Comparison of scintimammography and dedicated emission mammotomography
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Multi-Modality Imaging Laboratory Department of Radiology Department of Biomedical Engineering Duke University Medical Center, Durham, NC, USA. Comparison of Scintimammography and Dedicated Emission Mammotomography. Martin P. Tornai, Caryl N. Brzymialkiewicz, Spencer J. Cutler, Priti Madhav.

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Comparison of scintimammography and dedicated emission mammotomography

Multi-Modality Imaging Laboratory

Department of Radiology

Department of Biomedical Engineering

Duke University Medical Center, Durham, NC, USA

Comparison of Scintimammography and Dedicated Emission Mammotomography

Martin P. Tornai, Caryl N. Brzymialkiewicz, Spencer J. Cutler, Priti Madhav

Supported by NIH Grant RO1-CA96821 and DAMD 17-03-1-0558


Overview
Overview

  • Develop a “universal” breast phantom for emission and/or transmission imaging

    • Needs to be compressible for uncompressed and partial compression imaging comparisons

    • Needs to accommodate inserted lesions

    • Needs to have physical attributes similar to human torso

  • Make direct comparison of uncompressed breast SPECT and compressed scintimammography

    • Develop and compare various fillable lesion sizes

    • Compare different activity concentrations


Solid state imaging detector
Solid State Imaging Detector

Detector CdZnTe

Density 5.78 g/cm3

Effective Z 49

Elements 64 x 80

Crystal Dimensions 2.3 x 2.3 x 5 mm3

Pixel Size 2.5 x 2.5 mm2

FOV 16 x 20 cm2

Sensitivity 38 cts/sec/MBq

Uniformity (post corr) < ±4%

Energy Resolution 6.1% @ 140 keV

20.0 cm

16.0 cm

6.6 cm

LumaGEM™ 3200-S

(Gamma Medica Inc.)


Prototype emission mammotomograph

ROR

Polar Tilt, 

Azimuth, 

Prototype Emission Mammotomograph

Anthropomorphic torso and breast phantoms

(Radiology Support Devices, Inc.)

Integrated Gamma Camera

(Gamma Medica, Inc.)

Radius of Rotation control (Newport Corp., Sanyo-Denki)

Rotation stage and goniometer

(Newport Corp.)


Compressible breast phantom chest plate

Fill port

3 cm f insertion port

Compressible Breast Phantom & Chest Plate

Fillable Volume: ~700 mL

Nipple-Chest: 9 cm

Medial-Lateral: 12 cm

Superior-Inferior: 13 cm

“Skin” thickness: 0.16 cm

(Radiology Support Devices, Inc.)


Compressible breast phantom lesions
Compressible Breast Phantom & Lesions

Digital X-ray image

Stems: 1.6 mm OD x 4.5 cm polyethylene

70

140

500

300

Lesions

Volume “Diameter”

(microL) (mm)

40 +/- 0.15 4.2

70 +/- 0.15 5.1

140 +/- 0.15 6.4

300 +/- 0.30 8.2

500 +/- 0.30 9.8

40

140

140

(Harvard Apparatus)


Scintimammography acquisition parameters
Scintimammography Acquisition Parameters

20X clinical !

Lesion Concentration 40 microCi / mL

Lesion : Background Inf., 12 : 1, 7 : 1, 3 : 1

View Lateral (single view)

Compression 12 cm, 9 cm, 6 cm

Acquisition Time 10 min (equivalent)


Breast compression

9 cm

6 cm

4 cm

Breast Compression

12 cm

Cranio-Caudal Lateral


Scintimammography planar projections

9cm 3 : 1

9cm 12 : 1

9cm 7 : 1

Scintimammography (Planar) Projections

Compression Thickness

12 cm

9 cm

6 cm

12 : 1

7 : 1

Leaky Phantom

3 : 1


Scintimammography effects of compression
Scintimammography: Effects of Compression

12 : 1 Concentration Ratio



Spect acquisition parameters
SPECT Acquisition Parameters

20X clinical !

Lesion Concentration 40 microCi / mL

Lesion : Background Ratios Inf., 12 : 1, 7 : 1, 3 : 1

Mammotomography (q = 0 – 360)

Orbits: Vertical Axis of Rotation (VAOR)

ROR = 6.6 cm, f = 0 deg

Tilted Parallel Beam (TPB)

ROR = 5.2 cm, f = 45 deg

3 Lobed Sinusoid on Hemisphere (ProjSine)

ROR = 2.8 – 5.2 cm, f = 15 – 45 deg

Angular Increment : 2.8 deg

Acquisition Time : 10 min (equivalent)

Details about orbits and sampling on POSTER #

M2-269


Mammotomography orbits

0o

30o

Camera

Tilt ()

60o

90o

Mammotomography Orbits

VAOR

TPB45

ProjSine

Details about orbits and sampling on POSTER # M2-269


Mammotomography reconstructions

Maximum Intensity Projection (MIP)

Mammotomography Reconstructions

12 : 1 Concentration ProjSine Data

Transverse

Sagittal

OSEM reconstruction with 5 iterations, 8 subsets, calculated attenuation correction, 3D Hann filtration with fc = 0.8*Nyquist


Mammotomography mips

40 uL

300 uL

500 uL

70 uL

140 uL

Mammotomography MIPs

VAOR

TPB45

ProjSine

12 : 1

7 : 1

3 : 1


Spect snr contrast
SPECT SNR & Contrast

12 : 1 Concentration Data

ROI data from OSEM reconstruction with 3 iterations, 8 subsets, calculated attenuation correction, 3D Hann filtration with fc = 0.8*Nyquist



Conclusions
Conclusions

  • Developed a compressible breast+chest phantom useful for comparative emission breast imaging with physical limitations more consistent with a human torso

  • Measured various lesion sizes, locations (esp. near chest wall), and activity concentrations relative to backgrounds

  • Compared compressed breast, planar scintimammography with uncompressed breast SPECT mammotomography

  • Scintimammography has limited viewable breast volume towards the anterior chest wall

Under a wide range of “low noise” measurement conditions:

More lesions, lesion sizes, and (3D) lesion locations can be detected (and thus quantitated) with dedicated emission mammotomography than with compressed breast scintimammography



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