Technical Note: Skin thickness measurements using high‐resolution flat‐panel cone‐beam dedicated breast CTa)

Shi, Linxi; Vedantham, Srinivasan; Karellas, Andrew; O’Connell, Avice M

doi:10.1118/1.4793257

Cited by 40 publications

(58 citation statements)

References 29 publications

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“…Compared to the study by Huang et al (Huang et al, 2008), the mean skin thickness statistically differed ( p <0.001) and on average the t s from DBT was higher by 0.33 ± 0.04 mm. Compared to the study by Shi et al (Shi et al, 2013), the t s from DBT statistically differed ( p <0.001) and on average the t s from DBT was higher by 0.34 ± 0.03 mm. Importantly, t s estimated by x-ray imaging modalities includes the combined thickness of epidermis and dermis and excludes subcutaneous fat, as it is often indistinguishable from adipose tissue within the breast.…”

Section: Discussioncontrasting

confidence: 83%

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Digital breast tomosynthesis guided near infrared spectroscopy: volumetric estimates of fibroglandular fraction and breast density from tomosynthesis reconstructions

Vedantham

Shi

Michaelsen

et al. 2015

Biomed. Phys. Eng. Express

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A multimodality system combining a clinical prototype digital breast tomosynthesis with its imaging geometry modified to facilitate near-infrared spectroscopic imaging has been developed. The accuracy of parameters recovered from near-infrared spectroscopy is dependent on fibroglandular tissue content. Hence, in this study, volumetric estimates of fibroglandular tissue from tomosynthesis reconstructions were determined. A kernel-based fuzzy c-means algorithm was implemented to segment tomosynthesis reconstructed slices in order to estimate fibroglandular content and to provide anatomic priors for near-infrared spectroscopy. This algorithm was used to determine volumetric breast density (VBD), defined as the ratio of fibroglandular tissue volume to the total breast volume, expressed as percentage, from 62 tomosynthesis reconstructions of 34 study participants. For a subset of study participants who subsequently underwent mammography, VBD from mammography matched for subject, breast laterality and mammographic view was quantified using commercial software and statistically analyzed to determine if it differed from tomosynthesis. Summary statistics of the VBD from all study participants were compared with prior independent studies. The fibroglandular volume from tomosynthesis and mammography were not statistically different (p=0.211, paired t-test). After accounting for the compressed breast thickness, which were different between tomosynthesis and mammography, the VBD from tomosynthesis was correlated with (r =0.809, p<0.001), did not statistically differ from (p>0.99, paired t-test), and was linearly related to, the VBD from mammography. Summary statistics of the VBD from tomosynthesis were not statistically different from prior studies using high-resolution dedicated breast computed tomography. The observation of correlation and linear association in VBD between mammography and tomosynthesis suggests that breast density associated risk measures determined for mammography are translatable to tomosynthesis. Accounting for compressed breast thickness is important when it differs between the two modalities. The fibroglandular volume from tomosynthesis reconstructions is similar to mammography indicating suitability for use during near-infrared spectroscopy.

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Section: Discussioncontrasting

confidence: 83%

“…Additionally, the skin thickness ( t s ) determined from DBT reconstructions was compared with prior independent studies using dedicated breast CT (Huang et al, 2008, Shi et al, 2013). The mean ± standard deviation of t s determined from DBT was 1.78 ± 0.09 mm ( n =41 breasts).…”

Section: Discussionmentioning

confidence: 99%

Digital breast tomosynthesis guided near infrared spectroscopy: volumetric estimates of fibroglandular fraction and breast density from tomosynthesis reconstructions

Vedantham

Shi

Michaelsen

et al. 2015

Biomed. Phys. Eng. Express

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“…A realistic minimum skin thickness limit was set to 0.5 mm, while the maximum skin thickness limit was set to 5 mm. 39 Skin thickness estimates were smoothed, and a mask or "skin shell" was formed which contained the external skin surface and the internal breast-skin transition region. The skin was then defined as all nonadipose voxels within this skin shell which contained voxels belonging to the skin class (class 6) in addition to a variety of fractional glandular-equivalent densities (classes 2-5) present at the skin-adipose interface.…”

