Mammograms are low-dose x-rays of the breast that have been used for screening since the s.
Several technical modifications have been made to mammography since evolving from xeromammography to the development of screen-film mammography and full-field digital mammography FFDMand now digital breast tomosynthesis DBT. Digital breast tomosynthesis continues to expand in clinical practice.
The established sensitivity and specificity of screening mammography are Tomosynthesis is the newest development in hopes of improving these numbers. Basics of breast tomosynthesis Tomography is a well-known technique in radiology that uses motion to better exhibit relevant anatomy, while allowing superimposed structures to fade.
The most pervasive example today is computed tomography CT. More recently, this same concept has been applied in breast imaging with the development of breast tomosynthesis. Interest peaked late in the s when flat panel detectors became available. This system uses low-dose images to create cross-sectional images of the breast.
In the screening patient, both the craniocaudal CC and mediolateral oblique MLO projections are acquired; however, additional projections may be obtained if warranted.
The x-ray source moves in a single plane in an arc around the imaged breast. These projection images are then reconstructed into 1-mm-thick images for review.
Filtered back projection FBP is the most commonly used method for reconstruction, which is also often used for CT reconstruction. Therefore, a tomosynthesis sweep can be obtained in nearly all of the diagnostic views.
Magnification views for the evaluation of microcalcifications cannot be obtained using tomosynthesis, and these should be evaluated with standard 2D magnification views.
While the morphology of microcalcifications may be better demonstrated with magnification views, the distribution of microcalcifications is effectively imaged with tomosynthesis Figure 1.
In clinical practice to date, screening mammography may include breast tomosynthesis, but it also requires the 2 standard 2D mammographic views of each breast. The dose is about twice that of the digital view alone; however, total dose of both exposures is still less than the U. Moreover, the increased dose approximates the dose of standard screen-film mammography, and it is felt that this slight increase in dose is acceptable allowing for an increased cancer detection rate, fewer additional views,and decreased recall rate.
This software addition to the DBT package allows reconstruction of a 2D mammographic image from the acquired tomosynthesis data.
This negates the necessity of standard mammographic views in addition to the tomosynthesis projection data. Ultimately this allows for a decrease in patient dose and less time under compression for the patient. C-view 2D imaging software has been available in Europe, many countries in Latin America, and Asia since C-view software will be available as an optional package to new and existing customers in the United States.
Gur et al found that there was a lower sensitivity and similar specificity in interpretation of synthetically generated mammographic images in comparison to FFDM, when both are combined with DBT. In this study, 10 radiologists retrospectively interpreted mammograms in 2groups.
One set included FFDM and the other set had the synthetically generated mammograms. Both sets included DBT. Review of the literature In recent years, several articles have been published describing experience with tomosynthesis.Breast Imaging CME and Board Review Courses.
Found 19 listings. Order by: Date Title. Advances in Breast Imaging: MR, Mammography, Ultrasound & Tomosynthesis Breast Tomosynthesis. The evidence for annual screening mammography in women age is stressed as a valuable and beneficial addition to complete this set. The AAFP supports the U.S.
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UCSF Breast Imaging ; Leading experts from UCSF cover a wide range of relevant topics from digital mammography to breast tomosynthesis and breast MRI.
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The practical hands-on workshop reviews the fundamentals of Breast Tomosynthesis Interpretation This 1 day workshop is designed to provide an intensive, hands-on experience of tomosynthesis. Throughout the program, participants will develop their interpretive skills through extensive case reviews (50 cases) on dedicated workstations.
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