Type:
Educational Exhibit
Keywords:
Breast, Oncology, Mammography, Experimental, Comparative studies, Neoplasia
Authors:
P. Clauser1, A. De Nicolò1, V. Londero2, C. Zuiani2, M. Bazzocchi2; 1Udine, Italy/IT, 2Udine/IT
DOI:
10.1594/ecr2013/C-1961
Background
Patients
Between May and November 2012,
23 women underwent Digital Mammography and Ultrasound at our Institution with the identification of 27 suspicious lesions,
confirmed as malignant by percutaneous needle biopsy.
All women underwent DBT to better evaluate the extent of disease.
Written consent was obtained from all patients and the approval of Etichs commitee was also waved.
After surgery,
the diagnosis of malignancy was confirmed.
Imaging
We sequentially performed for each patient DM and DBT of both breasts in the standard cranio-caudal (CC) and mediolateral oblique (MLO) projections.
The same digital system (Giotto TOMO,
IMS,
Bologna,
Italy) was used.
This system has a W-target x-ray source,
combined with Rh-filter or Ag-filter depending on breast thickness,
and an a-Se digital detector (ANRAD LMAM),
with a sensitive area of 24×30 cm2 and a squared pixel pitch of 0.085 mm.
For DBT,
the movable x-ray source spanned an overall angular range of ±20°,
acquiring 13 projections at the requested position.
Exposure parameters were determined by Automatic Exposure Control (AEC).
AEC for DBT in one view was defined so as to deliver a radiation dose approximately 1.4 times that for digital mammography in one view.
Image reconstruction was based on an iterative method that used Total Variation (TV) regularisation,
and by default reconstructed voxel size of 0.085 mm×0.085 mm×1.0 mm.
Two radiologists with experience in breast imaging evaluated in consensus both DM and DBT images of the suspicious area for each patient.
Breast density and the presence of the following findings were assessed according to ACR BI-RADS lexicon (ACR):
- masses;
- microcalcifications;
- density asymmetry and architectural distortions alone or associated.
Masses
|
Shape
|
Round/Oval; Lobular; Irregular
|
Margins
|
Well-defined; Spiculated; Irregular; Indistinct
|
Density
|
High; Intermediate; Lowe (compared to surrounding parenchyma)
|
Microcalcifications
|
Type
|
Amorphous/Indistinct; Pleomorphous; Linear/Linear-branching; Punctate
|
Distribution
|
Cluster; Linear; Segmental; Regional
|