Low Dose Molecular Breast Imaging
|
|
- Giles Howard
- 6 years ago
- Views:
Transcription
1 Low Dose Molecular Breast Imaging Dr. M.K. O Connor Conflict of Interest Royalties - Gamma Medica Research funding GE Healthcare Research support MTTI Michael O Connor, Ph.D Dept. of Radiology Mayo Clinic This work has been funded in part by the following: National Institute of Health Dept. of Defense Susan G Komen Foundation Mayo Foundation Friends for an Earlier Breast Cancer Test Breast Density Classification ACR BI-RADS (qualitative score) Used by radiologists as part of routine practice BI-RADS 1 BI-RADS 2 BI-RADS 3 BI-RADS 4 <25% 25-49% 50-74% 75% Sens = 88% 82% 69% 62% Breast Density Comparative Relative Risks Risk factor Relative risk BRCA mutation 20 Lobular carcinoma in situ 8-10 Dense breast parenchyma 4-6 Personal history of breast cancer 3-4 Family history (1 relative) 2.1 Postmenopausal obesity 1.5 Mammographic density is perhaps the most undervalued and underutilized risk in studies investigating the causes of BC. Breast Density Legislation Connecticut enacted similar legislation in 2009 and a comparable breast density patient education bill, SB 173, is scheduled to be heard in the California Assembly this month.
2 Sensitivity of Mammogram, US, and MRI in Women at Increased Risk Subjects Sensitivity Sensitivity Sensitivity Author/year Country (no.) MMG (%) US (%) MRI (%) Kuhl, 2000 Germany Warner, 2004 Canada Kriege, 2004 Netherlands 1, NA 71 Kuhl, 2005 Germany Leach 2005 U.K NA 77 Sardanelli, ACRIN Year Screening Study of Ultrasound and Mammography in 2500 High-Risk Women 41 cancers detected 20 by mammography (sens 50%) 20 by ultrasound (sens 50%) Mammography: 3% biopsy, 29% positive Ultrasound: 5% biopsy, 9% positive Study PI Wendie Berg: "Women contemplating breast ultrasound screening must be aware of the substantial risk of false positives Study Co-I Etta Pisano: based on the study results, it is difficult to determine whether screening ultrasound is worthwhile Breast MRI Poor specificity (highly variable: 50% - 90%) Patient acceptance of MRI? ACRIN 6666 trial 42% declined free MRI (25% due to claustrophobia) Molecular Imaging of the Breast PEM (Positron Emission Mammography) Coincidence detection using 2 scanning arrays of LYSO crystals Clinical unit developed by Naviscan BSGI (Breast Specific Gamma Imaging) Single detector, multicrystal NaI based gamma camera Developed by Dilon Technologies MBI (Molecular Breast Imaging) Dual detector Cadmium Zinc Telluride based gamma cameras Clinical units developed by Gamma Medica and GE Healthcare Expensive (~10 times that of mammography) PEM (Positron Emission Mammography) FOV: 16 cm x 24 cm 2 scanning arrays of LYSO 2.4 mm resolution (in plane) 8.0 mm resolution (cross-plane) (JNM 2009;50: ) Patient fasting 4-6 hr. Inject 10 mci F-18 FDG Wait ~60 minutes Obtain CC / MLO views Scan time ~10 minutes / view Molecular Imaging of the Breast PEM (Positron Emission Mammography) Coincidence detection using 2 scanning arrays of LYSO crystals Clinical unit developed by Naviscan BSGI (Breast Specific Gamma Imaging) Single detector, multicrystal NaI based gamma camera Developed by Dilon Technologies MBI (Molecular Breast Imaging) Dual detector Cadmium Zinc Telluride based gamma cameras Clinical units developed by Gamma Medica and GE Healthcare
