Hellerhoff K, Gottwald W, Taphorn K, Berthe D, Braun M, Wagner K, Resch S, John D, Heck L, Birnbacher L, Herzen J, Grandl S. Grating-based x-ray dark-field mammography: Assessing complementary imaging information in simple cystic lesions and typical fibroadenoma.
Med Phys 2025;
52:2145-2154. [PMID:
39752625 PMCID:
PMC11972037 DOI:
10.1002/mp.17603]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 10/22/2024] [Accepted: 12/10/2024] [Indexed: 04/06/2025] Open
Abstract
BACKGROUND
A significant proportion of false positive recalls of mammography-screened women is due to benign breast cysts and simple fibroadenomas. These lesions appear mammographically as smooth-shaped dense masses and require the recalling of women for a breast ultrasound to obtain complementary imaging information. They can be identified safely by ultrasound with no need for further assessment or treatment.
PURPOSE
Grating-based x-ray dark-field breast imaging allows contrast formation based on both attenuation and small-angle x-ray scattering and provides complementary imaging information in one single acquisition.
METHODS
Experiments with ex-vivo mastectomy samples were performed with a three-grating Talbot-Lau interferometer using a laboratory-based polychromatic x-ray source. Attenuation and dark-field images were correlated to clinical mammography and complementary diagnostic imaging techniques.
RESULTS
Benign breast lesions with homogeneous internal structures such as fibroadenomas and simple fluid-filled cysts, typically presenting as dense breast lesions in standard mammography, showed a signal drop in the dark-field image. Complicated cysts provided a higher dark-field signal.
CONCLUSIONS
The results presented show that grating-based x-ray dark-field mammography could provide complementary imaging information in one single acquisition, eliminating the need for a second examination to identify harmless cysts and simple fibroadenomas.
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