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Fajardo LL, Hillis SL, Zheng B, Wong MD, Ghani MU, Omoumi FH, Li Y, Jenkins P, Peterson ME, Wu X, Liu H. A Pilot Study to Assess the Performance of Phase-Sensitive Breast Tomosynthesis. Radiology 2023; 306:e213198. [PMID: 36165790 PMCID: PMC9885338 DOI: 10.1148/radiol.213198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 07/22/2022] [Accepted: 08/09/2022] [Indexed: 01/26/2023]
Abstract
Background A new modality, phase-sensitive breast tomosynthesis (PBT), may have similar diagnostic performance to conventional breast tomosynthesis but with a reduced radiation dose. Purpose To perform a pilot study of the performance of a novel PBT system compared with conventional digital breast tomosynthesis (DBT) in patients undergoing additional diagnostic imaging workup for breast lesions. Materials and Methods In a prospective study from June 2020 to March 2021, participants with suspicious breast lesions detected at screening DBT or MRI were recruited for additional PBT imaging before additional diagnostic workup or biopsy. In this pilot study, nine radiologists independently evaluated image quality and assessed the likelihood of lesion malignancy by retrospectively evaluating DBT and PBT images in two separate reading sessions. Image quality was rated subjectively using a Likert scale from 1 to 5. Areas under the receiver operating characteristic curve (AUCs) were used to compare the lesion classification (malignant vs benign) performance of the radiologists. Results Images in 50 patients (mean age, 56 years ± 12 [SD]; 49 women) with 52 evaluable lesions (28 malignant) were assessed. For image appearance and general feature visibility, DBT images had a higher total mean image quality score (3.8) than PBT images (2.9), with P < .002 for each comparison. For classification of lesions as benign or malignant, the AUCs were 0.74 for both PBT and DBT. PBT images were acquired at a 24% mean radiation dose reduction (mean, 1.78 mGy vs 2.34 mGy for DBT; P < .001). Conclusion The phase-sensitive breast tomosynthesis system had a 24% lower mean radiation dose compared with digital breast tomosynthesis, although with lower image quality. Diagnostic performance of the system remains to be determined in larger studies. © RSNA, 2022 Online supplemental material is available for this article. See also the editorial by Gao and Moy in this issue.
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Affiliation(s)
- Laurie L. Fajardo
- From the Department of Radiology and Imaging Sciences, University of
Utah, Salt Lake City, Utah (L.L.F., P.J., M.E.P.); Departments of Radiology and
Biostatistics, University of Iowa, Iowa City, Iowa (S.L.H.); Advanced Medical
Imaging Center and School of Electrical and Computer Engineering, University of
Oklahoma, Norman, OK 73019 (B.Z., M.D.W., M.U.G., F.H.O., Y.L., H.L.); and
Department of Radiology, University of Alabama at Birmingham, Birmingham, Ala
(X.W.)
| | - Stephen L. Hillis
- From the Department of Radiology and Imaging Sciences, University of
Utah, Salt Lake City, Utah (L.L.F., P.J., M.E.P.); Departments of Radiology and
Biostatistics, University of Iowa, Iowa City, Iowa (S.L.H.); Advanced Medical
Imaging Center and School of Electrical and Computer Engineering, University of
Oklahoma, Norman, OK 73019 (B.Z., M.D.W., M.U.G., F.H.O., Y.L., H.L.); and
Department of Radiology, University of Alabama at Birmingham, Birmingham, Ala
(X.W.)
| | - Bin Zheng
- From the Department of Radiology and Imaging Sciences, University of
Utah, Salt Lake City, Utah (L.L.F., P.J., M.E.P.); Departments of Radiology and
Biostatistics, University of Iowa, Iowa City, Iowa (S.L.H.); Advanced Medical
Imaging Center and School of Electrical and Computer Engineering, University of
Oklahoma, Norman, OK 73019 (B.Z., M.D.W., M.U.G., F.H.O., Y.L., H.L.); and
Department of Radiology, University of Alabama at Birmingham, Birmingham, Ala
(X.W.)
