Breast cancer imaging: A perspective for the next decade

Abstract

Breast imaging is largely indicated for detection, diagnosis, and clinical management of breast cancer and for evaluation of the integrity of breast implants. In this work, a prospective view of techniques for breast cancer detection and diagnosis is provided based on an assessment of current trends. The potential role of emerging techniques that are under various stages of research and development is also addressed. It appears that the primary imaging tool for breast cancer screening in the next decade will be high-resolution, high-contrast, anatomical x-ray imaging with or without depth information. MRI and ultrasonography will have an increasingly important adjunctive role for imaging high-risk patients and women with dense breasts. Pilot studies with dedicated breast CT have demonstrated high-resolution three-dimensional imaging capabilities, but several technological barriers must be overcome before clinical adoption. Radionuclide based imaging techniques and x-ray imaging with intravenously injected contrast offer substantial potential as a diagnostic tools and for evaluation of suspicious lesions. Developing optical and electromagnetic imaging techniques hold significant potential for physiologic information and they are likely to be of most value when integrated with or adjunctively used with techniques that provide anatomic information. Experimental studies with breast specimens suggest that phase-sensitive x-ray imaging techniques can provide edge enhancement and contrast improvement but more research is needed to evaluate their potential role in clinical breast imaging. From the technological perspective, in addition to improvements within each modality, there is likely to be a trend towards multi-modality systems that combine anatomic with physiologic information. We are also likely to transition from a standardized screening, where all women undergo the same imaging exam (mammography), to selection of a screening modality or modalities based an individual-risk or other classification.

Technical Advances in Current PET and Hybrid Imaging Systems

“…25). Dedicated breast CT using a digital flat-panel detector has potential advantages over conventional X-ray mammography and whole-body CT, namely, it provides clearer images of suspected lesions by overcoming the tissue superposition problem of mammography and higher spatial resolutions and tumor contrast than conventional CT [94,95]. Diagnostic confidence in and the quantitative accuracy of PET assessments is possibly also enhanced by the anatomical and functional information provided by breastdedicated CT.…”

Current Status and New Developments in Breast Cancer Diagnosis and Detection

“…by the compagnie Generale de Radiologie 4 in France and this machine is the model on which modern mammography is based. Since then there have been incremental improvements in mammographic technology, culminating in the introduction of digital mammography in the 1990s.…”

Diagnosing breast cancer: an opportunity for innovative engineering

“…Screenfilm mammography, the use of X-rays and analogue film, has become the 'gold standard' for imaging the breast since then. 4 Mammography allows visualisation of soft-tissue abnormalities and is able to depict subtle calcifications that may be indicative of cancer. Screen-film, however, has several drawbacks: limited dynamic range and contrast, granularity and susceptibility to poor processing of the photographic film.…”