3 BSGI (Breast Specific Gamma Imaging) FOV: 15 cm x 20 cm Single array of NaI crystals 3 mm intrinsic resolution ~18% energy resolution No patient fasting required Inject mci Tc-99m sestamibi Image ~5 minutes post injection Obtain CC / MLO views Scan time ~10 minutes / view Molecular Imaging of the Breast PEM (Positron Emission Mammography) Coincidence detection using 2 scanning arrays of LYSO crystals Clinical unit developed by Naviscan BSGI (Breast Specific Gamma Imaging) Single detector, multicrystal NaI based gamma camera Developed by Dilon Technologies MBI (Molecular Breast Imaging) Dual detector Cadmium Zinc Telluride based gamma cameras Clinical units developed by Gamma Medica and GE Healthcare Breast Phantom: Comparison between Systems* Tumor Depth 1cm *Hruska CB, et al. Nucl Med Commun, 2005; 26: Cadmium Zinc Telluride (CZT) Detector 2.54 cm 3 cm 5 cm Excellent Intrinsic Resolution = 1.6 mm / 2.5 mm Excellent Energy Resolution 4.0% / 6.5% Can be operated at room temp No dead space ideal for breast imaging Expensive currently limited to small field of view detectors MC-NaI NaI CZT MC-CsI First commercial systems using CZT developed for nuclear cardiology Molecular Breast Imaging Procedure MBI Systems Currently at Mayo Clinic Patient receives an IV injection of a radiotracer (Tc-99m sestamibi) The tracer preferentially accumulates in cancer cells and is not influenced by breast density The breast is lightly compressed between the 2 gamma cameras, only light pain-free compression is necessary Imaging starts ~5 minutes post injection. Acquire CC and MLO views of each breast for 10 minutes / view GE Research Unit GM-I Research Unit GM-I Clinical Unit
4 Can MBI find lesions not visible on mammography? Can MBI find lesions not visible on mammography? 1.1cm nodular density in upper inner right breast 9.5cm from the nipple 2 x 1 cm IDC with multiple satellite lesions confirmed as DCIS at surgery Comparison of Screening MBI and Mammography ~1000 patients - asymptomatic Compare MBI and mammography in patients with dense breasts at increased risk of breast cancer MBI performed with 20 mci Tc-99m sestamibi Breast status 12-months Question is MBI a viable screening adjunct to mammography in patients with dense breasts? Diagnostic accuracy of screening mammography and MBI Sensitivity (all cancers) Sensitivity (Invasive cancers) Sensitivity (DCIS) Specificity Recall Rate Mammography alone 25% (3/12) 25% (2/8) 25% (1/4) 91% (839/925) 9.5% (89/936) MBI alone 83% (10/12) 100% (8/8) 50% (2/4) 93% (861/925) 7.8% (73/936) Mammography plus MBI 92% (11/12) 100% (8/8) 75% (3/4) 85% (789/925) 16% (146/936) PPV 18 % (3/17) 28% (10/36) 24% (11/45) Rhodes et al, Radiology 2011;258: Mammographically occult cancers detected on MBI 10 mm + 16 mm IDC 9 mm ILC 9 mm IDC 17 mm IDC + DCIS 7 mm tubulolobular ca 9 mm DCIS 13.5 mm ILC (total extent 5.1 cm)
5 Hendrick R.E. Radiation Doses and Cancer Risks from Breast Imaging Studies Radiology Oct; 257(1): O'Connor MK, Li H, Rhodes DJ, Hruska CB, Clancy CB, Vetter RJ. Comparison of radiation exposure and associated radiation-induced cancer risks from mammography and molecular imaging of the breast. Med Phys Dec;37(12): Relative Radiation Risks Radiation risk to patients Mammogram PEM (10 mci F-18 FDG) BSGI (25-30 mci Tc-99m mibi) MBI (20 mci Tc-99m mibi) ~ 0.5 msv ~ 7 msv ~ 9 msv ~ 6 msv For pop. of 100,000 women undergoing above procedures at age 40, estimated cancer mortality Mammogram ~ 2 PEM (10 mci F-18 FDG) ~ 30 BSGI (25-30 mci Tc-99m mibi) ~ 35 MBI (20 mci Tc-99m mibi) ~ 24 Where does the estimate of cancer mortality come from? Based on Table 12D from BEIR VII 100,000 women aged 30 Single dose of 100 mgy Over their lifetime Risk Models range of plausible values for LAR is labeled a subjective confidence interval to emphasize its dependence on opinions in addition to direct numerical observation (BEIR VII, page 278) Lifetime Attributable Risk (LAR) Because of the various sources of uncertainty it is important to regard specific estimates of LAR with a healthy skepticism, placing more faith in a range of possible values (BEIR VII, page 278)