| | - Molly Donovan Wong
- From the Department of Radiology and Imaging Sciences, University of
Utah, Salt Lake City, Utah (L.L.F., P.J., M.E.P.); Departments of Radiology and
Biostatistics, University of Iowa, Iowa City, Iowa (S.L.H.); Advanced Medical
Imaging Center and School of Electrical and Computer Engineering, University of
Oklahoma, Norman, OK 73019 (B.Z., M.D.W., M.U.G., F.H.O., Y.L., H.L.); and
Department of Radiology, University of Alabama at Birmingham, Birmingham, Ala
(X.W.)
| | - Muhammad U. Ghani
- From the Department of Radiology and Imaging Sciences, University of
Utah, Salt Lake City, Utah (L.L.F., P.J., M.E.P.); Departments of Radiology and
Biostatistics, University of Iowa, Iowa City, Iowa (S.L.H.); Advanced Medical
Imaging Center and School of Electrical and Computer Engineering, University of
Oklahoma, Norman, OK 73019 (B.Z., M.D.W., M.U.G., F.H.O., Y.L., H.L.); and
Department of Radiology, University of Alabama at Birmingham, Birmingham, Ala
(X.W.)
| | - Farid H. Omoumi
- From the Department of Radiology and Imaging Sciences, University of
Utah, Salt Lake City, Utah (L.L.F., P.J., M.E.P.); Departments of Radiology and
Biostatistics, University of Iowa, Iowa City, Iowa (S.L.H.); Advanced Medical
Imaging Center and School of Electrical and Computer Engineering, University of
Oklahoma, Norman, OK 73019 (B.Z., M.D.W., M.U.G., F.H.O., Y.L., H.L.); and
Department of Radiology, University of Alabama at Birmingham, Birmingham, Ala
(X.W.)
| | - Yuhua Li
- From the Department of Radiology and Imaging Sciences, University of
Utah, Salt Lake City, Utah (L.L.F., P.J., M.E.P.); Departments of Radiology and
Biostatistics, University of Iowa, Iowa City, Iowa (S.L.H.); Advanced Medical
Imaging Center and School of Electrical and Computer Engineering, University of
Oklahoma, Norman, OK 73019 (B.Z., M.D.W., M.U.G., F.H.O., Y.L., H.L.); and
Department of Radiology, University of Alabama at Birmingham, Birmingham, Ala
(X.W.)
| | - Peter Jenkins
- From the Department of Radiology and Imaging Sciences, University of
Utah, Salt Lake City, Utah (L.L.F., P.J., M.E.P.); Departments of Radiology and
Biostatistics, University of Iowa, Iowa City, Iowa (S.L.H.); Advanced Medical
Imaging Center and School of Electrical and Computer Engineering, University of
Oklahoma, Norman, OK 73019 (B.Z., M.D.W., M.U.G., F.H.O., Y.L., H.L.); and
Department of Radiology, University of Alabama at Birmingham, Birmingham, Ala
(X.W.)
| | - Michael E. Peterson
- From the Department of Radiology and Imaging Sciences, University of
Utah, Salt Lake City, Utah (L.L.F., P.J., M.E.P.); Departments of Radiology and
Biostatistics, University of Iowa, Iowa City, Iowa (S.L.H.); Advanced Medical
Imaging Center and School of Electrical and Computer Engineering, University of
Oklahoma, Norman, OK 73019 (B.Z., M.D.W., M.U.G., F.H.O., Y.L., H.L.); and
Department of Radiology, University of Alabama at Birmingham, Birmingham, Ala
(X.W.)
| | - Xizeng Wu
- From the Department of Radiology and Imaging Sciences, University of
Utah, Salt Lake City, Utah (L.L.F., P.J., M.E.P.); Departments of Radiology and
Biostatistics, University of Iowa, Iowa City, Iowa (S.L.H.); Advanced Medical
Imaging Center and School of Electrical and Computer Engineering, University of
Oklahoma, Norman, OK 73019 (B.Z., M.D.W., M.U.G., F.H.O., Y.L., H.L.); and
Department of Radiology, University of Alabama at Birmingham, Birmingham, Ala
(X.W.)
| | - Hong Liu
- From the Department of Radiology and Imaging Sciences, University of
Utah, Salt Lake City, Utah (L.L.F., P.J., M.E.P.); Departments of Radiology and
Biostatistics, University of Iowa, Iowa City, Iowa (S.L.H.); Advanced Medical
Imaging Center and School of Electrical and Computer Engineering, University of
Oklahoma, Norman, OK 73019 (B.Z., M.D.W., M.U.G., F.H.O., Y.L., H.L.); and
Department of Radiology, University of Alabama at Birmingham, Birmingham, Ala
(X.W.)
