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Zhai C, Hong Y, Lin Z, Chen Y, Guo M, Guo T, Wang H, Hu C. Addressing the imaging limitations of a microsphere-assisted nanoscope. OPTICS EXPRESS 2022; 30:39417-39430. [PMID: 36298895 DOI: 10.1364/oe.473535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 09/28/2022] [Indexed: 06/16/2023]
Abstract
In the past decade, microsphere-assisted nanoscopy has been developed rapidly to overcome the diffraction limit. However, due to the limited size and high surface curvature of microspheres, the magnified imaging still suffers from problems like limited view scope, imaging distortion, and low contrast. In this paper, we specialize in the imaging mechanism of microspheres and find irradiance as the key factor for microsphere imaging quality. Utilizing a modified optical tweezer system, we achieve precise manipulation of microspheres and further propose a high-quality large-field magnified imaging scheme. The results show that the imaging area of 5 µm microspheres can reach 16×12 µm2 with the minimum identifiable feature of 137 nm. This scheme provides a new solution for extending the measuring scope of microsphere-assisted nanoscope, and will certainly promote the application of this technology in practice.
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Øynes M, Strøm B, Tveito B, Hafslund B. Digital zoom of the full-field digital mammogram versus magnification mammography: a systematic review. Eur Radiol 2020; 30:4223-4233. [PMID: 32222798 PMCID: PMC7338280 DOI: 10.1007/s00330-020-06798-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 01/22/2020] [Accepted: 03/09/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To summarise and compare the performance of magnification mammography and digital zoom utilising a full-field digital mammography (FFDM) system in the detection and diagnosis of microcalcifications. METHODS We ran an extended search in MEDLINE, EMBASE, CINAHL, Engineering Village and Web of Science. Diagnostic test studies, experimental breast phantom studies and a Monte Carlo phantom study were included. A narrative approach was selected to summarise and compare findings regarding the detection of microcalcifications, while a hierarchical model with bivariate analysis was used for the meta-analysis of sensitivity and specificity for diagnosing microcalcifications. RESULTS Nine studies were included. Phantom studies suggested that the size of microcalcifications, magnification or zoom factor, exposure factors and detector technology determine whether digital zoom is equivalent to magnification mammography in the detection of microcalcifications. Pooled sensitivity for magnification and zoom calculated from the diagnostic test studies was 0.93 (95% CI 0.84-0.97) and 0.85 (95% CI 0.70-0.94), respectively. Pooled specificity was 0.55 (95% CI 0.51-0.58) and 0.56 (95% CI 0.50-0.62), respectively. The differences between the sensitivities and specificities were not statistically significant. CONCLUSIONS Digital zoom may be equivalent to magnification mammography. Diagnostic test studies and phantom studies using newer detector technology would contribute additional knowledge on this topic. KEY POINTS • The performance of digital zoom is comparable to magnification for detecting microcalcifications when newer detector technology and optimised imaging procedures are utilised. • The accuracy of digital zoom appears equivalent to geometric magnification in diagnosing microcalcifications.
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Affiliation(s)
- Mona Øynes
- Department of Health and Functioning, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Høgskulen på Vestlandet, Postbox 7030, 5020, Bergen, Norway.