6 Relative Radiation Risks For pop. of 100,000 women exposed to naturally occurring background radiation from age 0-80, estimated cancer mortality Background radiation U.S. Average (3.1 msv/year) ~1010 Colorado (~4.5 msv/year) ~1460 Florida (~2.5 msv/year) ~ 810 Cumulative Cancer Mortality Cancer mortality in 100,000 subjects U.S. Cancer Mortality Minnesota - 3 msv/year Colorado msv/year 50 msv at age Age(years) Estimated deaths due to background radiation. No epidemiological evidence to support these numbers 240 deaths MBI: Implications for Radiation Exposure to the Technologist from 8 patients / day, 20 mci / patient Radiation Dose Reduction Annual Technologist Dose mrem MBI Tech General NMT Cardiology NMT Radiographer Reduce dose / increase scan time? - already at ~40 minutes!! Improve the technology - detector / collimator optimization - energy window optimization - noise reduction algorithms - composite image from opposing detectors Pletta CK, et al. J Nucl Med 2009; 50 (Suppl 2): 428P. Molecular Breast Imaging Detector / Collimator Optimization Optimal pixel size for near-field imaging (0-3 cm) Clinical studies show average breast thickness = 6 cm Hence each collimator optimized over range 0 3 cm 100% 65% Monte Carlo simulations (MCNP) used to optimize detector and collimator design What is the optimal pixel size and collimation to achieve a spatial resolution = 5 mm at 3 cm? 45% 0.30
7 Molecular Breast Imaging Conventional Collimation CZT: 1.6 x 1.6 mm pixel Hexagonal hole Collimator: 2.5 mm hole diameter Molecular Breast Imaging Conventional Collimation CZT: 1.6 x 1.6 mm pixel Square hole Collimator: ~1.6 mm hole diameter Molecular Breast Imaging Collimator specifications Results from Simulation Better 3 cm Molecular Breast Imaging Matched Collimation on CZT detectors Tungsten collimator Square holes Each hole matched to individual pixel on CZT detector Factor of ~2 gain in sensitivity expected Molecular Breast Imaging Effect of Optimal Collimation CZT Detector MBI Radiation Dose Reduction Four dose reduction techniques have been developed and evaluated in order to reduce the administered dose of Tc- 99m sestamibi needed for MBI - collimator optimization - energy window optimization - noise reduction algorithms - composite image from opposing detectors
8 Wide energy window ( kev) ~1.4 gain in sensitivity System sensitivity effect of collimation and energy window Detector CZT 1.6 mm pixel Collimator Energy Window counts/ min/μci Relative gain in counts/pixel Standard Standard, 140 ± 10% Standard Wide, kev Tungsten design Standard 140 ± 10% Tungsten design Wide, kev GMI 1 cm CZT 2.5 mm pixel Standard Standard, 140 ± 10% Standard Wide, kev optimized design Standard 140 ± 10% optimized design Wide, kev GMI 3 cm
9 Contrast to Noise Ratio Lumagem 3200s Contrast to Noise Ratio Discovery 750b MBI Dose Reduction Comparison of count densities in patient studies MBI Dose Reduction Relative Gain = System # Studies Ratio of Cts (New: Old) GM CZT Dose 20 mci 8 mci MBI Radiation Dose Reduction Four dose reduction techniques have been developed and evaluated in order to reduce the administered dose of Tc- 99m sestamibi needed for MBI - collimator optimization - energy window optimization - noise reduction algorithms - composite image from opposing detectors Noise Reduction / Combined Images from Opposite Detectors Combined Images: Gaussian Neighborhood Geometric Mean (GNGM) Noise Reduction: Non-Local Means (NLM) denoising filter Wide Beam Reconstruction (UltraSPECT) Image Generation & analysis Filter parameters and order of application of noise reduction algorithms yet to be optimized
