Abstract
Wide-angle x-ray scatter (WAXS) could potentially be used to diagnose ductal carcinoma in situ (DCIS) in breast biopsies. The regions of interest were assumed to consist of fibroglandular tissue and epithelial cells and the model assumed that biopsies with DCIS would have a higher concentration of the latter. The scattered number of photons from a 2-mm diameter column of tissue was simulated using a 110-kV beam and selectively added in terms of momentum transfer. For a 1-min exposure, specificities and sensitivities of unity were obtained for biopsies 2- to 20-mm thick. The impact of sample and tumor cell layer thicknesses was studied. For example, a biopsy erroneously estimated to be 8mm would be correctly diagnosed if its actual thickness was between 7.3 and 8.7mm. An 8-mm thick malignant biopsy can be correctly diagnosed provided the malignant cell layer thickness is [Formula: see text]. WAXS methods could become a diagnostic tool for DCIS within breast biopsies.
Highlights
In vivo diagnosis of breast cancers is often difficult because the x-ray linear attenuation coefficients μ of fibroglandular and cancerous tissue are similar.[1]
Even with the advancements in medical imaging, such as digital mammography,[2] and threedimensional (3-D) imaging techniques, such as breast tomosynthesis[3] and cone-beam computed tomography (CBCT),[4] suspicious lesions will continue to exist since all these imaging methods are based on detecting differences in μ
The diagnosis of suspicious lesions is routinely done via removal of tissue and its subsequent analysis via histology
Summary
In vivo diagnosis of breast cancers is often difficult because the x-ray linear attenuation coefficients μ of fibroglandular and cancerous tissue are similar.[1]. LeClair et al.: Model predictions for the wide-angle x-ray scatter signals of healthy and malignant breast duct biopsies malignant tissue (9.0%) while the differences between malignant and fibrocystic change tissue were considered not significant (3.4%). Sidhu et al.[21] measured the SAXS signals of 357 breast tissue samples from 56 patients. Selected parameters from scatter profiles (e.g., ratios of areas under the axial and lateral peaks) of healthy and malignant tissue, combined with a statistical analysis, were used to identify key structural features. Two articles quantitatively showed how WAXS models and measurements can be used to estimate dμs∕dΩ of breast tissue.[42,43] The goal was to validate a protocol to compare the WAXS signals of cancerous versus fibroglandular tissue without the effects of fat since the latter is most likely to be present. A cadmium zinc telluride (CZT) photoncounting energy discriminating detector[45] would allow this type of analysis
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