Molecular breast imaging—A phantom study on the impact of collimator selection on the detection of sub-10mm breast lesions

Author(s):  
Carrie B. Hruska ◽  
Michael K. O’Connor
2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Yoko Satoh ◽  
Utaroh Motosugi ◽  
Masamichi Imai ◽  
Yoshie Omiya ◽  
Hiroshi Onishi

Abstract Background Using phantoms and clinical studies in prone hanging breast imaging, we assessed the image quality of a commercially available dedicated breast PET (dbPET) at the detector’s edge, where mammary glands near the chest wall are located. These are compared to supine PET/CT breast images of the same clinical subjects. Methods A breast phantom with four spheres (16-, 10-, 7.5-, and 5-mm diameter) was filled with 18F-fluorodeoxyglucose solution (sphere-to-background activity concentration ratio, 8:1). The spheres occupied five different positions from the top edge to the centre of the detector and were scanned for 5 min in each position. Reconstructed images were visually evaluated, and the contrast-to-noise ratio (CNR), contrast recovery coefficient (CRC) for all spheres, and coefficient of variation of the background (CVB) were calculated. Subsequently, clinical images obtained with standard supine PET/CT and prone dbPET were retrospectively analysed. Tumour-to-background ratios (TBRs) between breast cancer near the chest wall (close to the detector’s edge; peripheral group) and at other locations (non-peripheral group) were compared. The TBR of each lesion was compared between dbPET and PET/CT. Results Closer to the detector’s edge, the CNR and CRC of all spheres decreased while the CVB increased in the phantom study. The disadvantages of this placement were visually confirmed. Regarding clinical images, TBR of dbPET was significantly higher than that of PET/CT in both the peripheral (12.38 ± 6.41 vs 6.73 ± 3.5, p = 0.0006) and non-peripheral (12.44 ± 5.94 vs 7.71 ± 7.1, p = 0.0183) groups. There was no significant difference in TBR of dbPET between the peripheral and non-peripheral groups. Conclusion The phantom study revealed poorer image quality at < 2-cm distance from the detector’s edge than at other more central parts. In clinical studies, however, the visibility of breast lesions with dbPET was the same regardless of the lesion position, and it was higher than that in PET/CT. dbPET has a great potential for detecting breast lesions near the chest wall if they are at least 2 cm from the edge of the FOV, even in young women with small breasts.


2018 ◽  
Vol 25 (12) ◽  
pp. 1568-1576 ◽  
Author(s):  
Jason G. Ching ◽  
Rachel F. Brem

2020 ◽  
Vol 2 (5) ◽  
pp. 484-491
Author(s):  
Beatriz E Adrada ◽  
Tanya Moseley ◽  
S Cheenu Kappadath ◽  
Gary J Whitman ◽  
Gaiane M Rauch

Abstract Molecular breast imaging (MBI) is an increasingly recognized nuclear medicine imaging modality to detect breast lesions suspicious for malignancy. Recent advances have allowed the development of tissue sampling of MBI-detected lesions using a single-headed camera (breast-specific gamma imaging system) or a dual-headed camera system (MBI system). In this article, we will review current indications of MBI, differences of the two single- and dual-headed camera systems, the appropriate selection of biopsy equipment, billing considerations, and radiation safety. It will also include practical considerations and guidance on how to integrate MBI and MBI-guided biopsy in the current breast imaging workflow.


Author(s):  
Olivia Sullivan ◽  
Zongyi Gong ◽  
Kelly Klanian ◽  
Tushita Patel ◽  
Mark B. Williams

2020 ◽  
Author(s):  
Hongbiao Liu ◽  
Hongwei Zhan ◽  
Da Sun ◽  
Ying Zhang

Abstract Background: Breast cancer is a leading cause of cancer in females, and is the second leading cancer-related cause of death in this group. Early diagnosis is essential to breast cancer to be effectively treated, and ultrasound, mammography, and magnetic resonance imaging (MRI) represent three key technologies that are utilized for the diagnosis of breast lesions. Breast-specific gamma imaging (BSGI) is an approach to molecular breast imaging that allows for high-resolution radio-imaging that is not adversely impacted by breast tissue density. This study was therefore designed to assess the relative diagnostic efficacy of BSGI, MRI, mammography, and ultrasound in different molecular subtypes of breast cancer among Chinese women.Methods: Diagnostic findings from 390 patients that had undergone diagnosis and treatment in our breast surgery department were retrospectively reviewed. Patients had been diagnosed via BSGI, mammography, ultrasound, and MRI. The diagnostic efficacy of these different imaging modalities and their associated biological characteristics were compared in the present study.Results: A total of 229 of these 390 patients (58.7%) were diagnosed with malignant breast cancer, with the remaining 161 (41.3%) cases having been found to be benign. BSGI, MRI, mammography, and ultrasound yielded respective sensitivity values of 91.7%, 92.5%, 77.3%, and 82.1%, while the respective specificity values for these imaging modalities were 80.7%, 69.7%, 74.5%, and 70.8%. For lesions > 1 cm, BSGI offered a sensitivity of 92.5%. For mammographic breast density A, B, C, and D, BSGI offered a sensitivity of 93.3%, 94.0%, 91.5%, and 89.3%, respectively. BSGI also yielded a significantly higher lesion-to-normal lesion ratio (LNR) for malignant lesions relative to benign lesions (2.76±1.32 vs 1.46±0.49).Conclusions: These findings confirm that BSGI is highly sensitive and is superior to mammography in the detection and diagnosis of ductal carcinomas in situ (DCIS). Such diagnostic efficacy can be further improved by using BSGI as an auxiliary modality to mammography and ultrasound, potentially improving the reliability of breast lesion diagnosis, thereby ensuring that patients receive rapid and effective treatment without the risk of misdiagnosis or unnecessary surgical treatment.


