Contrast enhanced digital breast tomosynthesis

Breast cancer is the most common forms of cancer and a leading cause of mortality in women. Early and correct diagnosis is, therefore, essential to save lives. The development of diagnostic imaging applied to the breast has been impressive in recent years and the most used diagnostic test in the world is mammography, a low-dose X-ray technique used for imaging the breast. In the first half of the 20th century, the diagnosis was in practice only clinical, with consequent diagnostic delay and an unfavorable prognosis in the short term...

OBJECTIVE: To evaluate the cost effectiveness of supplemental breast imaging modalities for women with heterogeneously and extremely dense breasts and average or intermediate risk of breast cancer (BC) in the USA, and analyze capacity requirements for supplemental magnetic resonance imaging (MRI) and contrast-enhanced mammography (CEM). METHODS: Clinical and economic outcomes for supplemental imaging modalities including full- and abbreviated-protocol MRI (Fp-MRI, Ab-MRI), CEM, and ultrasound (U/S) as add-on to x-ray mammography (XM) or digital breast tomosynthesis (DBT), were compared to XM or DBT alone, in a decision tree linked to a Markov chain validated by comparison with a microsimulation analysis...

Breast cancer screening performance of supplemental imaging modalities by breast density and breast cancer risk has not been widely studied, and the optimal choice of modality for women with dense breasts remains unclear in clinical practice and guidelines. This systematic review aimed to assess breast cancer screening performance of supplemental imaging modalities for women with dense breasts, by breast cancer risk. Systematic reviews (SRs) in 2000 to 2021, and primary studies in 2019 to 2021, on outcomes of supplemental screening modalities (digital breast tomography [DBT], MRI (full/abbreviated protocol), contrast enhanced mammography (CEM), ultrasound (hand-held [HHUS]/automated [ABUS]) in women with dense breasts (BI-RADS C&D) were identified...

This study aims to evaluate the Average Glandular Dose (AGD) and diagnostic performance of CEM versus Digital Mammography (DM) as well as versus DM plus one-view Digital Breast Tomosynthesis (DBT), which were performed in the same patients at short intervals of time. A preventive screening examination in high-risk asymptomatic patients between 2020 and 2022 was performed with two-view Digital Mammography (DM) projections (Cranio Caudal and Medio Lateral) plus one Digital Breast Tomosynthesis (DBT) projection (mediolateral oblique, MLO) in a single session examination...

PURPOSE: Scatter radiation in contrast-enhanced digital breast tomosynthesis (CEDBT) reduces the image quality and iodinated lesion contrast. Monte Carlo simulation can provide accurate scatter estimation at the cost of computational burden. A model-based convolutional method trades off accuracy for processing speed. The purpose of this study is to develop a fast and robust deep-learning (DL) convolutional neural network (CNN)-based scatter correction method for CEDBT. APPROACH: Projection images and scatter maps of digital anthropomorphic breast phantoms were generated using Monte Carlo simulations...

PURPOSE: Differentiating between benign and malignant masses is one of the biggest challenges in breast imaging. The challenge is ingrained in the similarity of the attenuation coefficients between different types of lesion tissues and fibroglandular tissues. Contrast-enhanced imaging techniques can take advantage of the differing metabolism in different tissues, therefore, potentially allowing better differentiation of malignant and benign lesions. To facilitate the development and optimization of such technologies, we propose a fully digital 4D phantom that features time-varying enhancement patterns for different tissue types...

Our objective is to report a new breast phantom that provides the objective assessment for three types of clinical mammography, i.e. digital mammography (DM), contrast-enhanced digital mammography (CEDM), and digital breast tomosynthesis (DBT). The tissue-equivalent materials are used to represent the corresponding tissue, and the layer-by-layer structure with separate regions is designed for image quality assessment of different mammography modes. For DM imaging, substitutes for microcalcifications and fibroglandular tissue of different sizes are used to simulate the conventional breast...

Pectoralis major muscle sarcomas are extremely rare and can mimic breast lesion clinically. We report a case of poorly differentiated sarcoma of the pectoralis major muscle in a 63-year-old woman of south east Asian ethnicity presenting with a progressively increasing right breast lump. Mammography, ultrasonography (US), contrast-enhanced computed tomography, and biopsy were done to make the final diagnosis. Complete surgical excision was planned but deferred due to pulmonary metastasis, and the patient was treated with palliative chemotherapy...

PURPOSE: This study aims to investigate values of intra- and peri-tumoral regions in the mammography and magnetic resonance imaging (MRI) image for prediction of sentinel lymph node metastasis (SLNM) in invasive breast cancer (BC). METHODS: This study included 208 patients with invasive BC between Spe. 2017 and Apr. 2021. All patients underwent preoperative digital mammography (DM), digital breast tomosynthesis (DBT), dynamic contrast-enhanced MRI (DCE-MRI) and diffusion-weighted MRI (DWI) scans...

