Medical Imaging Research Unit, Faculty of Health Sciences, University of Cape Town, Observatory, Western Cape 7925, South Africa; CapeRay Medical (Pty) Ltd, Suite 2, 51 Bell Crescent, Westlake Business Park, Cape Town, Western Cape 7945, South Africa.
Med Eng Phys. 2019 Oct;72:27-37. doi: 10.1016/j.medengphy.2019.09.001.
Over the past 50 years, the application of mammography - an X-ray of the breast - to screen healthy women has been a successful strategy to reduce breast cancer mortality. The aim of this study was to review the literature on novel imaging approaches that have the potential to replace mammography.
An online literature search was carried out using PubMed, Google Scholar, ScienceDirect and Google Patents. The search keywords included "breast cancer", "imaging" and "screening", with 51 journal articles and five United States patents being selected for review. Seventeen relevant online sources were also identified and referenced.
In addition to full-field digital mammography (FFDM), a further nine imaging modalities were identified for review. These included: digital breast tomosynthesis (DBT); breast computed tomography (BCT); automated breast ultrasound (ABUS); fusion of FFDM and ABUS; fusion of DBT and ABUS; magnetic resonance imaging (MRI); optical imaging; radio-wave imaging; and tactile sensor imaging. Important parameters were considered: diagnostic success (sensitivity and specificity), especially in dense breasts; time to acquire the images; and capital cost of the equipment.
DBT is rapidly replacing FFDM although it still misses invasive cancers in dense tissue. The fusion of ABUS, either with FFDM or DBT, will lead to sensitivity and specificity approaching 100%. The fusion of opto-acoustic imaging with ultrasound holds considerable promise for the future.
在过去的 50 年中，应用乳腺 X 线摄影（乳房 X 光检查）对健康女性进行筛查已成为降低乳腺癌死亡率的成功策略。本研究旨在综述具有替代乳腺 X 线摄影潜力的新型成像方法的文献。
使用 PubMed、Google Scholar、ScienceDirect 和 Google Patents 进行在线文献检索。搜索关键词包括“乳腺癌”、“成像”和“筛查”，选择了 51 篇期刊文章和 5 项美国专利进行综述。还确定并引用了 17 个相关的在线资源。
除了全数字化乳腺 X 线摄影（FFDM）外，还确定了另外 9 种成像方式进行综述。这些方法包括：数字乳腺断层合成术（DBT）；乳腺计算机断层扫描（BCT）；自动乳腺超声（ABUS）；FFDM 和 ABUS 的融合；DBT 和 ABUS 的融合；磁共振成像（MRI）；光学成像；电波成像；以及触觉传感器成像。考虑了重要的参数：诊断成功率（灵敏度和特异性），特别是在致密乳房中；获取图像的时间；以及设备的资本成本。
DBT 正在迅速取代 FFDM，尽管它在致密组织中仍会漏诊浸润性癌症。ABUS 与 FFDM 或 DBT 的融合将导致灵敏度和特异性接近 100%。光声成像与超声的融合在未来具有很大的潜力。