10 Gaussian Neighborhood / Geometric Mean Algorithm Comparison of Noise Reduction algorithms 8 mci Raw data 4 mci GNGM / NLM 4 mci WBR Question is low-dose MBI (~4 mci) a viable screening adjunct to mammography in patients with dense breasts? Compare MBI and mammography in asymptomatic patients with dense breasts on prior mammogram 2400 patients over next 2 years 1100 patients imaged as of 7/25/11 14/15 cancers detected on MBI 1/15 cancer detected on mammography 1 cancer missed by MBI and mammography Screening Mammogram 2 cm IDC MBI (positive) Screening Mammogram MBI (20 mci) March 2008 MBI (4 mci) (positive) March 2011
11 Screening Mammogram MBI (4 mci) (positive) Ultrasound 6.5 mm Invasive Tubular carcinoma Screening Mammogram MBI (2 mci) (positive) Ultrasound ~3 cm Invasive Lobular carcinoma Screening Mammogram MBI (2 mci) MBI Multifocal DCIS with ADH Advantages of MBI Compared to mammography: Higher sensitivity in dense breasts Comparable radiation burden to the body Less compression, improved patient comfort Compared to MRI Comparable sensitivity, better specificity Offers option if contraindication to MRI (claustrophobia, pacemaker, clips) Avoids gadolinium and potential for NSF Easy to interpret 8 images vs 1000s for MRI 5-7 fold less expensive than MRI Screening for Breast Cancer Mammography has proven to be an excellent screening technique for the majority of women Sub-optimal in women with dense breast tissue Alternative techniques are required Possible techniques include ultrasound, MRI and low-dose molecular imaging Cost and specificity will be key factors to acceptance of any adjunct screening technique
Molecular Breast Imaging: History and Recent Developments
Molecular Breast Imaging: History and Recent Developments Associate Professor, Department of Imaging Physics The University of Texas MD Anderson Cancer Center, Houston, Texas Educational Objectives 1.
More informationMolecular Breast Imaging
Molecular Breast Imaging Development of a Low-Dose Screening Test for Dense Breasts Conflict of Interest Royalties for technologies licensed to Gamma Medica Ideas Carrie B. Hruska, Ph.D. Department of
More informationPhysics of MBI (~10 slides)
Physics of MBI (~10 slides) Molecular Breast Imaging (MBI) physics and performance testing JW Hugg, BR Simrak, PD Smith, BE Patt Gamma Medica, Inc., Northridge, CA Molecular Breast Imaging (MBI) is an
More informationScintimammography and Gamma Imaging of the Breast and Axilla
Scintimammography and Gamma Imaging of the Breast and Axilla Policy Number: 6.01.18 Last Review: 9/2017 Origination: 9/2006 Next Review: 9/2018 Policy Blue Cross and Blue Shield of Kansas City (Blue KC)
More informationHigh Risk Screening: A Multimodality Approach
High Risk Screening: A Multimodality Approach John Lewin, M.D., FACR, FSBI The Women s Imaging Center Denver, Colorado Disclosures Consultant to Hologic Previously received research funds from Hologic
More informationMedical Policy. MP Scintimammography and Gamma Imaging of the Breast and Axilla
Medical Policy MP 6.01.18 BCBSA Ref. Policy: 6.01.18 Last Review: 09/19/2018 Effective Date: 09/19/2018 Section: Radiology Related Policies 9.01.502 Experimental / Investigational Services DISCLAIMER Our
More informationNIH Public Access Author Manuscript Expert Rev Anticancer Ther. Author manuscript; available in PMC 2010 June 1.
NIH Public Access Author Manuscript Published in final edited form as: Expert Rev Anticancer Ther. 2009 August ; 9(8): 1073 1080. doi:10.1586/era.09.75. Molecular breast imaging Michael O'Connor, PhD,
More informationMedical Policy An independent licensee of the Blue Cross Blue Shield Association
Scintimammography and Gamma Imaging of the Breast and Axilla Page 1 of 28 Medical Policy An independent licensee of the Blue Cross Blue Shield Association Title: Scintimammography and Gamma Imaging of
More informationWhat is Molecular Breast Imaging?