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Ghani MU, Fajardo LL, Omoumi F, Yan A, Jenkins P, Wong M, Li Y, Peterson ME, Callahan EJ, Hillis SL, Zheng B, Wu X, Liu H. A phase sensitive x-ray breast tomosynthesis system: Preliminary patient images with cancer lesions. Phys Med Biol 2021; 66. [PMID: 34633295 DOI: 10.1088/1361-6560/ac2ea6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 10/11/2021] [Indexed: 11/11/2022]
Abstract
Phase-sensitive x-ray imaging continues to attract research for its ability to visualize weakly absorbing details like those often encountered in biology and medicine. We have developed and assembled the first inline-based high-energy phase sensitive breast tomosynthesis (PBT) system, which is currently undergoing patient imaging testing at a clinical site. The PBT system consists of a microfocus polychromatic x-ray source and a direct conversion-based flat panel detector coated with a 1 mm thick amorphous selenium layer allowing a high detective quantum efficiency at high energies. The PBT system scans a compressed breast over 15° with 9 angular projection views. The high-energy scan parameters are carefully selected to ensure similar or lower mean glandular dose levels to the clinical standard of care systems. Phase retrieval and data binning are applied to the phase contrast angular projection views and a filtered back-projection algorithm is used to reconstruct the final images. This article reports the distributions of radiation dose versus thickness of the compressed breasts at 59 and 89 kV and sample PBT images acquired from 3 patients. Preliminary PBT images demonstrate the feasibility of this new imaging modality to acquire breast images at lower radiation dose as compared to the clinical digital breast tomosynthesis system with enhanced lesion characteristics (i.e. lesion spiculation and margins).
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Affiliation(s)
- Muhammad U Ghani
- Advanced Medical Imaging Center and School of Electrical and Computer Engineering, University of Oklahoma, Norman, OK 73019, United States of America
| | - Laurie L Fajardo
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT 84132, United States of America
| | - Farid Omoumi
- Advanced Medical Imaging Center and School of Electrical and Computer Engineering, University of Oklahoma, Norman, OK 73019, United States of America
| | - Aimin Yan
- Advanced Medical Imaging Center and School of Electrical and Computer Engineering, University of Oklahoma, Norman, OK 73019, United States of America
| | - Peter Jenkins
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT 84132, United States of America
| | - Molly Wong
- Advanced Medical Imaging Center and School of Electrical and Computer Engineering, University of Oklahoma, Norman, OK 73019, United States of America
| | - Yuhua Li
- Advanced Medical Imaging Center and School of Electrical and Computer Engineering, University of Oklahoma, Norman, OK 73019, United States of America
| | - Michael E Peterson
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT 84132, United States of America
| | - Edward J Callahan
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT 84132, United States of America
| | - Stephen L Hillis
- Departments of Radiology and Biostatistics, University of Iowa, Iowa City, IA 52242, United States of America
| | - Bin Zheng
- Advanced Medical Imaging Center and School of Electrical and Computer Engineering, University of Oklahoma, Norman, OK 73019, United States of America
| | - Xizeng Wu
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL 35249, United States of America
| | - Hong Liu
- Advanced Medical Imaging Center and School of Electrical and Computer Engineering, University of Oklahoma, Norman, OK 73019, United States of America
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Ghani MU, Wu X, Fajardo LL, Jing Z, Wong MD, Zheng B, Omoumi F, Li Y, Yan A, Jenkins P, Hillis SL, Linstroth L, Liu H. Development and preclinical evaluation of a patient-specific high energy x-ray phase sensitive breast tomosynthesis system. Med Phys 2021; 48:2511-2520. [PMID: 33523479 DOI: 10.1002/mp.14743] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 01/19/2021] [Accepted: 01/20/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND This article reports the first x-ray phase sensitive breast tomosynthesis (PBT) system that is aimed for direct translation to clinical practice for the diagnosis of breast cancer. PURPOSE To report the preclinical evaluation and comparison of the newly built PBT system with a conventional digital breast tomosynthesis (DBT) system. METHODS AND MATERIALS The PBT system is developed based on a comprehensive inline phase contrast theoretical model. The system consists of a polyenergetic microfocus x-ray source and a flat panel detector mounted on an arm that is attached to a rotating gantry. It acquires nine projections over a 15° angular span in a stop-and-shoot manner. A dedicated phase retrieval algorithm is integrated with