| | - Bergliot Strøm
- Department of Health and Functioning, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Høgskulen på Vestlandet, Postbox 7030, 5020, Bergen, Norway
| | - Bente Tveito
- Division of Research, Internationalisation and Innovation, Library, Western Norway University of Applied Sciences, Høgskulen på Vestlandet, Postbox 7030, 5020, Bergen, Norway
| | - Bjørg Hafslund
- Department of Health and Functioning, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Høgskulen på Vestlandet, Postbox 7030, 5020, Bergen, Norway
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Raufer S, Idoff C, Zosuls A, Marino G, Blanke N, Bigio IJ, O'Malley JT, Burgess BJ, Nadol JB, Guinan JJ, Nakajima HH. Anatomy of the Human Osseous Spiral Lamina and Cochlear Partition Bridge: Relevance for Cochlear Partition Motion. J Assoc Res Otolaryngol 2020; 21:171-182. [PMID: 32166603 DOI: 10.1007/s10162-020-00748-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 02/20/2020] [Indexed: 11/29/2022] Open
Abstract
The classic view of cochlear partition (CP) motion, generalized to be for all mammals, was derived from basal-turn measurements in laboratory animals. Recently, we reported motion of the human CP in the cochlear base that differs substantially from the classic view. We described a human soft tissue "bridge" (non-existent in the classic view) between the osseous spiral lamina (OSL) and basilar membrane (BM), and showed how OSL and bridge move in response to sound. Here, we detail relevant human anatomy to better understand the relationship between form and function. The bridge and BM have similar widths that increase linearly from base to apex, whereas the OSL width decreases from base to apex, leading to an approximately constant total CP width throughout the cochlea. The bony three-dimensional OSL microstructure, reconstructed from unconventionally thin, 2-μm histological sections, revealed thin, radially wide OSL plates with pores that vary in size, extent, and distribution with cochlear location. Polarized light microscopy revealed collagen fibers in the BM that spread out medially through the bridge to connect to the OSL. The long width and porosity of the OSL may explain its considerable bending flexibility. The similarity of BM and bridge widths along the cochlea, both containing continuous collagen fibers, may make them a functional unit and allow maximum CP motion near the bridge-BM boundary, as recently described. These anatomical findings may help us better understand the motion of the structures surrounding the organ of Corti and how they shape the input to the cochlear sensory mechanism.
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Affiliation(s)
- Stefan Raufer
- Massachusetts Eye and Ear, Boston, MA, 02114, USA. .,Speech and Hearing Bioscience and Technology Program, Harvard Medical School, Boston, MA, 02115, USA. .,Medizinische Hochschule Hannover, Klinik für Hals-Nasen-Ohrenheilkunde, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
| | - Cornelia Idoff
- Massachusetts Eye and Ear, Boston, MA, 02114, USA.,Faculty of Medicine and Health Sciences, Linköping University, 58183, Linköping, Sweden
| | | | | | - Nathan Blanke
- Department of Biomedical Engineering, Boston University, Boston, MA, 02215, USA
| | - Irving J Bigio
- Department of Biomedical Engineering, Boston University, Boston, MA, 02215, USA
| | - Jennifer T O'Malley
- Massachusetts Eye and Ear, Boston, MA, 02114, USA.,Department of Otolaryngology, Harvard Medical School, Boston, MA, 02115, USA
| | - Barbara J Burgess
- Massachusetts Eye and Ear, Boston, MA, 02114, USA.,Department of Otolaryngology, Harvard Medical School, Boston, MA, 02115, USA
| | - Joseph B Nadol
- Massachusetts Eye and Ear, Boston, MA, 02114, USA.,Department of Otolaryngology, Harvard Medical School, Boston, MA, 02115, USA
| | - John J Guinan
- Massachusetts Eye and Ear, Boston, MA, 02114, USA.,Speech and Hearing Bioscience and Technology Program, Harvard Medical School, Boston, MA, 02115, USA.,Department of Otolaryngology, Harvard Medical School, Boston, MA, 02115, USA
| | - Hideko H Nakajima
- Massachusetts Eye and Ear, Boston, MA, 02114, USA.,Speech and Hearing Bioscience and Technology Program, Harvard Medical School, Boston, MA, 02115, USA.,Department of Otolaryngology, Harvard Medical School, Boston, MA, 02115, USA
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Alkhalifah KH, Brindhaban A, Asbeutah AM. Comparison between image quality in electronic zoom and geometric magnification in digital mammography. JOURNAL OF X-RAY SCIENCE AND TECHNOLOGY 2016; 24:681-689. [PMID: 27341625 DOI: 10.3233/xst-160580] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND Magnification mammography is performed to enhance the visibility of small structures at the expense of relatively high radiation dose as a complementary examination to standard mammography. The introduction of post-processing capabilities and the widespread use of digital mammography has promoted some controversy in the last decade on whether similar visibility can be achieved using electronic zoom. The aim of this study is to compare the visibility of small structures in images obtained by the two techniques stated above for different exposure conditions. METHODS Images of a Fluke Biomedical Model 18-220 Mammography Accreditation Phantom were obtained using standard techniques and geometric magnification, using a digital mammography unit, with different exposure factors. Three different target/filter combinations (Mo/Mo,Mo/Rh,Rh/Rh), variable kVp (26-32), and automatic exposure control were used. Images obtained using standard technique were electronically zoomed and compared to the corresponding magnification mammograms. Comparisons were based on the visibility of structures evaluated by five senior technologist with extensive experience in mammography. Statistical analysis was performed using non-parametric tests. RESULTS Visibility of structures was not affected by the kV used for a given target/filter combination for both techniques (p > 0.065). Target/filter combination of Mo/Mo provided better visibility of micro-calcification and fibers (p < 0.026) in geometric magnification technique and Mo/Rh in the digital zoom technique. No significant differences were observed in the visibility of simulated breast masses. The overall image score was significantly higher (p < 0.001) for geometric magnification over the digital zoom for Mo/Mo & Rh/Rh combinations. CONCLUSION Although sufficient image quality was maintained in electronically zoomed images, geometric magnification provided better overall visualization of structures in the phantom.
