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。为了提高乳腺癌的早期发现，建议对无症状的患者每年进行乳房x光检查。然而，乳房x光检查并非没有局限性。乳腺组织的重叠是乳房x线摄影二维特性的固有结果，可能导致感兴趣的病变被掩盖（降低敏感性）或重叠的正常组织被误认为病变（降低特异性）。数字乳房断层合成是一种新型的基于x射线的成像技术，正在研究取代乳房x线照相术用于乳腺癌的早期发现和诊断。断层合成是基于有限角度计算机断层扫描的概念，在该概念中，从有限角度范围获得的成像物体的投影提供了足够的信息，可以在三维空间中部分重建该物体。报告表明，与乳房x线摄影相比，断层合成降低了回调率（增加特异性）并提高了检出率（增加敏感性）。然而，在目前的乳腺断层合成实施中，乳房经历了与乳房x光检查相同的有力压迫。研究表明，乳房x光检查时剧烈的乳房压迫引起的疼痛是导致女性不接受推荐的年度筛查性乳房x光检查的一个重要因素。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，产生了更多的乳房切除术，而不是保乳手术。这项研究项目的目的是开发和测试新的图像采集和处理技术，使乳房断层合成图像的采集能够大大减少乳房压缩量，而不会损失图像质量或增加辐射剂量。为此，我们将(1)开发一种降低x射线散射对图像质量影响的方法；(2)开发新的图像采集技术，减少压缩层合成像，使辐射剂量和图像噪声水平与标准层合成像相同；(3)比较使用本项目开发的技术进行的标准层析合成和压缩层析合成的图像质量。该项目的成功完成将使我们能够在乳房压缩水平大幅降低、辐射剂量不增加、图像质量和组织覆盖率不下降的情况下进行乳腺断层合成成像。这将减少与乳腺癌筛查相关的疼痛，从而提高妇女对筛查的依从性，从而降低乳腺癌死亡率，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.