Advances in MammographyAdvances in Mammography

By: By: PAWAN KUMAR POPLIDEPT.OF RADIO-DIAGNOSISAIIMS, NEW DELHI

MammographyMammography

Past & PresentSimilar equipments were & are still being used,

these can be called as old fashioned equipments

cone

Tube

Breast Stand

MammographyMammography

In digital mammography screen-film system has been replaced by Detectors to give the digital images

Mammography Mammography

Present & future

CCD camera

Work station

Equipments look like this

MammogramMammogram

These digital mammograms are surely better in resolution & details

InterventionsInterventions

InterventionsInterventions

BiopsyBiopsy Hook-wire Hook-wire placementplacement

Girded plateGirded plateStereo tacticStereo tactic

Mammographic interventions basically are of two types

BiopsyBiopsy

Biopsies can be acquired in various ways

BiopsyBiopsy

Girded plate Used to guide the biopsies & hook wire placements

BiopsyBiopsy

Stereo tacticMethod is the latest way to acquire biopsies with high accuracy

Stereo images

Stereo tactic BiopsyStereo tactic Biopsy

Trigonometric calculations by computer

Mammography

10 degree + & - views taken

Mark target on both images

Computer guided steriotectic device

Insert biopsy needle - confirm position

Take biopsy

The various steps involved are:

Hook-wire PlacementHook-wire Placement

The same stereo-tactic method can be used to place the hook-wire in the lesion to guide the surgeon to the area

of interest during the surgery

Hook wireHook wire

Imaging !Imaging !

Imaging in various planes is possible with the latest equipments

MRIMRI

Special CoilsFacilitate high quality MR Images of breast

MRI-IMAGESMRI-IMAGES

Implant

It is of much use in: young females where mammography is contraindicated

For evaluation of breast implantsAs complement to mammography

USUS

Ultra-sound is yet other non-radiating modality,It is used to delineation of fluid pockets from solid masses

It is also used to scan the breasts of young females

USUS

Panoramic ViewLooking at whole breast in single image is possible on US

CTLMCTLM

Breast placed in A scan chamber scanned by laser in 360 degrees at 3mm intervals-3 D image is produced

Allows the radiologist to view image from any plane

Good for comparing contours of two breasts Good for comparing contours of two breasts

Computerized Tomography Laser Mammographyor

In this

CTLMCTLM

Computerised Tomography Laser MammographyEquipment comprises essentially two rings to

emit & receive LASER

CTLMCTLM

The Images appear like this

Normal mammogramCTML

CTLMCTLM

More of CTML images

CTLMCTLM

It is possible to rotate and see the images in 3D form by rotating it

Nuclear MedicineNuclear Medicine It involves injecting a radioactive tracer (dye) into

the patient. Since the dye accumulates differently in cancerous and non-cancerous tissues, scintimammography can help physicians determine whether cancer is present.

Currently, only the Miraluma Tc-99m sestamibi compound, is approved by FDA for breast imaging in the United States.

Nuclear MedicineNuclear Medicine

Normally Nuclear Medicine images look like these

ScintimammographyScintimammography

With latest equipments such images are possible

ScintimammographyScintimammography

Camera

Now cameras are smaller & more flexible to use

Nuclear MedicineNuclear MedicineUseful in case of…….Useful in case of……. Dense breast tissue Large, palpable (able to be felt) abnormalities that

cannot be imaged well with mammography or ultrasound

Breast implants When multiple tumors are suspected A lump at the surgical site after mastectomy

T-ScanT-Scan

Also known as EIS-electrical impedance scanning

It measures the way low level bio-electrical currents pass through the body, and creates A real time image “map” of breast

Some cancers distort the electric field

T-ScanT-Scan

Current source

Receptor

Equipment looks like thisPatient holds the source in her hand

and Radiologist holds the receptor

CTICTI

Computerized Thermal imagingComputerized Thermal imagingOrOr

Digital Infrared Thermal ImagingDigital Infrared Thermal Imaging

A thermal sensitive camera is used to capture & process the digital image based on heat radiated from body

Pathologies do alter the tissue temperature

Thermal CameraThermal Camera

Looks like this

CTICTI

Patient just stands in front of camera & image is obtained

CTICTI

Images look like these

CTICTI

Dedicated cameras are also available

Image from dedicated camera

CTICTI It is safe & valuable for women With mastectomies With breast implants   With sensitive breasts  With dense breasts During pregnancy 

•NO Radiation •NO Compression •NO Contact•NO Risks

Optical ImagingOptical Imaging

Optical mammography and optical biopsy allow investigators to determine nature of pathology.

An analysis of the spectrum light emitted from optically excited tissue helps to detect physical and chemical changes in tissue and determine whether the tissue is normal, benign or cancerous.

Optical ImagingOptical Imaging

This is how optical Imaging works

Optical ImagingOptical Imaging

Breast cup

The Equipment

Optical ImagesOptical Images

Optical ImageOptical Image

3 D Optical ImageAnimated

Mammograms

Optical TomoOptical Tomo

Optical tomography can also be done

Optical ImageOptical Image

Optical Biopsy-imagingOptical Biopsy-imaging

Transducer for Biopsy

Biopsy is also possible & Equipment is like this one

CADCAD

Computer aided detectionComputer aided detection

It is designed to help radiologists Reduce interpretative errors Two level reporting

CADCAD

The CAD modules

Image Storage

Mammography work station

How CAD worksHow CAD works

Computers marks the areas of more interest

To Conclude…To Conclude…

Tremendous advances are taking place in this field We are heading towards non-radiating

Mammography which supplements & compliments to regular mammography

Attempts are on to have Mammography completely free of radiation without compromising the information and image quality

Thank youThank you

Talk about this session with your friends….It will add to your knowledge

pkpopli@hotmail.com

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