a filtered back-projection method that reconstructs tomographic slices. The American College of Radiology (ACR) accreditation phantom, a contrast detail (CD) phantom and mastectomy tissue samples were imaged at the same glandular dose levels by both the PBT and a standard of care DBT system for image quality characterizations and comparisons. RESULTS The PBT imaging scores with the ACR phantom are in good to excellent range and meet the quality assurance criteria set by the Mammography Quality Standard Act. The CD phantom image comparison and associated statistical analyses from two-alternative forced-choice reader studies confirm the improvement offered by the PBT system in terms of contrast resolution, spatial resolution, and conspicuity. The artifact spread function (ASF) analyses revealed a sizable lateral spread of metal artifacts in PBT slices as compared to DBT slices. Signal-to-noise ratio values for various inserts of the ACR and CD phantoms further validated the superiority of the PBT system. Mastectomy sample images acquired by the PBT system showed a superior depiction of microcalcifications vs the DBT system. CONCLUSION The PBT imaging technology can be clinically employed for improving the accuracy of breast cancer screening and diagnosis.
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Affiliation(s)
- Muhammad U Ghani
- Advanced Medical Imaging Center and School of Electrical and Computer Engineering, University of Oklahoma, Norman, OK, 73019, USA
| | - Xizeng Wu
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL, 35249, USA
| | - Laurie L Fajardo
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT, 84132, USA
| | | | - Molly D Wong
- Advanced Medical Imaging Center and School of Electrical and Computer Engineering, University of Oklahoma, Norman, OK, 73019, USA
| | - Bin Zheng
- Advanced Medical Imaging Center and School of Electrical and Computer Engineering, University of Oklahoma, Norman, OK, 73019, USA
| | - Farid Omoumi
- Advanced Medical Imaging Center and School of Electrical and Computer Engineering, University of Oklahoma, Norman, OK, 73019, USA
| | - Yuhua Li
- Advanced Medical Imaging Center and School of Electrical and Computer Engineering, University of Oklahoma, Norman, OK, 73019, USA
| | - Aimin Yan
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL, 35249, USA
| | - Peter Jenkins
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT, 84132, USA
| | - Stephen L Hillis
- Department of Radiology and Biostatistics, University of Iowa, Iowa City, IA, 52242, USA
| | - Laura Linstroth
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT, 84132, USA
| | - Hong Liu
- Advanced Medical Imaging Center and School of Electrical and Computer Engineering, University of Oklahoma, Norman, OK, 73019, USA
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Fedon C, Rigon L, Arfelli F, Dreossi D, Quai E, Tonutti M, Tromba G, Cova MA, Longo R. Dose and diagnostic performance comparison between phase-contrast mammography with synchrotron radiation and digital mammography: a clinical study report. J Med Imaging (Bellingham) 2018; 5:013503. [PMID: 29430473 DOI: 10.1117/1.jmi.5.1.013503] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 01/04/2018] [Indexed: 12/31/2022] Open
Abstract
Two dosimetric quantities [mean glandular dose (MGD) and entrance surface air kerma (ESAK)] and the diagnostic performance of phase-contrast mammography with synchrotron radiation (MSR) are compared to conventional digital mammography (DM). Seventy-one patients (age range, 41 to 82 years) underwent MSR after a DM examination if questionable or suspicious breast abnormalities were not clarified by ultrasonography. The MGD and the ESAK delivered in both examinations were evaluated and compared. Two on-site radiologists rated the images in consensus according to the Breast Imaging Reporting and Data System assessment categories, which were then correlated with the final diagnoses by means of statistical generalized linear models (GLMs). Receiver operating characteristic curves were also used to assess the diagnostic performance by comparing the area under the curve (AUC). An important MGD and ESAK reduction was observed in MSR due to the monoenergetic beam. In particular, an average 43% reduction was observed for the MGD and a reduction of more than 50% for the ESAK. GLM showed higher diagnostic accuracy, especially in terms of specificity, for MSR, confirmed by AUC analysis ([Formula: see text]). The study design implied that the population was characterized by a high prevalence of disease and that the radiologists, who read the DM images before referring the patient to MSR, could have been influenced in their assessments. Within these limitations, the use of synchrotron radiation with the phase-contrast technique applied to mammography showed an important dose reduction and a higher diagnostic accuracy compared with DM. These results could further encourage research on the translation of x-ray phase-contrast imaging into the clinics.
