Dedicated breast computed tomography: Basic aspects

Abstract

X-ray mammography of the compressed breast is well recognized as the "gold standard" for early detection of breast cancer, but its performance is not ideal. One limitation of screening mammography is tissue superposition, particularly for dense breasts. Since 2001, several research groups in the USA and in the European Union have developed computed tomography (CT) systems with digital detector technology dedicated to x-ray imaging of the uncompressed breast (breast CT or BCT) for breast cancer screening and diagnosis. This CT technology--tracing back to initial studies in the 1970s--allows some of the limitations of mammography to be overcome, keeping the levels of radiation dose to the radiosensitive breast glandular tissue similar to that of two-view mammography for the same breast size and composition. This paper presents an evaluation of the research efforts carried out in the invention, development, and improvement of BCT with dedicated scanners with state-of-the-art technology, including initial steps toward commercialization, after more than a decade of R&D in the laboratory and/or in the clinic. The intended focus here is on the technological/engineering aspects of BCT and on outlining advantages and limitations as reported in the related literature. Prospects for future research in this field are discussed.

Evaluation of human observer performance on lesion detectability in single‐slice and multislice dedicated breast cone beam CT images with breast anatomical background

“…Data acquisition was performed with a full cone beam geometry, and the simulation parameters of CBCT system are summarized in Table . We followed the data acquisition geometry of the UC Davis prototype, where magnification was approximately 1.9 and the detector cell size was 0.388 × 0.388 in 2‐by‐2 averaging mode . To reduce aliasing, we used a detector quarter offset.…”

Synchrotron radiation external beam rotational radiotherapy of breast cancer: proof of principle

“…The kV-EBRT technique (Prionas et al, 2012) could be implemented on the rotating gantry of a cone-beam computed tomography (CT) scanner dedicated to the breast [see, for example, the recent review by Sarno et al (2015)], for example, as realized by the Davis group and operating typically at 80 kVp, thus providing precise three-dimensional localization of the tumor mass in the breast volume. The advantages of the kV-EBRT technique with respect to conventional radiotherapy were described as a simplified and more economical setup (which also does not require a bunker as for a linac), the potential for reduced patient repositioning error and improved treatment accuracy in fractionated radiotherapy, the use of a prone rather than a supine patient position.…”

Suitability of low density materials for 3D printing of physical breast phantoms

“…Another application of such phantoms is in testing, evaluation and clarification of the role and the benefits of new x-ray modalities in comparative studies to actual daily routine. Breast tomosynthesis (Sechopoulos 2013), contrast-enhanced mammography (Francescone et al 2014, Daniaux et al 2015, as well as new imaging modalities to be potentially established like breast computed tomography (CT) (Lindfors et al 2008, Mettivier and Russo 2011, Kalender et al 2012, Sarno et al 2015, dual-energy breast CT (Badr et al 2014) and phase-contrast breast imaging (Bravin et al 2013, Auweter et al 2014, Sarno et al 2017a are being explored.…”