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Miglioretti DL, Lange J, van den Broek JJ, Lee CI, van Ravesteyn NT, Ritley D, Kerlikowske K, Fenton JJ, Melnikow J, de Koning HJ, Hubbard RA. Radiation-Induced Breast Cancer Incidence and Mortality From Digital Mammography Screening: A Modeling Study. Ann Intern Med 2016; 164:205-14. [PMID: 26756460 PMCID: PMC4878445 DOI: 10.7326/m15-1241] [Citation(s) in RCA: 93] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Estimates of risk for radiation-induced breast cancer from mammography screening have not considered variation in dose exposure or diagnostic work-up after abnormal screening results. OBJECTIVE To estimate distributions of radiation-induced breast cancer incidence and mortality from digital mammography screening while considering exposure from screening and diagnostic mammography and dose variation among women. DESIGN 2 simulation-modeling approaches. SETTING U.S. population. PATIENTS Women aged 40 to 74 years. INTERVENTION Annual or biennial digital mammography screening from age 40, 45, or 50 years until age 74 years. MEASUREMENTS Lifetime breast cancer deaths averted (benefits) and radiation-induced breast cancer incidence and mortality (harms) per 100,000 women screened. RESULTS Annual screening of 100,000 women aged 40 to 74 years was projected to induce 125 breast cancer cases (95% CI, 88 to 178) leading to 16 deaths (CI, 11 to 23), relative to 968 breast cancer deaths averted by early detection from screening. Women exposed at the 95th percentile were projected to develop 246 cases of radiation-induced breast cancer leading to 32 deaths per 100,000 women. Women with large breasts requiring extra views for complete examination (8% of population) were projected to have greater radiation-induced breast cancer risk (266 cancer cases and 35 deaths per 100,000 women) than other women (113 cancer cases and 15 deaths per 100,000 women). Biennial screening starting at age 50 years reduced risk for radiation-induced cancer 5-fold. LIMITATION Life-years lost from radiation-induced breast cancer could not be estimated. CONCLUSION Radiation-induced breast cancer incidence and mortality from digital mammography screening are affected by dose variability from screening, resultant diagnostic work-up, initiation age, and screening frequency. Women with large breasts may have a greater risk for radiation-induced breast cancer. PRIMARY FUNDING SOURCE Agency for Healthcare Research and Quality, U.S. Preventive Services Task Force, National Cancer Institute.
