Spectral mammography

RATIONALE AND OBJECTIVES: To develop and validate a nomogram that combines contrast-enhanced spectral mammography (CESM) deep learning with clinical-pathological features to predict neoadjuvant chemotherapy (NAC) response (either low Miller Payne (MP-L) grades 1-2 or high MP (MP-H) grades 3-5) in patients with ER-positive/HER2-negative breast cancer. MATERIALS AND METHODS: In this retrospective study, 265 breast cancer patients were randomly allocated into training and test sets (used for models training and testing, respectively) at a 4:1 ratio...

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Mammography is an effective method for diagnosing breast diseases, and computer-aided detection (CAD) systems play an important role in the detection of breast masses. However, low contrast and the interference of surrounding tissues make the detection of masses challenging. In this paper, an efficient RetinaNet network named ERetinaNet is proposed to improve the accuracy and inference speed of mammographic breast mass detection. Efficient modules are designed and introduced into the network to facilitate the extraction of comprehensive features, while the structure of the network is simplified to improve the inference speed...

Contrast-enhanced mammography (CEM) is an emerging breast imaging technology with promise for breast cancer screening, diagnosis, and procedural guidance. However, best uses of CEM in comparison with other breast imaging modalities such as tomosynthesis, ultrasound, and MRI remain inconclusive in many clinical settings. This review article summarizes recent peer-reviewed literature, emphasizing retrospective reviews, prospective clinical trials, and meta-analyses published from 2020 to 2023. The intent of this article is to supplement prior comprehensive reviews and summarize the current state-of-the-art of CEM...

Locally advanced breast cancer (LABC) is a severe type of cancer with a poor prognosis, despite advancements in therapy. As the disease is often inoperable, current guidelines suggest upfront aggressive neoadjuvant chemotherapy (NAC). Complete pathological response to chemotherapy is linked to improved survival, but conventional clinical assessments like physical exams, mammography, and imaging are limited in detecting early response. Early detection of tissue response can improve complete pathological response and patient survival while reducing exposure to ineffective and potentially harmful treatments...

OBJECTIVES: To describe the feasibility and evaluate the performance of multiphasic photon-counting detector (PCD) CT for detecting breast cancer and nodal metastases with correlative dynamic breast MRI and digital mammography as the reference standard. METHODS: Adult females with biopsy-proven breast cancer undergoing staging breast MRI were prospectively recruited to undergo a multiphasic PCD-CT using a 3-phase protocol: a non-contrast ultra-high-resolution (UHR) scan and 2 intravenous contrast-enhanced scans with 50 and 180 s delay...

BACKGROUND The aim of this study was to evaluate the efficacy of contrast-enhanced spectral mammography (CESM) and digital breast tomosynthesis (DBT) in the diagnosis and chemotherapy of breast cancer. MATERIAL AND METHODS We retrospectively analyzed data on 125 lesions of 115 patients with breast diseases in Lanzhou First People's Hospital from January 2020 to June 2022. Patients were examined by digital breast tomographic fusion and contrast-enhanced spectral mammography after chemotherapy. We compared the diagnostic accuracy of the 2 imaging techniques, and the diagnostic efficacy was evaluated with ROC curves...

PURPOSE: Anatomical "noise" is an important limitation of full-field digital mammography. Understanding its impact on clinical judgments is made difficult by the complexity of breast parenchyma, which results in image texture not fully captured by the power spectrum. While the number of possible parameters for characterizing anatomical noise is quite large, a specific set of local texture statistics has been shown to be visually salient, and human sensitivity to these statistics corresponds to their informativeness in natural scenes...

BACKGROUND: Contrast-enhanced spectral mammography (CESM) with photon-counting x-ray detectors (PCDs) can be used to improve the classification of breast cancers as benign or malignant. Commercially-available PCD-based mammography systems use silicon-based PCDs. Cadmium-telluride (CdTe) PCDs may provide a practical advantage over silicon-based PCDs because they can be implemented as large-area detectors that are more easily adaptable to existing mammography systems. PURPOSE: The purpose of this work is to optimize CESM implemented with CdTe PCDs and to investigate the influence of the number of energy bins, electronic noise level, pixel size, and anode material on image quality...

OBJECTIVES: Image monitoring is essential to monitor response to neoadjuvant chemotherapy (NACT). Whilst breast MRI is the gold-standard technique, evidence suggests contrast-enhanced spectral mammography (CESM) is comparable. We investigate whether the addition of digital breast tomosynthesis (DBT) to CESM increases the accuracy of response prediction. METHODS: Women receiving NACT for breast cancer were included. Imaging with CESM+DBT and MRI was performed post-NACT...

