Emerging technologies in breast cancer detection.
Emerging technologies in breast cancer detection.
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乳腺癌检测的新兴技术。
DOI：
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发表时间：
2004
期刊：
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通讯作者：
D. M. Marcello
中科院分区：
文献类型：
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作者：
Andrew P. Smith;P. A. Hall;D. M. Marcello
虽然筛查性乳房X光检查被认为是早期检测乳腺癌的最有效方法，但这种方法存在局限性，这些局限性是改进现有乳房X光检查技术和开发新技术以改善乳腺癌检测的推动力。全视野数字乳腺X射线摄影（FFDM）系统使用数字探测器将X射线光子转换为数字信号，以便在高分辨率监视器上显示。这些系统提供了传统胶片屏幕乳房X线摄影所不具备的功能。对比度增强的乳房X线摄影利用了基本的生物学原理，即侵袭性癌症与血管分布增加有关。碘化造影剂--与计算机断层扫描（CT）检查中使用的造影剂相同--通常通过手臂静脉注射给药。它们分布在整个血液系统中，X射线成像显示在它们集中的区域对比度增加。断层合成采集涉及在短扫描期间以不同角度采集静止压缩乳房的多个图像。然后将单个图像重建成3D系列的薄高分辨率切片。切片可以单独显示或以动态电影模式显示。相对于标准2D投影乳腺X射线摄影，单个切片减少了组织重叠和结构噪声，总剂量与标准筛查乳腺X射线摄影所需的剂量相当。目前正在努力开发原型系统，以实现与数字乳房X光片共同配准的高分辨率全乳房3D超声图像。这项技术有可能提高乳腺成像研究的特异性，特别是在致密乳腺中。计算机辅助检测（CAD）程序旨在帮助放射科医生识别可能被忽视的可疑病变。CAD软件的工作原理类似于拼写检查器，并有可能增加癌症的检测磁共振成像（MRI）是一种普遍接受的诊断程序，用于许多乳腺相关的适应症。它最大的优点是对肿瘤非常敏感。如果可疑区域没有显示造影剂摄取，则其恶性的可能性非常小。反之，其特异性较差。如果该区域确实显示增强，它可能是或可能不是肿瘤。可能需要进一步的成像或活检来解决这个问题。超声波有望成为检测乳腺组织致密的女性癌症的一种方法，而传统的电影屏幕乳房X光检查往往存在问题。超声在乳腺成像中也发挥了重要作用，作为诊断性乳腺X线摄影的辅助手段，用于活检引导、可触及肿块评估和良性肿块的系列评估。
While screening mammography is recognized as the most effective method for early detection of breast cancer, this modality has limitations that are the driving force behind efforts to refine existing mammography technologies and develop new ones offering improved detection of breast cancer. Full-field digital mammography (FFDM) systems use digital detectors to convert x-ray photons to digital signals for display on high-resolution monitors. These systems offer capabilities not provided by conventional film-screen mammography. Contrast-enhanced mammography utilizes the basic biological principle that aggressive cancers are associated with increased vascularity. Iodinated contrast agents--the same used in computed tomography (CT) examinations--are administered through an injection in a vein usually in the arm. They distribute throughout the blood system, and x-ray imaging shows increased contrast in areas where they concentrate. Tomosynthesis acquisition involves acquiring multiple images of a stationary compressed breast at different angles during a short scan. The individual images are then reconstructed into a 3D series of thin high-resolution slices. The slices can be displayed individually or in a dynamic ciné mode. The individual slices reduce tissue overlap and structure noise relative to standard 2D projection mammography, with a total dose comparable to that required for standard screening mammography. Initial efforts are underway to develop prototype systems to achieve high-resolution, whole-breast 3D ultrasound images that are co-registered with digital mammograms. This technology has the potential to improve specificity in breast imaging studies, particularly in dense breasts. Computer-aided detection (CAD) programs are intended to help radiologists identify suspicious lesions that may otherwise be overlooked. CAD software works similarly to a spellchecker and has the potential to increase the detection of cancer Magnetic resonanace imaging (MRI) is a generally accepted diagnostic procedure for a number of breast related indications. Its greatest strength is that it is very sensitive to tumors. If a suspected area does not exhibit contrast agent uptake, the probability that it is malignant is very small. Conversely, its specificity is poorer. If the area does show enhancement, it may or may not be a tumor. Further imaging or biopsy may be needed to resolve the question. Ultrasound holds promise as a method for detection of cancers in women with dense breast tissue, which is often problematic with conventional film-screen mammography. Ultrasound has also assumed an important role in breast imaging, as an adjunct to diagnostic mammography for biopsy guidance, palpable mass evaluation, and serial evaluation of benign masses.