David A. Scaduto

Dual-Energy Contrast Enhanced Digital Breast Tomosynthesis

In September 2009, the Journal of the American Medical Association published an article questioning the efficacy of traditional techniques used for screening for breast cancer. L. Esserman, Y. Shieh and I. Thompson, "Rethinking screening for breast cancer and prostate cancer," JAMA 302, 1685-1692 (2009). This article suggested that conventional mammography did not appreciably decrease breast cancer mortality and morbidity, and indeed increased the risk of other radiation-induced cancers. To reduce the risk of breast cancer, the authors concluded, novel methods of detecting breast cancer must be developed.

Breast tomosynthesis, a three-dimensional form of breast imaging, is one such novel method. X-ray projections are used to capture image slices of the breast.Y. Hu, B. Zhao and W. Zhao, "Image artifacts in digital breast tomosynthesis: Investigation of the effects of system geometry and reconstruction parameters using a linear system approach," Medical Physics 35, 5242 (2008). Images are acquired over fewer than 50 degrees around the breast and are mathematically reconstructed into a three-dimensional image volume. This reconstructed image provides a better view of overlapping anatomy that is difficult to resolve using two-dimensional mammographic techniques. Stony Brook University Medical Center is currently conducting clinical trials with a prototype tomosynthesis unit, and various research studies are concurrently underway.

The present work investigates the use of radiocontrast agents with breast tomosynthesis in an effort to improve contrast resolution in the reconstructed image. Computer simulations are performed using modeling softwareJ. Siewerdsen, A. Waese, D. Moseley, S. Richard and D. Jaffray, "Spektr: A computational tool for x-ray spectral analysis and imaging system optimization," Medical Physics 31, 3057 (2004). to generate x-ray spectra at various input parameters based on published spectra modelsJ. Boone, T. Fewell and R. Jennings, "Molybdenum, rhodium, and tungsten anode spectral models using interpolating polynomials with application to mammography," Medical Physics 24, 1863 (1997).; optimal filtration, x-ray tube voltage and current parameters will be determined for use of an iodinated radiocontrast agent. These details will be used as input parameters for an existing optimization model to determine optimal contrast and spatial resolution of the unit when the radiocontrast agent is used.


Copyright 2011 David A. Scaduto