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Affiliation(s)
- Diana L. Miglioretti
- Division of Biostatistics, Department of Public Health Sciences, University of California Davis School of Medicine, Davis, CA 95616
- Center for Healthcare Policy and Research, University of California, Davis, Sacramento, CA, 95817
- Group Health Research Institute, Seattle, WA 98101
| | - Jane Lange
- Group Health Research Institute, Seattle, WA 98101
| | - Jeroen J. van den Broek
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, the Netherlands
| | - Christoph I. Lee
- Department of Radiology, University of Washington, Seattle, WA
- Department of Health Services, University of Washington, Seattle, WA
- Hutchinson Institute for Cancer Outcomes Research, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Nicolien T. van Ravesteyn
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, the Netherlands
| | - Dominique Ritley
- Center for Healthcare Policy and Research, University of California, Davis, Sacramento, CA, 95817
| | - Karla Kerlikowske
- Departments of Medicine and Epidemiology and Biostatistics, University of California, San Francisco, CA; General Internal Medicine Section, Department of Veterans Affairs, University of California, San Francisco, CA
| | - Joshua J. Fenton
- Center for Healthcare Policy and Research, University of California, Davis, Sacramento, CA, 95817
- Department of Family and Community Medicine, University of California, Davis, Sacramento, CA 95817
| | - Joy Melnikow
- Center for Healthcare Policy and Research, University of California, Davis, Sacramento, CA, 95817
- Department of Family and Community Medicine, University of California, Davis, Sacramento, CA 95817
| | - Harry J. de Koning
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, the Netherlands
| | - Rebecca A. Hubbard
- Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA 19104
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Schulz-Wendtland R, Dilbat G, Bani M, Fasching PA, Heusinger K, Lux MP, Loehberg CR, Brehm B, Hammon M, Saake M, Dankerl P, Jud SM, Rauh C, Bayer CM, Beckmann MW, Uder M, Meier-Meitinger M. Full Field Digital Mammography (FFDM) versus CMOS Technology, Specimen Radiography System (SRS) and Tomosynthesis (DBT) - Which System Can Optimise Surgical Therapy? Geburtshilfe Frauenheilkd 2013; 73:422-427. [PMID: 24771921 DOI: 10.1055/s-0032-1328600] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Revised: 04/16/2013] [Accepted: 04/16/2013] [Indexed: 10/26/2022] Open
Abstract
Aim: This prospective clinical study aimed to evaluate whether it would be possible to reduce the rate of re-excisions using CMOS technology, a specimen radiography system (SRS) or digital breast tomosynthesis (DBT) compared to a conventional full field digital mammography (FFDM) system. Material and Method: Between 12/2012 and 2/2013 50 patients were diagnosed with invasive breast cancer (BI-RADS™ 5). After histological verification, all patients underwent breast-conserving therapy with intraoperative imaging using 4 different systems and differing magnifications: 1. Inspiration™ (Siemens, Erlangen, Germany), amorphous selenium, tungsten source, focus 0.1 mm, resolution 85 µm pixel pitch, 8 lp/mm; 2. BioVision™ (Bioptics, Tucson, AZ, USA), CMOS technology, photodiode array, flat panel, tungsten source, focus 0.05, resolution 50 µm pixel pitch, 12 lp/mm; 3. the Trident™ specimen radiography system (SRS) (Hologic, Bedford, MA, USA), amorphous selenium, tungsten source, focus 0.05, resolution 70 µm pixel pitch, 7.1 lp/mm; 4. tomosynthesis (Siemens, Erlangen, Germany), amorphous selenium, tungsten source, focus 0.1 mm, resolution 85 µm pixel pitch, 8 lp/mm, angular range 50 degrees, 25 projections, scan time > 20 s, geometry: uniform scanning, reconstruction: filtered back projection. The 600 radiographs were prospectively shown to 3 radiologists. Results: Of the 50 patients with histologically proven breast cancer (BI-RADS™ 6), 39 patients required no further surgical therapy (re-excision) after breast-conserving surgery. A retrospective analysis (n = 11) showed a significant (p < 0.05) increase of sensitivity with the BioVision™, the Trident™ and tomosynthesis compared to the Inspiration™ at a magnification of 1.0 : 2.0 or 1.0 : 1.0 (tomosynthesis) (2.6, 3.3 or 3.6 %), i.e. re-excision would not have been necessary in 2, 3 or 4 patients, respectively, compared to findings obtained with a standard magnification of 1.0 : 1.0. Conclusion: The sensitivity of the BioVision™, the Trident™ and tomosynthesis was significantly (p < 0.05) higher and the rate of re-excisions was reduced compared to FFDM using a conventional detector at a magnification of 2.0 but without zooming.