What is Molecular Breast Imaging? The basics of Functional Imaging Functional imaging is the detection of breast abnormality based on the altered characteristic of the tissue, rather than its altered morphology
More informationNew Imaging Modalities for better Screening and Diagnosis
New Imaging Modalities for better Screening and Diagnosis Miri Sklair-Levy, MD Department of Diagnostic Imaging Sheba Medical Center, Sackler School of Medicine, Tel Aviv University Department of Diagnostic
More information2/14/2019. Advances in Breast Imaging. Outline. Jiali Wang, Ph.D., DABR Medical Physicist. February 23, 2019
Advances in Breast Imaging SCPMG Medical Imaging Technology & Informatics Jiali Wang, Ph.D., DABR Medical Physicist February 23, 2019 Outline History of breast imaging Advances in breast imaging a) Full-Field
More informationDetection to Prediction: Imaging Markers of Breast Cancer Risk
Detection to Prediction: Imaging Markers of Breast Cancer Risk Carrie B. Hruska, PhD, DABR Associate Professor of Medical Physics Mayo Clinic, Rochester, MN 2017 MFMER slide-1 Disclosure Per agreement
More informationScreening Options in Dense Breasts. Donna Plecha, M.D. Co-Director UHCMC Breast Centers Associate Professor of Radiology Director of Breast Imaging
Screening Options in Dense Breasts Donna Plecha, M.D. Co-Director UHCMC Breast Centers Associate Professor of Radiology Director of Breast Imaging Dense Breasted Women Decreased sensitivity of mammography
More informationCourtesy of Dan Kopans, M.D.
Molecular Breast Imaging New Modality for Diagnosing i Breast Cancer Don t we have enough tools for diagnosing i Breast Cancer??? By Lillian H. Stern, M.D. Current Modalities Mammograms (analogue v. digital)
More informationCZT Detectors for Medical Imaging and Plant Biology
Small Business, High Tech Development CZT Detectors for Medical Imaging and Plant Biology Haris Kudrolli Inc. Workshop 2018 January 11, 2018 Outline Scientific Section CZT detectors Plant Imaging Applications
More informationCurrent Status of Supplementary Screening With Breast Ultrasound
Current Status of Supplementary Screening With Breast Ultrasound Stephen A. Feig, M.D., FACR Fong and Jean Tsai Professor of Women s Imaging Department of Radiologic Sciences University of California,
More informationDescription. Section: Radiology Effective Date: April 15, 2017 Subsection: Radiology Original Policy Date: September 13, 2012 Subject:
Last Review Status/Date: March 2017 Page: 1 of 17 Description Scintimammography, breast-specific gamma imaging (BSGI), and molecular breast imaging (MBI) all refer to the use of radiotracers with nuclear
More informationBREAST MRI. Elizabeth A. Rafferty, M.D. Avon Comprehensive Breast Center Massachusetts General Hospital Harvard Medical School
BREAST MRI Elizabeth A. Rafferty, M.D. Avon Comprehensive Breast Center Massachusetts General Hospital Harvard Medical School BREAST MRI Any assessment of the breast parenchyma requires the administration
More informationBREAST MRI. Elizabeth A. Rafferty, M.D. Avon Comprehensive Breast Center Massachusetts General Hospital Harvard Medical School
BREAST MRI Elizabeth A. Rafferty, M.D. Avon Comprehensive Breast Center Massachusetts General Hospital Harvard Medical School BREAST MRI Any assessment of the breast parenchyma requires the administration
More information[N] = No product variation, policy applies as stated [Y] = Standard product coverage varies from application of this policy, see below
Original Issue Date (Created): August 09, 2002 Most Recent Review Date (Revised): September 24, 2013 Effective Date: November 1, 2013 I. POLICY Scintimammography, breast-specific gamma imaging and molecular
More informationDisclosures. Breast Cancer. Breast Imaging Modalities. Breast Cancer Screening. Breast Cancer 6/4/2014
: Information for the Primary Care Physician Disclosures No financial relationships with commercial entities producing health care products/services. Roxsann Roberts, MD Section Chief, MRI Erlanger/EmCare
More informationDiagnosis and Treatment of Patients with Primary and Metastatic Breast Cancer
Diagnosis and Treatment of Patients with Primary and Metastatic Breast Cancer Early Detection and Diagnosis Early Detection and Diagnosis Version 2005: Junkermann Version 2006 2009: Schreer / Albert Version
More informationEmerging Technologies in Breast Imaging
June 30, 2016 Emerging Technologies in Breast Imaging Jay A. Baker, M.D. Division of Breast Imaging New Technologies in Breast Imaging Full Field Digital Mammography (FFDM) X-ray/Mammography Computer-Aided
More informationRole of positron emission mammography (PEM) for assessment of axillary lymph node status in patients with breast cancer
Role of positron emission mammography (PEM) for assessment of axillary lymph node status in patients with breast cancer Poster No.: C-1260 Congress: ECR 2011 Type: Scientific Paper Authors: K. M. Kulkarni,
More informationBreast MRI: Friend or Foe?