2020 ◽  
Author(s):  
Hongbiao Liu ◽  
Hongwei Zhan ◽  
Da Sun ◽  
Ying Zhang

Abstract Background : Breast cancer is a leading cause of cancer in females, and is the second leading cancer-related cause of death in this group. Early diagnosis is essential to breast cancer to be effectively treated, and ultrasound, mammography, and MRI represent three key technologies that are utilized for the diagnosis of breast lesions. BSGI is an approach to molecular breast imaging that allows for high-resolution radio-imaging that is not adversely impacted by breast tissue density. This study was therefore designed to assess the relative diagnostic efficacy of BSGI, MRI, mammography, and ultrasound in different molecular subtypes of breast cancer among Chinese women. Methods : Diagnostic findings from 390 breast cancer patients that had undergone diagnosis and treatment in our breast surgery department were retrospectively reviewed. Patients had been diagnosed via BSGI, mammography, ultrasound, and MRI. The diagnostic efficacy of these different imaging modalities and their associated biological characteristics were compared in the present study. Results: A total of 229 of these 390 patients (58.7%) were diagnosed with malignant breast cancer, with the remaining 161 (41.3%) cases having been found to be benign. BSGI, MRI, mammography, and ultrasound yielded respective sensitivity values of 91.7%, 92.5%, 77.3%, and 82.1%, while the respective specificity values for these imaging modalities were 80.7%, 69.7%, 74.5%, and 70.8%. For lesions > 1 cm, BSGI offered a sensitivity of 92.5%, while for dense C and dense D breast tissue it yielded 91.5% and 89.3% sensitivity values, respectively, with these being similar to those achieved for dense A and dense B breast tissue (93.3% and 94.0%, respectively). BSGI also yielded a significantly higher LNR for malignant lesions relative to benign lesions (2.76±1.32 vs 1.46±0.49). Conclusions : These findings confirm that BSGI is highly sensitive and is superior to mammography in the detection and diagnosis of DCIS. Such diagnostic efficacy can be further improved by using BSGI as an auxiliary modality to mammography and ultrasound, potentially improving the reliability of breast lesion diagnosis, thereby ensuring that patients receive rapid and effective treatment without the risk of misdiagnosis or unnecessary surgical treatment.


Author(s):  
Sahar Mansour ◽  
Rasha Kamal ◽  
Lamiaa Hashem ◽  
Basma ElKalaawy

Objectives: to study the impact of artificial intelligence (AI) on the performance of mammogram with regard to the classification of the detected breast lesions in correlation to ultrasound aided mammograms. Methods: Ethics committee approval was obtained in this prospective analysis. The study included 2000 mammograms. The mammograms were interpreted by the radiologists and breast ultrasound was performed for all cases. The Breast Imaging Reporting and Data System (BI-RADS) score was applied regarding the combined evaluation of the mammogram and the ultrasound modalities. Each breast side-was individually assessed with the aid of AI scanning in the form of targeted heat-map and then, a probability of malignancy (abnormality scoring percentage) was obtained. Operative and the histopathology data were the standard of reference. Results: Normal assigned cases (BI-RADS 1) with no lesions were excluded from the statistical evaluation. The study included 538 benign and 642 malignant breast lesions (n = 1180, 59%). BI-RADS categories for the breast lesions with regard to the combined evaluation of the digital mammogram and ultrasound were assigned BI-RADS 2 (Benign) in 385 lesions with AI median value of the abnormality scoring percentage of 10, (n = 385/1180, 32.6%), and BI-RADS 5 (malignant) in 471, that had showed median percentage AI value of 88 (n = 471/1180, 39.9%). AI abnormality scoring of 59% yielded a sensitivity of 96.8% and specificity of 90.1% in the discrimination of the breast lesions detected on the included mammograms. Conclusions: AI could be considered as an optional primary reliable complementary tool to the digital mammogram for the evaluation of the breast lesions. The color hue and the abnormality scoring percentage presented a credible method for the detection and discrimination of breast cancer of near accuracy to the breast ultrasound. So consequently, AI- mammogram combination could be used as a one setting method to discriminate between cases that require further imaging or biopsy from those that need only time interval follows up. Advances in knowledge: Recently, the indulgence of AI in the work up of breast cancer was concerned. AI noted as a screening strategy for the detection of breast cancer. In the current work, the performance of AI was studied with regard to the diagnosis not just the detection of breast cancer in the mammographic-detected breast lesions. The evaluation was concerned with AI as a possible complementary reading tool to mammogram and included the qualitative assessment of the color hue and the quantitative integration of the abnormality scoring percentage.