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Affiliation(s)
- Christian Fedon
- Istituto Nazionale di Fisica Nucleare, Sezione di Trieste, Trieste, Italy.,Radboud University Medical Centre, Department of Radiology and Nuclear Medicine, Nijmegen, The Netherlands
| | - Luigi Rigon
- Istituto Nazionale di Fisica Nucleare, Sezione di Trieste, Trieste, Italy.,University of Trieste, Department of Physics, Trieste, Italy
| | - Fulvia Arfelli
- Istituto Nazionale di Fisica Nucleare, Sezione di Trieste, Trieste, Italy.,University of Trieste, Department of Physics, Trieste, Italy
| | - Diego Dreossi
- Elettra-Sincrotrone Trieste S.C.p.A., Basovizza, Trieste, Italy
| | - Elisa Quai
- University of Trieste, Department of Physics, Trieste, Italy
| | - Maura Tonutti
- Azienda Sanitaria Universitaria Integrata di Trieste, Department of Radiology, Trieste, Italy
| | - Giuliana Tromba
- Elettra-Sincrotrone Trieste S.C.p.A., Basovizza, Trieste, Italy
| | - Maria Assunta Cova
- Azienda Sanitaria Universitaria Integrata di Trieste, Department of Radiology, Trieste, Italy.,University of Trieste, Department of Medical, Surgical and Health Sciences, Trieste, Italy
| | - Renata Longo
- Istituto Nazionale di Fisica Nucleare, Sezione di Trieste, Trieste, Italy.,University of Trieste, Department of Physics, Trieste, Italy
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Sarno A, Mettivier G, Golosio B, Oliva P, Spandre G, Di Lillo F, Fedon C, Longo R, Russo P. Imaging performance of phase-contrast breast computed tomography with synchrotron radiation and a CdTe photon-counting detector. Phys Med 2016; 32:681-90. [DOI: 10.1016/j.ejmp.2016.04.011] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 04/21/2016] [Accepted: 04/22/2016] [Indexed: 11/25/2022] Open
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Izadifar Z, Honaramooz A, Wiebe S, Belev G, Chen X, Chapman D. Low-dose phase-based X-ray imaging techniques for in situ soft tissue engineering assessments. Biomaterials 2016; 82:151-67. [DOI: 10.1016/j.biomaterials.2015.11.044] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 11/23/2015] [Accepted: 11/29/2015] [Indexed: 02/01/2023]
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Longo R, Arfelli F, Bellazzini R, Bottigli U, Brez A, Brun F, Brunetti A, Delogu P, Di Lillo F, Dreossi D, Fanti V, Fedon C, Golosio B, Lanconelli N, Mettivier G, Minuti M, Oliva P, Pinchera M, Rigon L, Russo P, Sarno A, Spandre G, Tromba G, Zanconati F. Towards breast tomography with synchrotron radiation at Elettra: first images. Phys Med Biol 2016; 61:1634-49. [PMID: 26836274 DOI: 10.1088/0031-9155/61/4/1634] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The aim of the SYRMA-CT collaboration is to set-up the first clinical trial of phase-contrast breast CT with synchrotron radiation (SR). In order to combine high image quality and low delivered dose a number of innovative elements are merged: a CdTe single photon counting detector, state-of-the-art CT reconstruction and phase retrieval algorithms. To facilitate an accurate exam optimization, a Monte Carlo model was developed for dose calculation using GEANT4. In this study, high isotropic spatial resolution (120 μm)(3) CT scans of objects with dimensions and attenuation similar to a human breast were acquired, delivering mean glandular doses in the range of those delivered in clinical breast CT (5-25 mGy). Due to the spatial coherence of the SR beam and the long distance between sample and detector, the images contain, not only absorption, but also phase information from the samples. The application of a phase-retrieval procedure increases the contrast-to-noise ratio of the tomographic images, while the contrast remains almost constant. After applying the simultaneous algebraic reconstruction technique to low-dose phase-retrieved data sets (about 5 mGy) with a reduced number of projections, the spatial resolution was found to be equal to filtered back projection utilizing a four fold higher dose, while the contrast-to-noise ratio was reduced by 30%. These first results indicate the feasibility of clinical breast CT with SR.