Breast MRI: Friend or Foe? UCSF Postgraduate Course May 18, 2013 Cheryl Ewing, MD Clinical Professor of Surgery UCSF Department of Surgery APPLEGATE HAS DOUBLE MASTECTOMY IN CANCER SCARE DIAGNOSED WITH
More informationA Snapshot on Nuclear Cardiac Imaging
Editorial A Snapshot on Nuclear Cardiac Imaging Khalil, M. Department of Physics, Faculty of Science, Helwan University. There is no doubt that nuclear medicine scanning devices are essential tool in the
More informationBreast Imaging! Ravi Adhikary, MD!
Breast Imaging! Ravi Adhikary, MD! ACS Estimated Cancers Statistics 2014! Breast! New Cases in Women! 232,670 (+67,570 in situ)! Deaths in Women! 40,000! Colon! 48,380! 24,040! Cervical! 12,360! 4,020!
More informationDense Breasts. A Breast Cancer Risk Factor and Imaging Challenge
Dense Breasts A Breast Cancer Risk Factor and Imaging Challenge Renee Pinsky, MD University of Michigan Department of Radiology Division of Breast Imaging No Disclosures QUIZ: ARE YOU DENSE? a. Breast
More informationEmerging Techniques in Breast Imaging: Contrast-Enhanced Mammography and Fast MRI
Emerging Techniques in Breast Imaging: Contrast-Enhanced Mammography and Fast MRI Lilian Wang, M.D. Breast Imaging Section Department of Radiology Northwestern Medicine Overview Rationale for new imaging
More informationPositron Emission Mammography. Description
Subject: Positron Emission Mammography Page: 1 of 12 Last Review Status/Date: December 2016 Positron Emission Mammography Description Positron emission mammography (PEM) is a form of positron emission
More informationWhat s New in Breast Imaging. Jennifer A. Harvey, M.D., FACR Professor of Radiology University of Virginia
What s New in Breast Imaging Jennifer A. Harvey, M.D., FACR Professor of Radiology University of Virginia Disclosure Hologic, Inc. Shareholder and research agreement. Volpara Solutions, Ltd. Shareholder
More informationBreast MRI: Friend or Foe?
Breast : Friend or Foe? APPLEGATE HAS DOUBLE MASTECTOMY IN CANCER SCARE DIAGNOSED WITH CANCER IN ONE BREAST Comments: 0 ASSOCIATED PRESS 8/19/2008 UCSF Postgraduate Course March 19, 2009 E. Shelley Hwang
More informationSupplemental Screening for Dense Breasts. Reagan Leverett, MD, MS
Supplemental Screening for Dense Breasts Reagan Leverett, MD, MS Outline Anatomy and Density Risk of dense breasts Theory of Supplemental Screening Options for supplemental screening Tomosynthesis Ultrasound
More informationRole of PEM in Breast Cancer Management. Judy Kalinyak, MD, PhD Chief Medical Officer Naviscan, Inc (San Diego, CA)
Role of PEM in Breast Cancer Management Judy Kalinyak, MD, PhD Chief Medical Officer Naviscan, Inc (San Diego, CA) Role of PEM in Breast Cancer Management Introduction to Positron Emission Mammography
More informationScintimammography and Gamma Imaging of the Breast and Axilla
Scintimammography and Gamma Imaging of the Breast and Axilla Applies to all products administered or underwritten by Blue Cross and Blue Shield of Louisiana and its subsidiary, HMO Louisiana, Inc.(collectively
More informationBreast density: imaging, risks and recommendations
Breast density: imaging, risks and recommendations Maureen Baxter, MD Radiologist Director of Ruth J. Spear Breast Center Providence St. Vincent Medical Center Alison Conlin, MD/MPH Medical Oncologist
More informationMedical Policy. MP Positron Emission Mammography
Medical Policy BCBSA Ref. Policy: 6.01.52 Last Review: 09/19/2018 Effective Date: 09/19/2018 Section: Radiology Related Policies 6.01.18 Scintimammography and Gamma Imaging of the Breast and Axilla 6.01.29
More informationMedical Physics Graduate Program, Duke University, Durham, NC 27710, USA 2
Hindawi Publishing Corporation Journal of Oncology Volume 2012, Article ID 146943, 7 pages doi:10.1155/2012/146943 Research Article Initial In Vivo Quantification of Tc-99m Sestamibi Uptake as a Function
More informationBreast-Specific Gamma Imaging for the Detection of Breast Cancer in Dense Versus Nondense Breasts
Women s Imaging Original Research Rechtman et al. BSGI in Dense Versus Nondense Breasts Women s Imaging Original Research FOCUS ON: Lauren R. Rechtman 1 Megan J. Lenihan 1 Jennifer H. Lieberman 1 Christine
More informationSCREENING FOR BREAST CANCER BREAST IMAGING
SCREENING FOR BREAST CANCER BREAST IMAGING Liane Philpotts, MD, FSBI, FACR Professor, Radiology and Biomedical Imaging Division Chief, Breast Imaging Dec. 5, 2017 Warner, E. NEJM 2011 Screening for
More informationBreast Cancer Imaging
Breast Cancer Imaging I. Policy University Health Alliance (UHA) will cover breast imaging when such services meet the medical criteria guidelines (subject to limitations and exclusions) indicated below.