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Affiliation(s)
- R Schulz-Wendtland
- Gynäkologische Radiologie, Radiologisches Institut, Universitätsklinikum Erlangen, Erlangen
| | - G Dilbat
- Radiologische Praxis Roth und Weißenburg, Roth
| | - M Bani
- Frauenklinik, Universitätsklinikum Erlangen, Erlangen
| | - P A Fasching
- Frauenklinik, Universitätsklinikum Erlangen, Erlangen
| | - K Heusinger
- Frauenklinik, Universitätsklinikum Erlangen, Erlangen
| | - M P Lux
- Frauenklinik, Universitätsklinikum Erlangen, Erlangen
| | - C R Loehberg
- Frauenklinik, Universitätsklinikum Erlangen, Erlangen
| | - B Brehm
- Gynäkologische Radiologie, Radiologisches Institut, Universitätsklinikum Erlangen, Erlangen
| | - M Hammon
- Gynäkologische Radiologie, Radiologisches Institut, Universitätsklinikum Erlangen, Erlangen
| | - M Saake
- Gynäkologische Radiologie, Radiologisches Institut, Universitätsklinikum Erlangen, Erlangen
| | - P Dankerl
- Gynäkologische Radiologie, Radiologisches Institut, Universitätsklinikum Erlangen, Erlangen
| | - S M Jud
- Frauenklinik, Universitätsklinikum Erlangen, Erlangen
| | - C Rauh
- Frauenklinik, Universitätsklinikum Erlangen, Erlangen
| | - C M Bayer
- Frauenklinik, Universitätsklinikum Erlangen, Erlangen
| | - M W Beckmann
- Frauenklinik, Universitätsklinikum Erlangen, Erlangen
| | - M Uder
- Radiologisches Institut, Universitätsklinikum Erlangen, Erlangen
| | - M Meier-Meitinger
- Gynäkologische Radiologie, Radiologisches Institut, Universitätsklinikum Erlangen, Erlangen
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7
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Wiesinger B, Stütz A, Schmehl J, Groezinger G, Claussen CD, Wiskirchen J. Comparison of visibility for four self-expanding nitinol bare stents in vitro. Acta Radiol 2012; 53:1020-5. [PMID: 22969090 DOI: 10.1258/ar.2012.120187] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Sufficient radiopacity of stents is a prerequisite for safe interventions and minimization of the radiation dose for the patient and the interventionist. Modern nitinol stents are considered less radiopaque compared to formerly used stents. PURPOSE To evaluate the objective detection rate (ODR) and the subjective radiopacity score (SRS) of four self-expanding nitinol stents with their markers on a phantom human pelvis. MATERIAL AND METHODS We evaluated the ODR (as a percentage of correctly identified stents) and the SRS (on a scale from 0 = not visible to 4 = excellent visibility) for four self-expanding nitinol stents (SinusSuperflex, SMART, Luminexx, Zilver) with 8 mm diameter and 40 mm length. Stents were placed on a phantom human pelvis and images of the stents were taken in four different positions (right and left lumbosacral joint and near the right and left limbus acetabuli) using the following modes: spotfilm, pulsed fluoroscopy (4, 7.5, 15, and 30 pulses/min) and at three different digital magnification modes. Dose area products (DAPs) were assessed. RESULTS ODR and SRS, respectively, were significantly increased for the SMART stent compared to all other tested stents (P < 0.05): SMART 93.53% and 2.43, SinusSuperflex 90.81% and 2.21, Luminexx 90.39% and 2.20, and Zilver 89.28% and 2.21. ODR was significantly reduced in position 3 where the bone overlap was more pronounced for all stents (detection rates 77.14-79.56%). An increase in magnification significantly improved the ODR and SRS for all stents (70.33-99.25% and 1.07-3.28, respectively, P < 0.05). Increased pulsing frequency did not improve the ODR of the various stents but did increase the DAP. CONCLUSION The SMART stent had the best overall performance. In the presence of bone overlap, all self-expanding nitinol stents had poor results. Increased pulsing frequency did not improve ODR or SRS but did increase the DAP. Use of digital magnification modes had no effect on DAP increasing ODR and SRS.