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Mettivier G, Fedon C, Di Lillo F, Longo R, Sarno A, Tromba G, Russo P. Glandular dose in breast computed tomography with synchrotron radiation. Phys Med Biol 2015; 61:569-87. [DOI: 10.1088/0031-9155/61/2/569] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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Jian W, Wu M, Shi H, Wang L, Zhang L, Luo S. Signs analysis and clinical assessment: phase-contrast computed tomography of human breast tumours. PLoS One 2015; 10:e0124143. [PMID: 25844722 PMCID: PMC4386813 DOI: 10.1371/journal.pone.0124143] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Accepted: 03/12/2015] [Indexed: 12/12/2022] Open
Abstract
Purpose To analyse the diagnostic signs present in slices of human breast tumour specimens using synchrotron radiation phase-contrast imaging computed tomography (PCI-CT) for the first time and assess the feasibility of this technique for clinical applications. Materials and Methods The ethics committee of our university and relevant clinical hospital approved this prospective study, and written informed consent was obtained from all patients. PCI-CT of human breast tumour specimens with synchrotron radiation was performed at the Shanghai Synchrotron Radiation Facility (SSRF). A total of 14 specimens of early-stage carcinomas and 8 specimens of adenomas were enrolled. Based on raw data reconstruction, the diagnostic signs present in the slices were analysed and correlated with histopathology. We proposed a criterion for clinical diagnosis according to the evaluated signs and the Breast Imaging Reporting and Data System (BI-RADS) for reference. The criterion was then assessed by clinicians in a double-blind method. Finally, descriptive statistics were evaluated, depending on the assessment results. Results The 14 carcinoma specimens and 8 adenoma specimens were diagnosed as malignant and benign tumours, respectively. The total coincidence rate was 100%. Conclusion Our study results demonstrate that the X-ray diagnostic signs observed in the specimen slices and the criterion used for clinical diagnosis were accurate and reliable. The criterion based on signs analysis can be used to differentiate early-stage benign or malignant tumours. As a promising imaging method, PCI-CT can serve as a possible and feasible supplement to BI-RADS in the future.
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Affiliation(s)
- Wushuai Jian
- School of Biomedical Engineering, Capital Medical University, Beijing, China
| | - Mingshu Wu
- School of Biomedical Engineering, Capital Medical University, Beijing, China
| | - Hongli Shi
- School of Biomedical Engineering, Capital Medical University, Beijing, China
| | - Liting Wang
- School of Biomedical Engineering, Capital Medical University, Beijing, China
| | - Lu Zhang
- School of Biomedical Engineering, Capital Medical University, Beijing, China
| | - Shuqian Luo
- School of Biomedical Engineering, Capital Medical University, Beijing, China
- * E-mail:
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Longo M, Rigon L, Lopez FCM, Chen R, Dreossi D, Zanconati F, Longo R. A simplified edge illumination set-up for quantitative phase contrast mammography with synchrotron radiation at clinical doses. Phys Med Biol 2015; 60:N21-34. [PMID: 25574755 DOI: 10.1088/0031-9155/60/3/n21] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
This work presents the first study of x-ray phase contrast imaging based on a simple implementation of the edge illumination method (EIXPCi) in the field of mammography with synchrotron radiation. A simplified EIXPCi set-up was utilized to study a possible application in mammography at clinical doses. Moreover, through a novel algorithm capable of separating and quantifying absorption and phase perturbations of images acquired in EIXPCi modality, it is possible to extract quantitative information on breast images, allowing an accurate tissue identification. The study was carried out at the SYRMEP beamline of Elettra synchrotron radiation facility (Trieste, Italy), where a mastectomy specimen was investigated with the EIXPCi technique. The sample was exposed at three different energies suitable for mammography with synchrotron radiation in order to test the validity of the novel algorithm in extracting values of linear attenuation coefficients integrated over the sample thickness. It is demonstrated that the quantitative data are in good agreement with the theoretical values of linear attenuation coefficients calculated on the hypothesis of the breast with a given composition. The results are promising and encourage the current efforts to apply the method in mammography with synchrotron radiation.