More informationDr Robin Wilson, The Royal Marsden
Screening: State of the Art High risk and dense breasts Robin Wilson Smart Breast Screening? 1 in 8 women in the will get breast cancer 8 in 9 will not 55% of breast cancers are not screen detected One
More informationScintimammography and Gamma Imaging of the Breast and Axilla
Scintimammography and Gamma Imaging of the Breast and Axilla Policy Number: 6.01.18 Last Review: 9/2014 Origination: 9/2006 Next Review: 9/2015 Policy Blue Cross and Blue Shield of Kansas City (Blue KC)
More informationPET/CT in Breast Cancer
PET/CT in Breast Cancer Rodolfo Núñez Miller, M.D. Nuclear Medicine and Diagnostic Imaging Section Division of Human Health International Atomic Energy Agency Vienna, Austria Overview Introduction Locorregional
More informationBreast Imaging Update: Old Dog New Tricks
Breast Imaging Update: Old Dog New Tricks Claire McKay, DO M&S Imaging Assoc. San Antonio, TX cmckayhart@juno.com Goals Describe modalities available, old and new Provide understanding of pros and cons
More informationThe Cure Starts Here 2/9/2015. You can get up and use the restroom anytime, but be discreet please. Objectives
Objectives The Cure Starts Here Deborah Thames R.T. (R)(M)(QM) Staging a Patient through Imaging Modalities Knowing the Choices with BI-RADs and the Lexicon Treatment Options and Managing Patient Care
More informationHere are examples of bilateral analog mammograms from the same patient including CC and MLO projections.
Good afternoon. It s my pleasure to be discussing Diagnostic Breast Imaging over the next half hour. I m Wei Yang, Professor of Diagnostic Radiology and Chief, the Section of Breast Imaging as well as
More informationMR sin plass i brystkreftdiagnostikk, dagens anbefalinger og fremtidsperspektiver
MR sin plass i brystkreftdiagnostikk, dagens anbefalinger og fremtidsperspektiver Kathinka Kurz, MD, PhD, seksjonsoverlege SUS, kathinka.dehli.kurz@sus.no Technique - Subtraction Without contrast agent
More informationImaging Surveillance in Women with a History of Treated Breast Cancer. Wei Tse Yang, M.D.
