mammography 3D
211238462
Corporate Medical Policy Digital Breast Tomosynthesis (DBT) 3D Mammography Description of Procedure or Service DBT is a three dimensional (3D) breast imaging technology that uses a rotating X ray source to acquire
DBT is a three dimensional (3D) breast imaging technology that uses a rotating X ray source to acquire multiple image slices at several angles. The X ray source rotates around the breast in an arc. Serial exposures are taken every few degrees in the arc rotation. These images are then reconstituted by software to produce a 3Dimage of the breast, similar to computed tomography (CT/CAT scanning) For screening, DBT is used in conjunction with full film digital mammography (FFDM) The results must be interpreted by a radiologist specialized in mammography. Tomosynthesis typically involves additional imaging time and radiation exposure.
85543769
Accuracy of Synthetic 2D Mammography Compared With Conventional 2D Digital Mammography Obtained With 3D Tomosynthesis.
OBJECTIVE The purpose of this study was to compare the diagnostic performance of synthetic 2D imaging generated from 3D tomosynthesis (DBT) with traditional 2D full field digital mammography (FFDM) by use of the most up to date software algorithm in an urban academic radiology practice. MATERIALS AND METHODS The records of patients undergoing screening mammography with DBT, synthetic 2D imaging, and FFDM between August 13, 2014, and January 31, 2016, were retrospectively collected. The cohort included all biopsy proven breast cancers detected with screening mammography during the study period (n 89) and 100 cases of negative or benign (BI RADS category 1 or 2) findings after 365 days of follow up. In separate sessions, three readers blinded to outcome reviewed DBT plus synthetic 2D or DBT plus FFDM screening mammograms and assigned a BI RADS category and probability of malignancy to each case. The diagnostic performance of each modality was assessed by calculating sensitivity and specificity. Reader performance was assessed by ROC analysis to estimate the AUC of the likelihood of malignancy. RESULTS No statistically significant difference was found in diagnostic accuracy (sensitivity, specificity, positive predictive value, or negative predictive value) between DBT plus synthetic 2D mammography and DBT plus FFDM. There was no statistically significant difference between the AUC of DBT plus synthetic 2D mammography and the AUC of DBT plus FFDM for any reader. CONCLUSION DBT plus synthetic 2D mammography performs as well as and not worse than DBT plus FFDM in measures of diagnostic accuracy and may be a viable alternative for decreasing radiation dose without sacrificing diagnostic performance.
AJR. American journal of roentgenology
Katherine Simon Katerina Dodelzon Michele B Drotman Allison Levy Elizabeth Kagan Arleo Gulce Askin Janine T Katzen
113595882
Does the synthesised digital mammography (3D DM) change the ACR density pattern?
Poster: "ECR 2015 B 0211 Does the synthesised digital mammography (3D DM) change the ACR density pattern?" by: "P. MARTINEZ MIRAVETE1, M. Millor Muruzabal2, P. Garcia Barquin2, A. Elizalde2, L. J. Pina Insausti2, J. Etxano2, P. Bartolome2; 1Zaragoza/ES, 2Pamplona/ES"
Paula Martinez Miravete Maite Millor Muruzabal Paula Garcia-Barquin Arlette Elizalde Luis Javier Pina Insausti Jon Etxano Pablo Bartolome
86404754
Generating synthetic mammograms for stationary 3D mammography
Purpose. Investigate synthetic mammography approaches for carbon nanotube (CNT) enabled stationary digital breast tomosynthesis (sDBT) Methods. Projection images of breast mimicking phantoms containing soft tissue masses and microcalcification clusters collected by sDBT were used to develop weighted intensity forward projection algorithms that generated a synthetic mammogram from the reconstructed 3D image space. Reconstruction was accomplished by an adapted fan volume modification of the simultaneous iterative reconstruction technique. Detectability indices were used to quantify mass and calcification visibility. The image processing chain was then applied to projection views collected by sDBT on women with "suspicious" breast lesions detected by standard screening 2D digital mammography. Results. Quantifying detectability allowed correlation between the visibility of clinically important image features and the order of the polynomial weighting function used during forward projection. The range of weighted functions exists between the extremes of an average intensity projection (zero order) and maximum intensity projection (infinite order) with lower order weights emphasizing soft tissue features and higher order weights emphasizing calcifications. Application of these algorithms to patient images collected by sDBT, coupled with dense artifact reduction and background equalization steps, produced synthetic mammograms on which additional post processing approaches can be explored, with the actual mammogram providing a reference for comparison. Conclusions. An image processing chain with adjustable weighting during forward projection, dense artifact reduction, and background equalization can yield a range of sDBT based synthetic mammograms that display clinically important features differently, potentially improving the ability to appreciate the association of masses and calcifications.
Medical Imaging
Connor Puett Christina R Inscoe Jianping Lu Yueh Z Lee Otto Zhou
201672526
Breast phantoms for 2D digital mammography with realistic anatomical structures and attenuation characteristics based on clinical images using 3D printing.