Section: F Skin Segmentationmentioning

confidence: 99%

Population of 224 realistic human subject-based computational breast phantoms

et al. 2015

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Purpose: To create a database of highly realistic and anatomically variable 3D virtual breast phantoms based on dedicated breast computed tomography (bCT) data. Methods: A tissue classification and segmentation algorithm was used to create realistic and detailed 3D computational breast phantoms based on 230+ dedicated bCT datasets from normal human subjects. The breast volume was identified using a coarse three-class fuzzy C-means segmentation algorithm which accounted for and removed motion blur at the breast periphery. Noise in the bCT data was reduced through application of a postreconstruction 3D bilateral filter. A 3D adipose nonuniformity (bias field) correction was then applied followed by glandular segmentation using a 3D bias-corrected fuzzy C-means algorithm. Multiple tissue classes were defined including skin, adipose, and several fractional glandular densities. Following segmentation, a skin mask was produced which preserved the interdigitated skin, adipose, and glandular boundaries of the skin interior. Finally, surface modeling was used to produce digital phantoms with methods complementary to the XCAT suite of digital human phantoms. Results: After rejecting some datasets due to artifacts, 224 virtual breast phantoms were created which emulate the complex breast parenchyma of actual human subjects. The volume breast density (with skin) ranged from 5.5% to 66.3% with a mean value of 25.3% ± 13.2%. Breast volumes ranged from 25.0 to 2099.6 ml with a mean value of 716.3 ± 386.5 ml. Three breast phantoms were selected for imaging with digital compression (using finite element modeling) and simple ray-tracing, and the results show promise in their potential to produce realistic simulated mammograms. Conclusions: This work provides a new population of 224 breast phantoms based on in vivo bCT data for imaging research. Compared to previous studies based on only a few prototype cases, this dataset provides a rich source of new cases spanning a wide range of breast types, volumes, densities, and parenchymal patterns.

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“…It has been shown that in case of tumour or when radiotherapy was applied, the skin is thickening [41–43, 46, 47]. According to different studies, mean skin thickness in normal breast varies in range of 1.44-2.05 mm, while in breasts after radiotherapy – 1.44-2.68 mm [41–43, 46, 47]. …”

Section: Purposementioning

confidence: 99%

Dose estimation for different skin models in interstitial breast brachytherapy

Lasota¹,

Kabacińska²,

Makarewicz

2014

jcb

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PurposeSkin is a major organ at risk in breast-conserving therapy (BCT). The American Brachytherapy Society (ABS) recommendations require monitoring of maximum dose received, however, there is no unambiguous way of skin contouring provided. The purpose of this study was to compare the doses received by the skin in different models.Material and methodsStandard treatment plans of 20 patients who underwent interstitial breast brachytherapy were analyzed. Every patient had a new treatment plan prepared according to Paris system and had skin contoured in three different ways. The first model, Skin 2 mm, corresponds to the dermatological breast skin thickness and is reaching 2 mm into an external patient contour. It was rejected in a further analysis, because of distinct discontinuities in contouring. The second model, Skin 4 mm, replaced Skin 2 mm, and is reaching 2 mm inside and 2 mm outside of the External contour. The third model, Skin EXT, is created on the External contour and it expands 4 mm outside. Doses received by the most exposed 0.1 cc, 1 cc, 2 cc, and the maximum doses for Skin 4 mm and Skin EXT were compared.ResultsMean, median, maximum, and standard deviation of percentage dose difference between Skin EXT and Skin 4 mm for the most exposed 0.1 cc (D0.1cc) of skin were 18.01%, 17.20%, 27.84%, and 4.01%, respectively. All differences were statistically significant (p < 0.05).ConclusionsMonitoring of doses received by skin is necessary to avoid complications and obtain a satisfactory cosmetic effect. It is difficult to assess the compatibility of treatment plans with recommendations, while there is no unambiguous way of skin contouring. Especially, if a mean difference of doses between two models of skin contouring is 18% for the most exposed 0.1 cc and can reach almost 28% in some cases. Differences of this magnitude can result in skin complications during BCT.

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Technical Note: Skin thickness measurements using high‐resolution flat‐panel cone‐beam dedicated breast CTa)

Cited by 40 publications

References 29 publications

Digital breast tomosynthesis guided near infrared spectroscopy: volumetric estimates of fibroglandular fraction and breast density from tomosynthesis reconstructions

Digital breast tomosynthesis guided near infrared spectroscopy: volumetric estimates of fibroglandular fraction and breast density from tomosynthesis reconstructions

Population of 224 realistic human subject-based computational breast phantoms

Dose estimation for different skin models in interstitial breast brachytherapy

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