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Affiliation(s)
- Mariaconcetta Longo
- Post Graduate School of Medical Physics, La Sapienza University of Rome, 00171 Rome, Italy
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Wong MD, Yan A, Ghani M, Li Y, Fajardo L, Wu X, Liu H. Dose and detectability improvements with high energy phase sensitive x-ray imaging in comparison to low energy conventional imaging. Phys Med Biol 2014; 59:N37-48. [PMID: 24732108 DOI: 10.1088/0031-9155/59/9/n37] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The objective of this study was to demonstrate the potential benefits of using high energy x-rays for phase sensitive breast imaging through a comparison with conventional mammography imaging. We compared images of a contrast-detail phantom acquired on a prototype phase sensitive x-ray imaging system with images acquired on a commercial flat panel digital mammography unit. The phase contrast images were acquired using a micro-focus x-ray source with a 50 µm focal spot at 120 kVp and 4.5 mAs, with a magnification factor of 2.46 and a 50 µm pixel pitch. A phase attenuation duality-based phase retrieval algorithm that requires only a single phase contrast image was applied. Conventional digital mammography images were acquired at 27 kVp, 131 mAs and 28 kVp, 54 mAs. For the same radiation dose, both the observer study and signal-to-noise ratio (SNR)/figure of merit comparisons indicated a large improvement by the phase retrieved image as compared to the clinical system for the larger disc sizes, but the improvement was not enough to detect the smallest discs. Compared to the double dose image acquired with the clinical system, the observer study also indicated that the phase retrieved image provided improved detection capabilities for all disc sizes except the smallest discs. Thus the SNR improvement provided by phase contrast imaging is not yet enough to offset the noise reduction provided by the clinical system at the doubled dose level. However, the potential demonstrated by this study for high energy phase sensitive x-ray imaging to improve lesion detection and reduce radiation dose in mammography warrants further investigation of this technique.
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Affiliation(s)
- Molly Donovan Wong
- Center for Bioengineering and School of Electrical and Computer Engineering, University of Oklahoma, 110 West Boyd Street, Devon Energy Hall 150, Norman, OK 73019, USA
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Longo R, Tonutti M, Rigon L, Arfelli F, Dreossi D, Quai E, Zanconati F, Castelli E, Tromba G, Cova MA. Clinical study in phase- contrast mammography: image-quality analysis. PHILOSOPHICAL TRANSACTIONS. SERIES A, MATHEMATICAL, PHYSICAL, AND ENGINEERING SCIENCES 2014; 372:20130025. [PMID: 24470410 DOI: 10.1098/rsta.2013.0025] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The first clinical study of phase-contrast mammography (PCM) with synchrotron radiation was carried out at the Synchrotron Radiation for Medical Physics beamline of the Elettra synchrotron radiation facility in Trieste (Italy) in 2006-2009. The study involved 71 patients with unresolved breast abnormalities after conventional digital mammography and ultrasonography exams carried out at the Radiology Department of Trieste University Hospital. These cases were referred for mammography at the synchrotron radiation facility, with images acquired using a propagation-based phase-contrast imaging technique. To investigate the contribution of phase-contrast effects to the image quality, two experienced radiologists specialized in mammography assessed the visibility of breast abnormalities and of breast glandular structures. The images acquired at the hospital and at the synchrotron radiation facility were compared and graded according to a relative seven-grade visual scoring system. The statistical analysis highlighted that PCM with synchrotron radiation depicts normal structures and abnormal findings with higher image quality with respect to conventional digital mammography.
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Affiliation(s)
- Renata Longo
- Department of Physics, University of Trieste and INFN-Trieste, , via Valerio 2, Trieste 34127, Italy
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