Image Quality Improvement and Breast Compression Reduction in Breast Tomosynthesi

描述（由申请人提供）：乳腺癌是美国女性中最常见的非皮肤癌。为了增加乳腺癌的早期发现，建议对无症状患者进行年度筛查性乳房X线检查。然而，乳房X光检查并非没有限制。腺体组织的叠加是乳房X线摄影的二维性质的固有结果，并且可能导致感兴趣病变的掩蔽（降低灵敏度）或重叠的正常组织作为病变的假象（降低特异性）。乳腺数字断层合成摄影是一种新型的基于X射线的成像技术，正在研究取代乳腺X射线摄影术，用于乳腺癌的早期检测和诊断。断层合成是基于有限角度计算机断层摄影的概念，其中从有限角度范围采集的成像对象的投影给出足够的信息以在三维中部分地重建该对象。报告表明，与乳腺X射线摄影相比，断层合成摄影降低了回叫率（提高了特异性），提高了检出率（提高了灵敏度）。然而，在乳房断层合成的当前实施方式中，乳房经历与乳房X射线照相术中使用的相同的有力压缩。研究表明，在乳房X线摄影过程中，这种剧烈的乳房压迫引起的疼痛是女性不接受推荐的年度筛查乳房X线摄影的重要因素。这种筛查依从性的降低导致乳腺癌死亡率的增加和治疗选择的减少，从而导致乳房切除术的数量高于保乳手术。 本研究项目的目的是开发和测试新的图像采集和处理技术，这些技术将允许在不损失图像质量或增加辐射剂量的情况下，大幅减少乳房压缩量来采集乳房断层合成图像。为此，我们将（1）开发一种方法，以减少X射线散射对图像质量的影响;（2）开发新的图像采集技术，用于减少压缩断层合成，产生与标准断层合成相同的辐射剂量和图像噪声水平;（3）比较标准断层合成和使用本项目开发的技术进行的减少压缩断层合成之间的图像质量。 成功完成本项目将使患者能够在大幅降低乳房压迫水平的情况下进行乳房断层合成成像，而不会增加辐射剂量，也不会损失图像质量和组织覆盖范围。这将减少与乳腺癌筛查相关的疼痛，从而增加女性的筛查依从性，这将降低乳腺癌死亡率，并增加可以进行保乳手术的病例数量。

DESCRIPTION (provided by applicant): Breast cancer is the most prevalent non-skin cancer in women in the US. To increase the early detection of breast cancer, annual screening mammography has been recommended for asymptomatic patients. However, mammography is not without limitations. The superposition of glandular tissue is an inherent consequence of the two dimensional nature of mammography, and may result in the masking of lesions of interest (reducing sensitivity) or the false appearance of overlapping normal tissues as lesions (reducing specificity). Digital tomosynthesis of the breast is a novel x-ray based imaging technique being investigated to replace mammography for the early detection and diagnosis of breast cancer. Tomosynthesis is based on the concept of limited angle computed tomography, in which projections of the imaged object acquired from a limited angular range give enough information to partially reconstruct that object in three dimensions. Reports indicate that tomosynthesis reduces callback rate (increasing specificity) and increases detection rate (increasing sensitivity) compared to mammography. However, in current implementations of breast tomosynthesis, the breast undergoes the same vigorous compression as that used in mammography. It has been shown that the pain resulting from this vigorous breast compression during mammography is an important factor in women not undergoing the recommended annual screening mammography. This reduction in screening adherence results in an increase in breast cancer mortality and in a reduction in treatment options, yielding a higher number of mastectomies as opposed to breast conserving surgeries. The objective of this research project is to develop and test new image acquisition and processing techniques that will allow for the acquisition of breast tomosynthesis images with a substantial reduction in the amount of breast compression used with no loss in image quality or increase in radiation dose. For this, we will (1) develop a method to reduce the impact of x-ray scatter on image quality; (2) develop new image acquisition techniques for reduced compression tomosynthesis that result in the same radiation dose and image noise levels as standard tomosynthesis; (3) compare the image quality between standard tomosynthesis and reduced compression tomosynthesis performed with the techniques developed in this project. Successful completion of this project will result in the ability to perform breast tomosynthesis imaging with substantially reduced breast compression levels, with no increase in radiation dose, and no loss in image quality and tissue coverage. This will result in a reduction in the pain associated with breast cancer screening, resulting in an increase in screening adherence by women, which will decrease breast cancer mortality and increase the number of cases in which breast conserving surgery can be performed.