Assessment of the additional clinical potential of X-ray dark-field imaging for breast cancer in a preclinical setup.

breast cancer interferometry mammography microcalcifications

Journal

Therapeutic advances in medical oncology
ISSN: 1758-8340
Titre abrégé: Ther Adv Med Oncol
Pays: England
ID NLM: 101510808

Informations de publication

Date de publication:
2020
Historique:
received: 06 04 2020
accepted: 20 08 2020
entrez: 30 9 2020
pubmed: 1 10 2020
medline: 1 10 2020
Statut: epublish

Résumé

Mammography can identify calcifications up to 50-100 μm in size as a surrogate parameter for breast cancer or ductal carcinoma Talbot-Lau X-ray phase-contrast imaging and X-ray dark-field imaging were used to acquire images of breast specimens. The radiation dosage with the technique is comparable with conventional mammography. Three X-ray gratings with periods of 5-10 µm between the X-ray tube and the flat-panel detector provide three different images in a single sequence: the conventional attenuation image, differential phase image, and dark-field image. The images were read by radiologists. Radiological findings were marked and examined pathologically. The results were described in a descriptive manner. A total of 81 breast specimens were investigated with the two methods; 199 significant structures were processed pathologically, consisting of 123 benign and 76 malignant lesions (DCIS or invasive breast cancer). X-ray dark-field imaging identified 15 additional histologically confirmed carcinoma lesions that were visible but not declared suspicious on digital mammography alone. Another four malignant lesions that were not visible on mammography were exclusively detected with X-ray dark-field imaging. Adding X-ray dark-field imaging to digital mammography increases the detection rate for breast cancer and DCIS associated lesions with micrometer-sized calcifications.The use of X-ray dark-field imaging may be able to provide more accurate and detailed radiological classification of suspicious breast lesions.Adding X-ray dark-field imaging to mammography may be able to increase the detection rate and improve preoperative planning in deciding between mastectomy or breast-conserving therapy, particularly in patients with invasive lobular breast cancer.

Sections du résumé

BACKGROUND BACKGROUND
Mammography can identify calcifications up to 50-100 μm in size as a surrogate parameter for breast cancer or ductal carcinoma
METHODS METHODS
Talbot-Lau X-ray phase-contrast imaging and X-ray dark-field imaging were used to acquire images of breast specimens. The radiation dosage with the technique is comparable with conventional mammography. Three X-ray gratings with periods of 5-10 µm between the X-ray tube and the flat-panel detector provide three different images in a single sequence: the conventional attenuation image, differential phase image, and dark-field image. The images were read by radiologists. Radiological findings were marked and examined pathologically. The results were described in a descriptive manner.
RESULTS RESULTS
A total of 81 breast specimens were investigated with the two methods; 199 significant structures were processed pathologically, consisting of 123 benign and 76 malignant lesions (DCIS or invasive breast cancer). X-ray dark-field imaging identified 15 additional histologically confirmed carcinoma lesions that were visible but not declared suspicious on digital mammography alone. Another four malignant lesions that were not visible on mammography were exclusively detected with X-ray dark-field imaging.
CONCLUSIONS CONCLUSIONS
Adding X-ray dark-field imaging to digital mammography increases the detection rate for breast cancer and DCIS associated lesions with micrometer-sized calcifications.The use of X-ray dark-field imaging may be able to provide more accurate and detailed radiological classification of suspicious breast lesions.Adding X-ray dark-field imaging to mammography may be able to increase the detection rate and improve preoperative planning in deciding between mastectomy or breast-conserving therapy, particularly in patients with invasive lobular breast cancer.

Identifiants

pubmed: 32994806
doi: 10.1177/1758835920957932
pii: 10.1177_1758835920957932
pmc: PMC7502853
doi:

Types de publication

Journal Article

Langues

eng

Pagination

1758835920957932

Informations de copyright

© The Author(s), 2020.

Déclaration de conflit d'intérêts

Conflict of interest statement: MR is an employee of Siemens Healthcare GmbH, Erlangen, Germany. All other authors declare that they do not have any conflicts of interest.

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Auteurs

Julius Emons (J)

Department of Gynecology and Obstetrics, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Bayern, Germany.

Peter A Fasching (PA)

Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen-EMN, Universitätsstrasse 21-23, Erlangen 91054, Germany.

Marius Wunderle (M)

Department of Gynecology and Obstetrics, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Bayern, Germany.

Felix Heindl (F)

Department of Gynecology and Obstetrics, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Bayern, Germany.

Jens Rieger (J)

Erlangen Center for Astroparticle Physics, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany.

Florian Horn (F)

Erlangen Center for Astroparticle Physics, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany.

Georg Pelzer (G)

Erlangen Center for Astroparticle Physics, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany.

Andre Ritter (A)

Erlangen Center for Astroparticle Physics, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany.

Thomas Weber (T)

Erlangen Center for Astroparticle Physics, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany.

Marcus Radicke (M)

Siemens Healthcare GmbH, Erlangen, Germany.

Iris Polifka (I)

Institute of Pathology, Erlangen University Hospital, Erlangen, Germany.

David L Wachter (DL)

Institute of Pathology, Erlangen University Hospital, Erlangen, Germany.

Evelyn Wenkel (E)

Institute of Diagnostic Radiology, Erlangen University Hospital, Erlangen, Bayern, Germany.

Thilo Michel (T)

Erlangen Center for Astroparticle Physics, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany.

Michael Uder (M)

Institute of Diagnostic Radiology, Erlangen University Hospital, Erlangen, Bayern, Germany.

Arndt Hartmann (A)

Institute of Pathology, Erlangen University Hospital, Erlangen, Germany.

Gisela Anton (G)

Erlangen Center for Astroparticle Physics, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany.

Matthias W Beckmann (MW)

Department of Gynecology and Obstetrics, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Bayern, Germany.

Rüdiger Schulz-Wendtland (R)

Institute of Diagnostic Radiology, Erlangen University Hospital, Erlangen, Bayern, Germany.

Sebastian M Jud (SM)

Department of Gynecology and Obstetrics, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Bayern, Germany.

Classifications MeSH