Recent advances in X-ray imaging of breast tissue: From two- to three-dimensional imaging

Abstract

Breast cancer is a globally widespread disease whose detection has already been significantly improved by the introduction of screening programs. Nevertheless, mammography suffers from low soft tissue contrast and the superposition of diagnostically relevant anatomical structures as well as from low values for sensitivity and specificity especially for dense breast tissue. In recent years, two techniques for X-ray breast imaging have been developed that bring advances for the early detection of breast cancer. Grating-based phase-contrast mammography is a new imaging technique that is able to provide three image modalities simultaneously (absorption-contrast, phase-contrast and dark-field signal). Thus, an enhanced detection and delineation of cancerous structures in the phase-contrast image and an improved visualization and characterization of microcalcifications in the dark-field image is possible. Furthermore, latest studies about this approach show that dosecompatible imaging with polychromatic X-ray sources is feasible. In order to additionally overcome the limitations of projection-based imaging, efforts were also made towards the development of breast computed tomography (BCT), which recently led to the first clinical installation of an absorption-based BCT system. Further research combining the benefits of both imaging technologies is currently in progress. This review article summarizes the latest advances in phase-contrast imaging for the female breast (projection-based and threedimensional view) with special focus on possible clinical implementations in the future.

Quantitative X-ray phase contrast computed tomography with grating interferometry

“…While many studies focus on tissue characterization in GBPC micro-CT at high spatial and electron density resolution, one promising development of GBPC-CT towards clinical application could be phase contrast breast tomography [ 187 , 188 ]. The needed energy range of breast imaging is still in a range feasible for complementarity of the attenuation and phase contrast signal, as the tube voltage for breast phase contrast CT would be lower than conventional CT tube voltages.…”

Editorial

“…The review paper by L. Heck and J. Herzen [6] addresses the specific application of Phase Contrast Imaging to mammography. After a discussion on Phase-Contrast Mammography and on Grating Based Mammography to obtain 2D images of the breast, the authors tackle the possibility of 3-D imaging by using Phase-Contrast Breast Computed Tomography and compare the preliminary results as obtained at synchrotron sources with those obtained with a more standard CT device (Breast Computed Tomography).…”

A Deep Learning Breast Cancer Prediction Framework

“…Finally, ML methods have been quantified and tested against future approaches. An abundance of ultrasound imaging techniques has been used in [18] to look for (occasional forms of) cancer, including breast X-ray, ultrasound imaging (US), and computed tomography (CT). They compared how the various ML methods had been used for detecting and classifying the various cancers.…”