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ePaper created 2015-01-06, 15:49:55 | version 1.34.00
Reducing patient dose in tomosynthesis One area in which extensive research and development ef- forts have been focused is the creation of a 2D image gener- ated from a tomosynthesis data set. This method provides a 2D image for use during tomosynthesis review, but does not require an X-ray exposure to generate the 2D image as it is created directly from the tomosynthesis slices. In November 2011, Hologic announced the commercial release and CE mark of its C-ViewTM 2D image reconstruction algorithm that eliminates the need for a conventional 2D mammo- gram as a component of a tomosynthesis screening proce- dure. This approach, which received U.S. FDA approval in May 2013, provides the advantage of reducing the number of exposures, leading to shorter exam times, increased pa- tient comfort due to reduced time under compression and reduced patient dose. This software allows screening with tomosynthesis at comparable dose as conventional digital mammography. Tomosynthesis guided biopsy The ultimate diagnosis of a breast cancer lesion is through biopsy tissue sampling. The ability for tomosynthesis to identify lesions not readily visible with digital mammogra- phy or ultrasound has created an issue: How can a lesion that cannot be located using standard imaging methods be biopsied? Many lesions found with tomosynthesis can, in retrospect, be located and biopsied under stereotactic guidance, or biopsied using ultrasound imaging. But sub- tle lesions found in tomosynthesis sometimes can only be identified using tomosynthesis imaging. This requires that biopsy systems employ imaging and localisation using to- mosynthesis. With tomosynthesis-guided biopsy, it is possible to deter- mine the x-y-z location of a lesion with a single tomo scan. Advantages of this procedure compared to stereotactic bi- opsy include improved visibility of lesions that are occult in 2D imaging, faster lesion targeting, fewer X-ray exposures and reduced patient procedure time. Conclusion Breast tomosynthesis has been proven in several large-scale screening studies to increase the detection rate of invasive breast cancers*, while at the same time reducing false posi- tive recalls*. Advanced processing algorithms have made it possible to generate a 2D image from the tomosynthesis data set, thereby reducing dose to the patient, while still provid- ing the 2D image needed for optimal performance. Finally, it is now possible to perform biopsies using tomosynthesis guidance, enabling accurate targeting of all lesions, includ- ing those visible only on tomosynthesis imaging. * Data on file ADS-00955 © 2014 All right reserved. Hologic, C-View, Dimensions and Selenia are trademarks and/or registered trademarks of Hologic, Inc., and/or its subsidiaries in the United States and/or other countries. This information is intended for medical profession- als and is not intended as a product solicitation or promotion where such activities are prohibited. Because Hologic materials are distributed through websites, eBroadcasts and tradeshows, it is not always possible to control where such materials appear. For informa- tion on specific products available for sale in a particular country, please contact your local Hologic representative or write to womenshealth@hologic.com. C-ViewTM images eliminate the need for additional exposures and keep the dose for tomosynthesis exams the same as that of a digital mammography exam. Tomosynthesisis is effective in locating lesions that are occult in 2D imaging*. In the image above, the architectural distor- tion is essentially occult in the 2D mammograms, but is easily visualized in the tomosynthesis images. Tomosynthesis-guided biopsy of this lesion might be appropriate, and more effective than stereotactic localization. mammography RadBook 2014 83