Trimodel Mammography with Perfect Coregistration
Abstract
The overarching challenges addressed by this proposal are as follows: (1) to eliminate the mortality associated with metastatic breast cancer and (2) to conquer the problems of overdiagnosis and overtreatment for breast cancer. By far, the best strategy to eliminate the mortality associated with metastatic breast cancer is to detect and treat breast cancer at very early stages before it has a chance to metastasize. Conventional x-ray mammography is the most common medical imaging tool used to screen for early breast cancers. Despite the fact that tremendous progress has been made to improve the image quality of mammography, its sensitivity and specificity are both still limited by the physical principles governing conventional x-ray mammography: for the detection of typical indications of cancer or pre-cancerous growth (dense masses and small clusters of calcium deposits or microcalcifications), a single mechanism -- the absorption of x rays in matter -- determines how well these features can be identified in mammography. Unfortunately, the optimal detection performance for these two detection tasks often has competing requirements on the imaging system. As a result, traditional mammography requires that the performance of both detection tasks be somewhat compromised, resulting in the current high rate of overdiagnosis. The overall objective of this proposal is to develop a tri-modal x-ray mammography system to improve both the sensitivity (number of true cancers found) and specificity (number of correctly diagnosed healthy patients) of breast cancer detection. In this new imaging system, the current x-ray absorption based mammography will be maintained and supplemented with two additional contrast mechanisms: the first utilizes a contrast mechanism based on x-ray refraction (how the x-ray paths deviate within the object) and permits improved visualization of low contrast masses; the detection of microcalcifications can be accomplished with the second novel concomitant contrast mechanism: x-ray dark field contrast. It should be emphasized that all three types of images (absorption, phase contrast, and dark field contrast images) are generated from a single data acquisition with perfect co-registration (every point in each image corresponds exactly to that point in the other two images). This is dramatically different from other multi-modal imaging methods (such as PET/CT, etc.) which often suffer from mis-registration. Our central hypothesis is that the proposed tri-modal mammography system provides a new tool to optimally detect cancer masses and microcalcifications through the three complementary contrast mechanisms without requiring image registration or additional radiation dose; this has the potential to significantly improve early-stage diagnostic accuracy for breast cancer while reducing the rate of overdiagnosis in healthy women. To fully test this central hypothesis, we will optimize the design of the proposed tri-modal system and integrate it into a conventional mammographic imaging system. Once assembled, we will perform objective and subjective evaluations of the system performance using phantoms and mastectomy specimens. Upon the completion of this project, the first clinical prototype tri-modal mammography imaging system will have been constructed. As the interim outcome, preclinical evaluations of the proposed multi-contrast imaging system will have been performed to assess its potential benefits, which should provide sufficient evidence to justify the eventual goal of human subject trials.
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Apr 04, 2016
- Source ID
- W81XWH1610031
Entities
People
- Ke Li
Organizations
- United States Army
- University of Wisconsin–Madison