Cone-beam volume CT mammographic imaging: feasibility study

Abstract

X-ray projection mammography, using a film/screen combination or digital techniques, has proven to be the most effective imaging modality for early detection of breast cancer currently available. However, the inherent superimposition of structures makes small carcinoma (a few millimeters in size) difficult to detect in the occultation case or in dense breasts, resulting in a high false positive biopsy rate. The cone-beam x-ray projection based volume imaging using flat panel detectors (FPDs) makes it possible to obtain three-dimensional breast images. This may benefit diagnosis of the structure and pattern of the lesion while eliminating hard compression of the breast. This paper presents a novel cone-beam volume CT mammographic imaging protocol based on the above techniques. Through computer simulation, the key issues of the system and imaging techniques, including the x-ray imaging geometry and corresponding reconstruction algorithms, x-ray characteristics of breast tissues, x-ray setting techniques, the absorbed dose estimation and the quantitative effect of x-ray scattering on image quality, are addressed. The preliminary simulation results support the proposed cone-beam volume CT mammographic imaging modality in respect to feasibility and practicability for mammography. The absorbed dose level is comparable to that of current two-view mammography and would not be a prominent problem for this imaging protocol. Compared to traditional mammography, the proposed imaging protocol with isotropic spatial resolution will potentially provide significantly better low contrast detectability of breast tumors and more accurate location of breast lesions.