Biomedical Imaging Physics, Department of Physics and Munich School of BioEngineering, Technical University of Munich, James-Franck-Strasse 1, 85748 Garching, Germany.
Biomedical Imaging Physics, Department of Physics and Munich School of BioEngineering, Technical University of Munich, James-Franck-Strasse 1, 85748 Garching, Germany.
Phys Med. 2020 Nov;79:69-79. doi: 10.1016/j.ejmp.2020.10.025. Epub 2020 Nov 7.
Breast cancer is a globally widespread disease whose detection has already been significantly improved by the introduction of screening programs. Nevertheless, mammography suffers from low soft tissue contrast and the superposition of diagnostically relevant anatomical structures as well as from low values for sensitivity and specificity especially for dense breast tissue. In recent years, two techniques for X-ray breast imaging have been developed that bring advances for the early detection of breast cancer. Grating-based phase-contrast mammography is a new imaging technique that is able to provide three image modalities simultaneously (absorption-contrast, phase-contrast and dark-field signal). Thus, an enhanced detection and delineation of cancerous structures in the phase-contrast image and an improved visualization and characterization of microcalcifications in the dark-field image is possible. Furthermore, latest studies about this approach show that dose-compatible imaging with polychromatic X-ray sources is feasible. In order to additionally overcome the limitations of projection-based imaging, efforts were also made towards the development of breast computed tomography (BCT), which recently led to the first clinical installation of an absorption-based BCT system. Further research combining the benefits of both imaging technologies is currently in progress. This review article summarizes the latest advances in phase-contrast imaging for the female breast (projection-based and three-dimensional view) with special focus on possible clinical implementations in the future.
乳腺癌是一种在全球范围内广泛存在的疾病，通过引入筛查计划，其检测已经得到了显著改善。然而，乳腺 X 线摄影的软组织对比度低，并且存在与诊断相关的解剖结构的叠加，以及灵敏度和特异性低的问题，尤其是对于致密乳腺组织。近年来，已经开发出两种用于乳腺 X 射线成像的技术，为乳腺癌的早期检测带来了进步。基于光栅的相衬乳腺 X 射线摄影是一种新的成像技术，能够同时提供三种图像模式（吸收对比度、相衬对比度和暗场信号）。因此，可以在相衬图像中增强对癌性结构的检测和描绘，并在暗场图像中改善微钙化的可视化和特征描述。此外，关于该方法的最新研究表明，使用多色 X 射线源进行剂量兼容的成像是可行的。为了进一步克服基于投影的成像的局限性，还努力开发乳腺计算机断层扫描（BCT），最近导致了第一个吸收式 BCT 系统的临床安装。目前正在结合这两种成像技术的优势进行进一步的研究。本文综述了女性乳腺相衬成像的最新进展（基于投影和三维视图），特别关注未来可能的临床应用。