PURPOSE: Full-field digital mammography (FFDM) is widely used in breast cancer screening. However, to improve cancer detection rates, new diagnostic tools have been introduced. Contrast enhanced mammography (CEM) and digital breast tomosynthesis (DBT) are used in the diagnostic setting, however their accuracies need to be compared.The aim of the study was to evaluate the diagnostic performance of CEM and DBT in women recalled from breast cancer screening program. METHODS: The study included 402 consecutive patients recalled from breast cancer screening program, who were randomized into two groups, to undergo either CEM (202 patients) or DBT (200 patients)...

The ultimate goals of the application of artificial intelligence (AI) to digital breast tomosynthesis (DBT) are the reduction of reading times, the increase of diagnostic performance, and the reduction of interval cancer rates. In this review, after outlining the journey from computer-aided detection/diagnosis systems to AI applied to digital mammography (DM), we summarize the results of studies where AI was applied to DBT, noting that long-term advantages of DBT screening and its crucial ability to decrease the interval cancer rate are still under scrutiny...

This study compares the mean glandular dose (MGD) across 2D, 3D projection and Contrast-Enhanced Digital Mammography (CEDM) mammographic techniques. The important metadata were extracted from the digital mammography console. 650 subjects were clustered based on projections, age and CBT. The MGD of 2D, 3D, and CEDM was positively correlated with CBT but inversely correlated with the age factor. This study indicate MGD of CEDM was 16% and 22% lower compared to 2D and 3D techniques, respectively.

Dedicated breast computed tomography (BCT) is an emerging breast imaging modality. The latest development has been the introduction of a spiral breast computed tomography scanner equipped with a photon-counting detector (SBCT). SBCT promises multiple advantages: Unlike conventional mammography, contrast enhanced spectral mammography (CESM: both 2D), and digital breast tomosynthesis (DBT: pseudo 3D), SBCT enables 3D breast imaging without tissue overlap. SBCT achieves high isotropic spatial resolution of breast tissue enabling the assessment of both soft tissue and microcalcifications...

Since four decades mammography is used for early breast cancer detection in asymptomatic women and still remains the gold standard imaging modality. However, population screening programs can be personalized and women can be divided into different groups based on risk factors and personal preferences. The availability of new and evolving imaging modalities, for example, digital breast tomosynthesis, dynamic-contrast-enhanced magnetic resonance imaging (MRI), abbreviated MRI protocols, diffusion-weighted MRI, and contrast-enhanced mammography leads to new challenges and perspectives regarding the feasibility and potential harms of breast cancer screening...

BACKGROUND: Diagnostic performance based on X-ray breast imaging is subject to breast density. Although digital breast tomosynthesis (DBT) is reported to outperform conventional mammography in denser breasts, mass detection and malignancy characterization are often considered challenging yet. PURPOSE: As an improved diagnostic solution to the dense breast cases, we propose a dual-energy DBT imaging technique that enables breast compositional imaging at comparable scanning time and patient dose compared to the conventional single-energy DBT...

Microcalcification clusters (MCs) are among the most important biomarkers for breast cancer, especially in cases of nonpalpable lesions. The vast majority of deep learning studies on digital breast tomosynthesis (DBT) are focused on detecting and classifying lesions, especially soft-tissue lesions, in small regions of interest previously selected. Only about 25% of the studies are specific to MCs, and all of them are based on the classification of small preselected regions. Classifying the whole image according to the presence or absence of MCs is a difficult task due to the size of MCs and all the information present in an entire image...

Currently, there is a multitude of methods for evaluating the costs and benefits of programs, tools, etc. While cost-benefit analysis (CBA) is commonly used, cost-effectiveness analysis (CEA) is a more appropriate method of evaluation in clinical contexts, such as radiology practices, as CEAs use units such as life years gained as opposed to money (as is the case for CBAs). This review examines CEAs performed within the past 15 years to highlight their applications and key findings in the context of medical imaging...

In X-ray breast imaging, Digital Mammography (DM) and Digital Breast Tomosynthesis (DBT), are the standard and largely used techniques, both for diagnostic and screening purposes. Other techniques, such as dedicated Breast Computed Tomography (BCT) and Contrast Enhanced Mammography (CEM) have been developed as an alternative or a complementary technique to the established ones. The performance of these imaging techniques is being continuously assessed to improve the image quality and to reduce the radiation dose...

Breast cancer, which is the most common cancer in women, is a major problem both in Poland and worldwide. Mammography remains the primary screening method. However, the sensitivity of mammographic screening is lower in women with dense glandular breasts due to tissue overlap and the effect of the glandular tissue obscuring the tumor and the fact that tumors and glandular tissue show similar X-ray absorption. Consequently, other methods are being sought to increase breast cancer detection rates. Currently, the most common and used methods are ultrasonography, magnetic resonance imaging and advanced mammographic methods (digital breast tomosynthesis and contrast-enhanced spectral mammography)...

PURPOSE: To systematically review studies on the effectiveness of supplementary imaging for breast cancer screening in women with dense breasts. MATERIALS AND METHODS: A systematic search of peer-reviewed publications in English (January 2000 to March 2021) was carried out. Eight databases were used to retrieve the studies: MEDLINE, CINAHL, Cochrane Central Register of Controlled Trials, Cochrane Clinical Answers, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, PubMed, and Web of Science...