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Affiliation(s)
- Benjamin Wiesinger
- Division of Diagnostic Radiology, Department of Radiology, University of Tübingen
| | - Alexander Stütz
- Division of Diagnostic Radiology, Department of Radiology, University of Tübingen
| | - Jörg Schmehl
- Division of Diagnostic Radiology, Department of Radiology, University of Tübingen
| | - Gerd Groezinger
- Division of Diagnostic Radiology, Department of Radiology, University of Tübingen
| | | | - Jakub Wiskirchen
- Department of Radiology, Franziskus Krankenhaus, Bielefeld, Germany
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Schulz-Wendtland R, Dilbat G, Bani M, Fasching PA, Lux MP, Wenkel E, Schwab S, Loehberg CR, Jud SM, Rauh C, Bayer CM, Beckmann MW, Uder M, Meier-Meitinger M. Full Field Digital Mammography (FFDM) versus CMOS Technology versus Tomosynthesis (DBT) - Which System Increases the Quality of Intraoperative Imaging? Geburtshilfe Frauenheilkd 2012; 72:532-538. [PMID: 26640287 DOI: 10.1055/s-0032-1314942] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
Aim: The aim of this prospective clinical study was to assess whether it would be possible to reduce the rate of re-excisions and improve the quality using CMOS technology or digital breast tomosynthesis (DBT) compared to a conventional FFDM system. Material and Methods: An invasive breast cancer (BI-RADS 5) was diagnosed in 200 patients in the period from 5/2011 to 1/2012. After histological verification, a breast-conserving therapy was performed with intraoperative imaging. Three different imaging systems were used: 1) Inspiration™ (Siemens, Erlangen, Germany), amorphous selenium, tungsten source, focus 0.1 mm, resolution 85 µm pixel pitch, 8 l/mm as the standard; 2) BioVision™ (Bioptics, Tucson, USA), flat panel photodiode array, tungsten source, focus 0.05, resolution 50 µm pixel pitch, 12 l/mm; 3) Tomosynthesis (Siemens, Erlangen, Germany), amorphous selenium, tungsten source, focus 0.1 mm, resolution 85 µm pixel pitch, 8 l/mm, range: 50°, 25 projections, scan time > 20 s, geometry: uniform scanning, reconstruction: filtered back projection. The 600 radiograms were prospectively shown to 3 radiologists. Results: Out of a total of 200 patients with histologically confirmed breast cancer (BI-RADS 6) 156 patients required no further operative therapy (re-excision) after breast-conserving therapy. A retrospective analysis (n = 44) showed an increase in sensitivity with tomosynthesis compared to the BioVision™ (CMOS technology) and the Inspiration™ at a magnification of 1.0 : 1.0 of 8 % (p < 0.05), i.e. re-excision would not have been necessary in 16 patients with tomosynthesis. Conclusions: The sensitivity of tomosynthesis for intraoperative radiography is significantly (p < 0.05) higher compared to both CMOS technology and an FFDM system with a conventional detector. Additional studies using higher magnification, e.g. 2.0 : 1.0, but no zooming will be necessary to evaluate the method further.
