Hellerhoff Karin, Gottwald Wolfgang, Taphorn Kirsten, Berthe Daniel, Braun Michael, Wagner Kai, Resch Sandra, John Dominik, Heck Lisa, Birnbacher Lorenz, Herzen Julia, Grandl Susanne
Breast Imaging Department, Red Cross Hospital Munich, Munich, Germany.
Research Group Biomedical Imaging Physics, Department of Physics, TUM School of Natural Sciences and Munich Institute of Biomedical Engineering, Technical University of Munich, Garching, Germany.
Med Phys. 2025 Apr;52(4):2145-2154. doi: 10.1002/mp.17603. Epub 2025 Jan 3.
A significant proportion of false positive recalls of mammography-screened women is due to benign breast cysts and simple fibroadenomas. These lesions appear mammographically as smooth-shaped dense masses and require the recalling of women for a breast ultrasound to obtain complementary imaging information. They can be identified safely by ultrasound with no need for further assessment or treatment.
Grating-based x-ray dark-field breast imaging allows contrast formation based on both attenuation and small-angle x-ray scattering and provides complementary imaging information in one single acquisition.
Experiments with ex-vivo mastectomy samples were performed with a three-grating Talbot-Lau interferometer using a laboratory-based polychromatic x-ray source. Attenuation and dark-field images were correlated to clinical mammography and complementary diagnostic imaging techniques.
Benign breast lesions with homogeneous internal structures such as fibroadenomas and simple fluid-filled cysts, typically presenting as dense breast lesions in standard mammography, showed a signal drop in the dark-field image. Complicated cysts provided a higher dark-field signal.
The results presented show that grating-based x-ray dark-field mammography could provide complementary imaging information in one single acquisition, eliminating the need for a second examination to identify harmless cysts and simple fibroadenomas.
乳腺钼靶筛查女性中相当一部分假阳性召回是由于良性乳腺囊肿和单纯纤维腺瘤。这些病变在钼靶上表现为形状光滑的致密肿块，需要召回女性进行乳腺超声检查以获取补充成像信息。它们可以通过超声安全识别，无需进一步评估或治疗。
基于光栅的X射线暗场乳腺成像允许基于衰减和小角度X射线散射形成对比度，并在一次采集过程中提供补充成像信息。
使用基于实验室的多色X射线源，通过三光栅Talbot-Lau干涉仪对离体乳房切除样本进行实验。将衰减图像和暗场图像与临床钼靶及补充诊断成像技术进行关联。
内部结构均匀的良性乳腺病变，如纤维腺瘤和单纯液性囊肿，在标准钼靶中通常表现为致密乳腺病变，在暗场图像中显示信号下降。复杂囊肿提供更高的暗场信号。
所呈现的结果表明，基于光栅的X射线暗场乳腺成像可以在一次采集中提供补充成像信息，无需进行二次检查来识别无害囊肿和单纯纤维腺瘤。