The aim of this work was to develop a production process for breast phantoms for 2D digital mammography (DM) with realistic anatomical structures and attenuation characteristics based on clinical images using 3D printing. The presented production process is based on PolyJet 3D printing technology using a polypropylene like printing material. First, an attenuation calibration function for this material and the achievable lateral resolution of the printing process of about 200 um was determined. Subsequently, to generate the digital 3D model of the breast phantom, the pixel intensities of the unprocessed clinical image that are related to the attenuation along the z axis of the breast, were converted to corresponding phantom heights using the calibration function. To validate the process, an image of the 3D printed breast phantom was acquired on the full field digital mammography (FFDM) system used for calibration and compared with the clinical image in terms of anatomical structures and associated attenuation characteristics. The exposure parameters and image impression of the phantom were evaluated using five other FFDM systems of different manufacturers and types. Results demonstrated that the anatomical structures in the images and the attenuation characteristics of a female breast and the derived phantom agreed on the FFDM system used for calibration. The automatic exposure control segmentation, the automatically selected exposure parameters and the image postprocessing of the clinical and phantom image indicated a high level of conformity. As shown, the phantom is also suitable for other FFDM systems. In conclusion, an approach to produce anthropomorphic breast phantoms for DM offering realistic anatomical structures and attenuation characteristics based on clinical images was successfully developed. As shown, the phantom realistically simulated the original female breast. Therefore, it is to expect that such phantoms are promising to support bridging the gap between physical technical and diagnostic image quality assessment. In addition, they enable a variety of practical and scientific applications for which present technical phantoms are not suitable.
Physics in medicine and biology
Stephan Schopphoven Pierre Cavael Karin Bock Martin Fiebich Ulf Mader
132303150
Screening mammography: Is 3D better?
Findings suggest 3D mammography may have advantages over 2D mammography in several areas when it comes to cancer diagnosis in younger women.
Els Judith M Orvos
55067919
Is synthetised Digital Mammography (3D DM) superior to conventional Digital Mammography (2D DM) A retrospective study of 210 patients
Poster: "ECR 2015 B 0923 Is synthetised Digital Mammography (3D DM) superior to conventional Digital Mammography (2D DM) A retrospective study of 210 patients" by: "P. Martinez Miravete1, P. Garcia Barquin2, M. Millor Muruzabal2, J. Etxano2, A. Elizalde2, L. Pina2, L. R. Zalazar2; 1Zaragoza/ES, 2Pamplona/ES"
Paula Garcia Barquin
201753154
Pilot trial of digital breast tomosynthesis (3D mammography) for population based screening in BreastScreen Victoria
To estimate detection measures for tomosynthesis and standard mammography; to assess the feasibility of using tomosynthesis in population based screening for breast cancer.
The Medical journal of Australia
Nehmat Houssami Darren Lockie Michelle Clemson Vicki Pridmore David Taylor Georgina Marr Jill Evans Petra Macaskill
197540699
3D mammography is on the upswing in the US, as experts argue about its value
While some doctors are happily recommending digital breast tomosynthesis, Jeanne Lenzer reports that the value of adding an extra dimension to mammography remains decidedly unproven
BMJ
Jeanne Lenzer
190866823
Followup mammography after breast conservation therapy: Is 3D Tomosynthesis(3DT) worth it?
6628 Background: Screening three dimensional tomosynthesis mammography (3DT) is more cost effective than two dimensional mammography (2DM) for detecting breast cancer, however cost effectiveness as a follow up for treated breast cancer is unknown. We retrospectively analyzed the downstream workup and costs associated with 3DT compared to 2DM when employed as initial follow up imaging in breast conservation therapy (BCT) Methods: Between the years 2015 2017, 450 consecutive BCT patients ages 32 89 with a follow up 3DT (n 162) or 2DM (n 288) were reviewed in this IRB approved study. The primary endpoint was further workup after follow up mammogram and associated healthcare costs at 1 year. Downstream workup was secondarily tested for correlation with clinical and treatment related variables. A single 3DT cost an estimated $149 compared to $111 for a 2DM, based on Centers for Medicare claims data Oncology Care Model. Results: Patient clinical characteristics were 6% DCIS, 10% T1a, 29% T1b, 35% T1c, 19% T2, 88% N0, 9% N1, 3% N2, 76% ER+/PR+/HerNeu2 12% TNBC, and 14% Her2Neu+ Whole breast radiation was given with conventional (59% and hypo (39% fractionation (81% with a boost) and 10% received accelerated partial breast irradiation. First post treatment mammogram was received within 3 months (20% 3 6 months (32% and after 6 months (48% following RT. There were no differences in breast density, patient age, T/N stage, receptor status, type of RT, or mammogram timing between those in the 2DM and 3DT groups. The following downstream workup ensued for 3DT compared to 2D imaging: 18% vs 29% short interval (6 month) mammogram (OR 1.83, P 0.01) 6% vs 11% breast MRI (OR 1.90, P 0.08) 4% ultrasound for each, and 3% biopsy for each (1 positive in the 2D group) Including downstream workup, the estimated cost per patient in the 3DT group $249.00 compared to $253.64 in the 2D group. With multivariable analysis the independent predictors for reduced downstream workup was the use of 3DT and follow up mammogram at least 6 months after radiation (P 0.05) Conclusions: Excess workup was reduced with 3DT compared to 2DM in the post treatment setting. A single 3DT costs approximately 34% more than 2DM, however in this study the associated reduction in downstream workup with 3DT actually made it more cost effective.
Journal of Clinical Oncology
Shaakir Hasan Steven Gresswell Brittany Colosimo Kevin Weinberger Sidney Anderson Matthew Bigbey Rodney E Wegner Betty E Shindel Thomas B Julian Mark G Trombetta