2020 ◽  
Author(s):  
hongbiao liu ◽  
Hongwei Zhan ◽  
Da Sun ◽  
Ying Zhang

Abstract Background: Breast cancer is a leading cause of cancer in females, and is the second leading cancer-related cause of death in this group. Early diagnosis is essential to breast cancer to be effectively treated, and ultrasound, mammography, and magnetic resonance imaging (MRI) represent three key technologies that are utilized for the diagnosis of breast lesions. Breast-specific gamma imaging (BSGI) is an approach to molecular breast imaging that allows for high-resolution radio-imaging that is not adversely impacted by breast tissue density. This study was therefore designed to assess the relative diagnostic efficacy of BSGI, MRI, mammography, and ultrasound in different molecular subtypes of breast cancer among Chinese women. Methods: Diagnostic findings from 390 patients that had undergone diagnosis and treatment in our breast surgery department were retrospectively reviewed. Patients had been diagnosed via BSGI, mammography, ultrasound, and MRI. The diagnostic efficacy of these different imaging modalities and their associated biological characteristics were compared in the present study. Results: A total of 229 of these 390 patients (58.7%) were diagnosed with malignant breast cancer, with the remaining 161 (41.3%) cases having been found to be benign. BSGI, MRI, mammography, and ultrasound yielded respective sensitivity values of 91.7%, 92.5%, 77.3%, and 82.1%, while the respective specificity values for these imaging modalities were 80.7%, 69.7%, 74.5%, and 70.8%. For lesions > 1 cm, BSGI offered a sensitivity of 92.5%. For mammographic breast density A, B, C, and D, BSGI offered a sensitivity of 93.3%, 94.0%, 91.5%, and 89.3%, respectively. BSGI also yielded a significantly higher lesion-to-normal lesion ratio (LNR) for malignant lesions relative to benign lesions (2.76±1.32 vs 1.46±0.49). Conclusions: These findings confirm that BSGI is highly sensitive and is superior to mammography in the detection and diagnosis of ductal carcinomas in situ (DCIS). Such diagnostic efficacy can be further improved by using BSGI as an auxiliary modality to mammography and ultrasound, potentially improving the reliability of breast lesion diagnosis, thereby ensuring that patients receive rapid and effective treatment without the risk of misdiagnosis or unnecessary surgical treatment.


2020 ◽  
Author(s):  
Yoko Satoh ◽  
Utaroh Motosugi ◽  
Masamichi Imai ◽  
Yoshie Omiya ◽  
Hiroshi Onishi

Abstract Background: Using phantoms and clinical studies in prone hanging breast imaging, we assessed the image quality of a commercially available dedicated breast PET (dbPET) at the detector's edge, where mammary glands near the chest wall are located. These are compared to supine PET/CT breast images of the same clinical subjects.Methods: A breast phantom with four spheres (16, 10, 7.5, and 5 mm diameter) was filled with 18F-fluorodeoxyglucose solution (sphere-to-background activity concentration ratio, 8:1). The spheres occupied five different positions from the top edge to the centre of the detector and were scanned for 5 min in each position. Reconstructed images were visually evaluated, and the contrast-to-noise ratio (CNR), contrast recovery coefficient (CRC) for the 5-mm sphere, and coefficient of variation of the background (CVB) were calculated. Subsequently, clinical images obtained with standard supine PET/CT and prone dbPET were retrospectively analysed. Tumour-to-background ratios (TBRs) between breast cancer near the chest wall (close to the detector’s edge; peripheral group) and at other locations (non-peripheral group) were compared. The TBR of each lesion was compared between dbPET and PET/CT.Results: Closer to the detector’s edge, the CNR and CRC decreased while the CVB increased in the phantom study for all sphere sizes. The disadvantages of this placement were visually confirmed. Regarding clinical images, TBR of dbPET was significantly higher than that of PET/CT in both the peripheral (12.38±6.41 vs 6.73±3.5, p=0.0006) and non-peripheral (12.44±5.94 vs 7.71±7.1, p=0.0183) groups. There was no significant difference in TBR of dbPET between the peripheral and non-peripheral groups.Conclusion: The phantom study revealed poorer image quality at <2 cm distance from the detector's edge than at other more central parts. In clinical studies, however, the visibility of breast lesions with dbPET was the same regardless of the lesion position, and it was higher than that in PET/CT. dbPET has a great potential for detecting breast lesions near the chest wall if they are at least 2 cm from the edge of the FOV, even in young women with small breasts.


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