OBJECTIVE: To investigate the correlation between the risk of breast cancer for high-risk females and the density and background parenchymal enhancement (BPE) on contrast-enhanced spectral mammography (CESM). METHODS: Females at high-risk, without breast cancer history and received CESM from July 2016 to December 2017 were retrospectively enrolled. The longest follow-up time was 4.5 years, and patients who developed breast cancer with maximized follow-up time were classified as cancer cohort, while females who did not develop breast cancer were categorized as control cohort...

PURPOSE: To compare contrast-enhanced spectral mammography (CESM) with mammography (Mx), ultrasound (US), and magnetic resonance imaging (MRI) regarding breast cancer detection rate and preoperative local staging. MATERIAL AND METHODS: This prospective observational, single-centre study included 128 female patients (mean age 55.8 ± 11.5 years) with a newly diagnosed malignant breast tumour during routine US and Mx were prospectively enrolled...

BACKGROUND: Neoadjuvant chemotherapy (NAC) has been regarded as one of the standard treatments for patients with locally advanced breast cancer. No previous study has investigated the feasibility of using a contrast-enhanced spectral mammography (CESM)-based radiomics nomogram to predict pathological complete response (pCR) after NAC. OBJECTIVE: To develop and validate a CESM-based radiomics nomogram to predict pCR after NAC in breast cancer. METHODS: A total of 118 patients were enrolled, which are divided into a training dataset including 82 patients (with 21 pCR and 61 non-pCR) and a testing dataset of 36 patients (with 9 pCR and 27 non-pCR)...

PURPOSE: Most photon-counting detectors (PCDs) being developed use cadmium telluride (CdTe), which has nonoptimal characteristic x-ray emission with energies in the range used for breast imaging. New PCD using a gallium arsenide (GaAs) has been developed. Since GaAs has characteristic x-rays lower in energy than those of CdTe, it is hypothesized that this new PCD might be beneficial for spectral x-ray breast imaging. APPROACH: We performed simulations using realistic mammography x-ray spectra with both CdTe and GaAs PCDs...

OBJECTIVE: To construct and test a nomogram based on intra- and peritumoral radiomics and clinical factors for predicting malignant BiRADS 4 lesions on contrast-enhanced spectral mammography. METHODS: A total of 884 patients with BiRADS 4 lesions were enrolled from two centers. For each lesion, five ROIs were defined using the intratumoral region (ITR), peritumoral regions (PTRs) of 5 and 10 mm around the tumor, and ITR plus PTRs of 5 mm and 10 mm...

PURPOSE: To investigate the diagnostic efficiency of the kinetic curves of enhanced lesions on contrast-en-hanced spectral mammography (CESM) and whether they were similar to those of magnetic resonance imaging (MRI). METHODS: Two hundred and twelve patients with 222 enhanced lesions were included in this prospective study. Single-view craniocaudal of an affected breast was acquired at 3, 5, and 7 min after contrast media injection. The kinetic patterns of each lesion were evaluated and classified as elevated (type I), steady (type II), and depressed (type III)...

Objective: This article investigates the effect of varying breast tumor size on the fluence rate distribution within a breast model during the diffuse optical imaging procedure. Background: Early detection of breast cancer is of significant importance owing to its wide spread among women worldwide. Mastectomy surgery became very common due to the late detection of breast cancers by the conventional diagnostic methods such as X-ray mammography and magnetic resonance imaging. On the contrary, optical imaging techniques provide a safe and more sensitive methodology, which is suitable for the early detection criteria...

The aim of this study was to evaluate the diagnostic performance of contrast-enhanced spectral mammography (CESM) in predicting breast lesion malignancy due to microcalcifications compared to lesions that present with other radiological findings. Three hundred and twenty-one patients with 377 breast lesions that underwent CESM and histological assessment were included. All the lesions were scored using a 4-point qualitative scale according to the degree of contrast enhancement at the CESM examination. The histological results were considered the gold standard...

AIM: To assess the cost impact of switching from contrast-enhanced magnetic resonance imaging (CE-MRI) to contrast-enhanced spectral mammography (CESM) for loco-regional staging of breast cancer from a public healthcare perspective. MATERIALS AND METHODS: The CE-MRI cost was obtained from the NHS reference cost. The CESM cost was calculated using a bottom-up approach including use of the machine, pump injector, contrast medium, image storage, and time allocation for staff reporting and cannulation...

This paper proposes a robust longitudinal registration method for Contrast Enhanced Spectral Mammography in monitoring neoadjuvant chemotherapy. Because breast texture intensity changes with the treatment, a non-rigid registration procedure with local intensity compensations is developed. The approach allows registering the low energy images of the exams acquired before and after the chemotherapy. The measured motion is then applied to the corresponding recombined images. The difference of registered images, called residual, makes vanishing the breast texture that did not changed between the two exams...