Computed tomography for imaging the breast

Despite the success of screening mammography contributing to the reduction of cancer mortality, a number of other imaging techniques are being studied for breast cancer screening. In our laboratory, a dedicated breast computed tomography (CT) system has been developed and is currently undergoing patient testing. The breast CT system is capable of scanning the breast with the woman lying prone on a tabletop, with the breast in the pendant position. A 360 degrees scan currently requires 16.6 s, and a second scanner with a 9-second scan time is nearly operational. Extensive effort was placed on computing the radiation dose to the breast under CT geometry, and the scan parameters are selected to utilize the same radiation dose levels as two-view mammography. A total of 55 women have been scanned, ten healthy volunteers in a Phase I trial, and 45 women with a high likelihood of having breast cancer in a Phase II trial. The breast CT process leads to the production of approximately three hundred 512 x 512 images for each breast. Subjective evaluation of the breast CT images reveals excellent anatomical detail, good depiction of microcalcifications, and exquisite visualization of the soft tissue components of the tumor when contrasted against adipose tissues. The use of iodine contrast injection dramatically enhances the visualization of tumors. While a thorough scientific investigation based upon observer performance studies is in progress, initial breast CT images do appear promising and it is likely that breast CT will play some role in breast cancer imaging.