Tomosynthesis for Improved Breast Cancer Detection

描述(申请人提供)：这项研究的目的是研究断层合成乳房X光检查，以提高乳腺癌检测的敏感性和特异性。通过移除重叠的组织，该系统可以检测到模糊的病变，并允许更好地对病变进行3D表征。这项研究的具体目标是：(1)利用标本和患者图像优化断层合成技术。(2)实现断层合成图像和CAD输出的软拷贝显示系统，以最大限度地提高放射科医生的工作效率和绩效。(3)进行前瞻性的先导性研究，以评估放射科医生在乳房断层合成方面的表现。(4)研究乳腺肿块的计算机辅助设计作为乳腺断层合成的重要组成部分。在初步研究中，我们评估了用于断层合成扫描的研究性数字乳腺摄影系统的物理特性，并优化了用于断层合成的放射学技术。我们将胸部断层合成的经验转化为乳房X光摄影，并在幻影、乳房切除标本和患者身上证明了我们的重建算法的可行性。我们开发了新的CAD算法来检测乳房X光检查中的乳腺肿块，并将这一经验应用到3D断层合成数据中。这项建议提出了一个完整的计划，以证明物理和临床的可行性。在成功完成每个目标后，直接的好处将是关键的信息，这些信息将促进我们的工业合作伙伴将这种乳房断层合成系统进行商业翻译，以及其他学术团体和制造商对类似系统的评估。

DESCRIPTION (provided by applicant): The purpose of this study is to investigate tomosynthesis mammography to improve the sensitivity and specificity of breast cancer detection. By removing overlapping tissue, this system can allow detection of obscured lesions and permit better 3D characterization of lesions. The specific aims of the proposed study are to: (1) Optimize tomosynthesis technique using specimen and patient images. (2) Implement soft-copy display system for tomosynthesis images and CAD outputs to maximize radiologist productivity and performance. (3) Perform prospective pilot studies to evaluate radiologist performance with breast tomosynthesis. (4) Investigate CAD of breast masses as an integral component of breast tomosynthesis. In preliminary studies, we evaluated the physical characteristics of an investigational digital mammography system modified for tomosynthesis scanning, and optimized the radiographic technique for tomosynthesis. We translated our experience with chest tomosynthesis into mammography, and demonstrated feasibility of our reconstruction algorithm on phantoms, mastectomy specimens, and patients. We developed novel CAD algorithms for the detection of breast masses in mammography, and will parlay that experience into the 3D tomosynthesis data. This proposal presents a complete plan to demonstrate physical and clinical feasibility. Upon the successful completion of each aim, the immediate benefit will be crucial information which will facilitate commercial translation of this breast tomosynthesis system by our industrial partner, as well as the evaluation of similar systems from other academic groups and manufacturers.