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Affiliation(s)
- R Schulz-Wendtland
- Gynäkologische Radiologie, Radiologisches Institut des Universitätsklinikums Erlangen, Erlangen
| | - G Dilbat
- Radiologie, Radiologie Roth, Roth
| | - M Bani
- Universitätsfrauenklinik, Universitätsklinikum Erlangen, Erlangen
| | - P A Fasching
- Universitätsfrauenklinik, Universitätsklinikum Erlangen, Erlangen
| | - M P Lux
- Universitätsfrauenklinik, Universitätsklinikum Erlangen, Erlangen
| | - E Wenkel
- Gynäkologische Radiologie, Radiologisches Institut des Universitätsklinikums Erlangen, Erlangen
| | - S Schwab
- Radiologisches Institut, Universitätsklinikum Erlangen, Erlangen
| | - C R Loehberg
- Universitätsfrauenklinik, Universitätsklinikum Erlangen, Erlangen
| | - S M Jud
- Universitätsfrauenklinik, Universitätsklinikum Erlangen, Erlangen
| | - C Rauh
- Universitätsfrauenklinik, Universitätsklinikum Erlangen, Erlangen
| | - C M Bayer
- Universitätsfrauenklinik, Universitätsklinikum Erlangen, Erlangen
| | - M W Beckmann
- Direktor der Frauenklinik, Universitätsklinikum Erlangen, Erlangen
| | - M Uder
- Direktor des Radiologischen Instituts, Universitätsklinikum Erlangen, Erlangen
| | - M Meier-Meitinger
- Gynäkologische Radiologie, Radiologisches Institut des Universitätsklinikums Erlangen, Erlangen
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9
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Schulz-Wendtland R, Dilbat G, Bani MR, Lux MP, Meier-Meitinger M, Wenkel E, Schwab S, Beckmann MW, Uder M, Adamietz B. Use of Tomosynthesis in Intraoperative Digital Specimen Radiography - Is a Reduction of Breast Re-excision Rates Possible? Geburtshilfe Frauenheilkd 2011; 71:1080-1084. [PMID: 25253902 PMCID: PMC4166918 DOI: 10.1055/s-0031-1280427] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2011] [Revised: 09/16/2011] [Accepted: 09/09/2011] [Indexed: 10/14/2022] Open
Abstract
Aim: A prospective clinical study was done to see whether it is possible to reduce the rate of re-excisions using digital breast tomosynthesis (DBT) compared commercial FFDM. Material and Method: Between 1/2011 and 5/2011 we diagnosed an invasive breast cancer (BI-RADS 5) in 100 patients. After histological verification we performed breast-conserving therapy with intraoperative imaging using one of 2 different systems: 1. Tomosynthesis (Siemens, Erlangen, Germany), amorphous selenium, Tungsten source, focus 0.1 mm, resolution 85 µm, pixel pitch, 8 l/mm, range: 50°, 25 projections, time for scanning > 20 s, geometry: same scanning scope, reconstruction: filtered back projection; or 2. Inspiration™ (Siemens, Erlangen, Germany), amorphous selenium, tungsten source, focus 0.1 mm, resolution 85 µm, pixel pitch, 8 l/mm as the standard. The 100 radiograms obtained with both systems were prospectively shown on a monitor to 3 radiologists. Results: Out of a total of 100 patients with histologically proven breast cancer (BI-RADS 6) no re-excision was necessary in 78 patients. A retrospective analysis (n = 22) demonstrated an increase in sensitivity of tomosynthesis compared to the Inspiration™ at a magnification of 1.0 : 1.0 of 8 % (p < 0.05), i.e., in 8 patients re-excision would not have been necessary with tomosynthesis. Conclusion: Tomosynthesis has a significant higher sensitivity (p < 0.05) compared with a commercial FFDM system. Studies with higher numbers of patients will be necessary to evaluate this method.
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Affiliation(s)
- R. Schulz-Wendtland
- Universitätsklinikum Erlangen (University Hospital in Erlangen), Department of Radiology, Gynaecological Radiology, Erlangen
| | - G. Dilbat
- Radiological Practice Roth and Weissenburg, Roth
| | - M. R. Bani
- Universitätsklinikum Erlangen (University Hospital in Erlangen), Department of Gynaecology and Obstetrics, Erlangen
| | - M. P. Lux
- Universitätsklinikum Erlangen (University Hospital in Erlangen), Department of Gynaecology and Obstetrics, Erlangen
| | - M. Meier-Meitinger
- Universitätsklinikum Erlangen (University Hospital in Erlangen), Department of Radiology, Gynaecological Radiology, Erlangen
| | - E. Wenkel
- Universitätsklinikum Erlangen (University Hospital in Erlangen), Department of Radiology, Gynaecological Radiology, Erlangen
| | - S. Schwab
- Universitätsklinikum Erlangen (University Hospital in Erlangen), Department of Radiology, Erlangen
| | - M. W. Beckmann
- Universitätsklinikum Erlangen (University Hospital in Erlangen), Department of Gynaecology and Obstetrics, Erlangen
| | - M. Uder
- Universitätsklinikum Erlangen (University Hospital in Erlangen), Department of Radiology, Erlangen
| | - B. Adamietz
- Universitätsklinikum Erlangen (University Hospital in Erlangen), Department of Radiology, Gynaecological Radiology, Erlangen
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