More sensitive imaging system for detecting breast cancer
12 December 2005
Duke University Medical Centre and Siemens Medical Solutions are
collaborating to develop a digital breast tomosynthesis (tomo) system that
could detect mass lesions often undetectable by conventional mammography.
The new system is based on Siemens’ Mammomat NovationDR full-field
digital mammography system. A prototype was presented at the recent
Radiological Society of North America (RSNA) congress in Chicago.
The new prototype employs a Mammomat NovationDR system that has been
modified with a motorised X-ray tube to acquire image projections of the
breast from many different angles, as well as a digital detector for
increased speed and quality image capture. Preliminary results conducted at
Duke University with several mastectomy and patient cases suggest that the
new tomo system is able to detect subtle mass lesions otherwise difficult to
pick up with standard mammography. When fully developed, this new solution
is expected to further enhance diagnostic ability by improving sensitivity
of breast cancer detection and more importantly, increase workflow by
reducing false positives/misdiagnosis and unnecessary biopsies.
Holger Schmidt, President, Special Systems Division, Siemens Medical
Solutions, said: “Through a dedicated team of researchers at both Duke
University and Siemens, we have developed a breast tomosynthesis system. We
hope it will be a major step in diagnosis that will revolutionise the way
breast cancer is treated.”
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Preliminary results conducted at Duke University with
several mastectomy and patient cases suggest that the prototype
digital breast tomosynthesis system is able to detect subtle mass
lesions otherwise difficult to pick up with standard mammography. |
“Breast tomosynthesis may be one of the first techniques that can
actually replace conventional 2D mammography,” said Joseph Lo, Ph.D.,
Assistant Research Professor of Radiology, Duke Advanced Imaging
Laboratories, Duke University Medical Centre. “While mammography is
sensitive at finding cancer, it sometimes results in false positives —
leading to workflow issues for the clinician and unnecessary strain on the
patient. The goal of our studies is to reduce these false positives by
providing 3D information at the same high resolution and reasonable dose as
mammography, while also improving patient comfort.”
Featuring a large field-of-view enabled by a large area detector, the
prototype system is designed to be suitable for nearly all breast sizes. It
has the potential to provide high sensitivity and specificity that could
allow radiologists to detect and characterise suspicious lesions more
precisely. With low-dose 3D mammography it may eliminate normal tissue
overlap, which might otherwise obscure lesions. Additionally, enhanced
visibility to view masses may be made possible with high contrast
resolution.
"If digital breast tomosynthesis fulfills its promise of providing the
unusual combination of greater sensitivity coupled with greater specificity
and improved patient comfort, it may rapidly replace routine 2D mammography
in the screening setting,” said Jay Baker, M.D., Division of Breast Imaging,
Department of Radiology, Duke University Medical Centre. “While careful
clinical trials are required to confirm the potential advantages of
tomosynthesis, initial testing has been encouraging and tomosynthesis images
have demonstrated extraordinary anatomic clarity."
Ongoing studies are underway in an effort to improve upon the existing
prototype and to optimise radiographic techniques to produce superb image
quality with reduced dose. Researchers are also exploring a new
acquisition-and-viewing workstation based on Siemens’ syngo platform with
the intent to enhance image processing and workflow. Preliminary clinical
trials are planned to begin in the coming months.
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