Masses are significantly more conspicuous on breast CT images compared with screen-film mammograms, but microcalcification lesions are not as well visualized on our early-generation dedicated breast CT images.

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Dedicated breast CT: Initial clinical experience

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° 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 × 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.

Computed tomography for imaging the breast

The present invention provides a system 10 for irradiating a breast 20 of a patient 22. The system 10 comprises a gantry 12 rotatable about a horizontal axis 14 and comprising a radiation source 16 for generating a radiation beam 18 and a detector 24 spaced from the radiation source 16, and a barrier 26 disposed between the patient 22 and the gantry 12. The barrier 26 is provided with an opening 30 adapted to allow a breast 20 passing therethrough to be exposed to the radiation beam 18. In some embodiments, the barrier 26 is provided with an opening 30 adapted to allow both the breast 20 and the tissue leading from the breast to axilla and the muscle tissue of the adjacent chest wall passing therethrough to be exposed to the radiation beam 18.

System and Method for Imaging and Treatment of Tumorous Tissue in Breasts Using Computed Tomography and Radiotherapy

Experience with a dedicated breast CT scanner (General Electric CT/M) using a contrast medium enhancement technique indicates that CT is superior to mammography, thermography, or physical examination for diagnosing both benign and malignant mammary disease especially in dense, thick, or fibrocystic breasts. CT is capable of diagnosing totally unsuspected early miniature carcinomas. It can identify and differentiate potential precancerous lesions from benign fibrocystic disease, and is the diagnostic tool of choice for evaluating and following severe fibrocystic disease. CT evaluation also affords definitive diagnostic help in instances where the mammographic, thermographic, and/or physical examinations are inconclusive. It can influence immediate surgical intervention or mitigate against an unnecessary biopsy. The study not only demonstrates morphologic changes in the breast but also accurately depicts an altered iodine pool in mammary tissues.

Computed tomographic evaluation of the breast

The inner product computer is a special-purpose computational unit intended to be used as an adjunct to a general-purpose digital computer to perform numerical processing tasks which previously exceeded the capacity of the general-purpose computer. The algorithmic structure of the inner product is briefly reviewed in the first section of this paper. Methods are described for computing the inner product of complex vectors with a series of four real inner products. Several hardware implementations of the inner product computer are described and then compared in terms of speed and complexity; a figure of merit is developed to simplify the comparison. The utility of this computational unit is demonstrated via the examination of a large-scale numerical problem, computerized three-dimensional x-ray reconstruction (computerized tomography) arising in the biomedical sciences. Finally, a comparison is given of the size of a general-purpose computer required to execute a large-scale processing task with that of an inner product computer to execute the same task. The inner product computer greatly reduces computational costs for the solution of a large class of problems, including computerized tomography, image restoration, weather forecasting, and economic modeling.

Inner Product Computers

This is an initial report of the first clinical study using computerized tomographic mammography (CTM). A study is being conducted comparing CTM and conventional mammographic techniques in patients who subsequently undergo breast biopsy. This report analyzes the experience with 160 breast lesions found in patients who were examined using CTM without contrast material. One hundred lesions were benign and 60 were malignant. Mammography correctly identified 54 of the malignant lesions while CTM identified 41. Five lesions were missed by both modalities. The report also analyzes results experienced with 79 lesions found in patients who were examined with CTM both before and after the intravenous injection of contrast material. Forty-six of these lesions were benign and 33 were malignant. Mammography correctly identified 28 of the malignant lesions while CTM identified 27. Only one lesion was missed by both modalities. It is planned to continue this study, especially to enlarge our experience with the use of contrast material in breast scanning.

E C Reese

Papers

Clinical evaluation of computerized tomographic mammography.