 2
•  X-rays are produced using
Bremsstrahlung, a process in
which electrons are accelerated
against an anode, causing
photons to be fired off across a
continuous spectrum.
•  The rays that pass through the
tissue cause photographic film
to expose creating an image.
•  A newer process, called full
field digital mammography uses
digital receptors.
Full Field Digital Mammography
•  The use of a reusable digital flat
panel to detect incoming X-
rays.
•  The energy from incoming
photons is converted to a
voltage then run through an
ADC and processed.
•  An image is generated in
seconds.
•  Digital imaging appeared later
in mammography than most of
radiology due to the high
contrast and resolution
requirement for mammograms.
Kieran Maher, 2000
Problems with Mammograms
•  Mammograms require the breast tissue to be compressed
between two plates of glass.
•  Many women dislike the feeling, which reduces the
likeliness of getting tested often.
•  Compression causes overlapping in the breast tissue, which
can obscure imaging.
•  Mammograms typically only take 2 images at orthogonal
axes.
•  Mammograms produce false positives and false negatives.
Of all biopsies taken from breasts that tested positive, only
20% came back with cancer.
Advantages of DTS
•  Minimal pressure is needed, just enough to hold
the breast in place.
•  A lower dose of radiation is required, up to 50%
reduction for dense breasts.
•  The cost of DTS is expected to drop below the
cost a of traditional mammogram.
•  It is the only procedure that is expected to fully
replace mammography.
Required Dose vs. Breast Thickness for varying anode materials

Anode Material

Molybdenum/Rhodium

Molybdenum

Tungsten/Rhodium
Mathematics Behind DTS
•  Filtered back projection is used
to reconstruct 3D structures
from 2D images.
•  This is a form of an inverse
Radon Transformation.
•  A radon transformation is an
integral of some function all
lines passing though the object
of interest.
•  Here, in the two dimensional
we could integrate over all lines
parameterized in the following
way: (x(t),y(t)) = t(sin a, -cos
a) + s(cos a, sin a)
•  The resulting Radon transform
would be:
Application of Math
•  What’s been done here is an integral of all line
integrals in the space this object is in.
•  In practice, there is no actual integral, rather, the
function is the exponential attenuation caused by
the X-rays penetrating the tissue.
•  Now, given the functions, we want to put it back
together, using an inverse Radon transformation.
•  However, the inverse Radon transformation is
very unstable when dealing with noisy data so an
alternative is used: filtered back projection.
Left Mediolateral Oblique,
Mammogram
Same Left Mediolateral Oblique,
DTS
Mammomat Inspiration
•  The Mammomat is a
prototype developed by
Siemens.
•  Comes with complete
setup (X-ray machine and
computer)
•  Fast, improves workflow.
•  Can be combined with
computer aided diagnosis
(CAD),
•  Upgradeable
•  User friendly.
Technical Specifications:
X-Ray Generator
•  Power output - 5kW
•  kV Range - 23kV-
35kV
•  Exposure Time:
10 ms to 4 s (large
focus)
60 ms to 6 s (small
focus)
Source: MAMMOMAT Inspiration - Technical Specifications, Siemens
Technical Specifications:
Flat Detector
•  Solid-state detector of
amorphous selenium.
•  Dimensions: 24 cm x
30 cm (9.5'' x 12'')
•  Pixel Size: 85 µm
•  Image matrix :2816 x
3584 (24 cm x 30 cm)
2016 x 2816 (18 cm x
24 cm)

Source: MAMMOMAT Inspiration - Technical Specifications, Siemens


Approval Status
The Mammomat
Inspiration has been
approved in the EU
but not in the US by
the FDA.
Prototype work is
being conducted in
both the EU and the
US.
Summary
•  Digital tomosynthesis is a process used to
reconstruct 3-D images of from 2-D scans.
•  Advantages of DTS include comfort, speed,
and lower radiation dosage.
•  It may eventually replace conventional
mammography as it become less expensive.
•  Currently, it is only approved in the EU.
Sources
•  Breastcancer.org
http://www.breastcancer.org/symptoms/testing/types/
dig_tomosynth.jsp
•  Joseph Y. Lo, Ph.D. research pages
http://deckard.mc.duke.edu/~jyl/bme.html
•  MAMMOMAT Inspiration - Technical Specifications, Siemens
http://www.medical.siemens.com/
•  Duke Advanced Imaging Laboratory
•  http://dailabs.duhs.duke.edu/research.html
•  Kieran Maher Flat X-Ray Panel Receptors
•  http://homepage.mac.com/kieranmaher/digrad/DRPapers/FlatPanel/
index.html
Questions

•  1) What are the •  2) Tomosynthesis involves


advantages of Digital which of the following:
Tomosynthesis vs.
conventional •  A. Application of
Mamography electrodes to the skin
•  A. Comfort •  B. Radio waves
•  B. Lower radiation dose •  C. Images taken at
•  C. Better for dense breast multiple angles
tissue •  D. Consuming chemicals
•  D. All of the above to show up on images
•  E. None of the above •  E. None of the Above

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