Imaging Surveillance in Women with a History of Treated Breast Cancer Wei Tse Yang, M.D. Breast Cancer 1. Extent 2. Response 3. Recurrence Surveillance Breast Cancer 1. Extent 2. Response Surveillance
More informationMANAGEMENT OF DENSE BREASTS. Nichole K Ingalls, MD, MPH NW Surgical Specialists September 25, 2015
MANAGEMENT OF DENSE BREASTS Nichole K Ingalls, MD, MPH NW Surgical Specialists September 25, 2015 No financial disclosures National Cancer Institute National Cancer Institute Increased Cancer Risk... DENSITY
More informationTissue Breast Density
Tissue Breast Density Reporting breast density within the letter to the patient is now mandated by VA law. Therefore, this website has been established by Peninsula Radiological Associates (PRA), the radiologists
More informationAngela Gilliam, MD University of Colorado Surgical Grand Rounds November 3, 2008
Angela Gilliam, MD University of Colorado Surgical Grand Rounds November 3, 2008 Breast Cancer Most common cancer in American women 180,000 new cases per year Second most common cause of cancer death 44,000
More informationWe are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists. International authors and editors
We are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists 4,000 116,000 120M Open access books available International authors and editors Downloads Our
More informationSources of Data of Stochastic Effects of Radiation. Michael K O Connor, Ph.D. Dept. of Radiology, Mayo Clinic
Sources of Data of Stochastic Effects of Radiation Michael K O Connor, Ph.D. Dept. of Radiology, Mayo Clinic Biological Effects of Ionizing Radiation (BEIR) 2007 National Academy of Science National Research
More informationContrast-Enhanced Spectral Mammography
Contrast-Enhanced Spectral Mammography Illuminating Breast Cancer Detection SenoBright HD TM gehealthcare.com/senobright Mammography is the most reliable imaging technique for breasts, but limitations
More informationEARLY DETECTION: MAMMOGRAPHY AND SONOGRAPHY
EARLY DETECTION: MAMMOGRAPHY AND SONOGRAPHY Elizabeth A. Rafferty, M.D. Avon Comprehensive Breast Center Massachusetts General Hospital Harvard Medical School Breast Cancer Screening Early detection of
More informationMammography is a most effective imaging modality in early breast cancer detection. The radiographs are searched for signs of abnormality by expert
Abstract Methodologies for early detection of breast cancer still remain an open problem in the Research community. Breast cancer continues to be a significant problem in the contemporary world. Nearly
More informationStandard Breast Imaging Modalities. Lilian Wang, M.D. Breast Imaging Section Department of Radiology Northwestern Medicine
Standard Breast Imaging Modalities Lilian Wang, M.D. Breast Imaging Section Department of Radiology Northwestern Medicine Overview Standard breast imaging modalities Mammography Ultrasound MRI Imaging
More informationBreast Tomosynthesis. What is breast tomosynthesis?
Scan for mobile link. Breast Tomosynthesis Breast tomosynthesis is an advanced form of mammography, a specific type of breast imaging that uses low-dose x-rays to detect cancer early when it is most treatable.
More informationBreast Cancer Screening and Diagnosis
Breast Cancer Screening and Diagnosis Priya Thomas, MD Assistant Professor Clinical Cancer Prevention and Breast Medical Oncology University of Texas MD Anderson Cancer Center Disclosures Dr. Thomas has
More informationScreening with Abbreviated Breast MRI (AB-MR)
Screening with Abbreviated Breast MRI (AB-MR) Christopher Comstock, MD, FACR, FSBI Department of Radiology Memorial Sloan-Kettering Cancer Center New York, NY Outline History of our approach to screening
More informationConflict of Interest Disclosure
Challenges and Opportunities for SPECT & PET in 2013: Implementing Latest Acquisition and Processing Protocols Timothy M. Bateman M.D. Co-Director, Cardiovascular Radiologic Imaging Mid America Heart Institute
More informationThe Comparative Clinical Effectiveness and Value of Supplemental Screening Tests Following Negative Mammography in Women with Dense Breast Tissue
The New England Comparative Effectiveness Public Advisory Council Public Meeting December 13, 2013 The Comparative Clinical Effectiveness and Value of Supplemental Screening Tests Following Negative Mammography
More informationCompressive Re-Sampling for Speckle Reduction in Medical Ultrasound
Compressive Re-Sampling for Speckle Reduction in Medical Ultrasound Professor Richard Mammone Rutgers University Email Phone Number Christine Podilchuk, Lev Barinov, Ajit Jairaj and William Hulbert ClearView
More informationCurrent Strategies in the Detection of Breast Cancer. Karla Kerlikowske, M.D. Professor of Medicine & Epidemiology and Biostatistics, UCSF
Current Strategies in the Detection of Breast Cancer Karla Kerlikowske, M.D. Professor of Medicine & Epidemiology and Biostatistics, UCSF Outline ν Screening Film Mammography ν Film ν Digital ν Screening
More informationScintimammography. What is scintimammography?
Scan for mobile link. Scintimammography Scintimammography uses small amounts of radioactive materials called radiotracers, a special camera and a computer to help investigate an abnormality discovered
More informationBREAST DENSITY WHAT IS IT? WHY IS IT IMPORTANT? & What IOWA SF250 Means to Patients and Providers
BREAST DENSITY WHAT IS IT? WHY IS IT IMPORTANT? & What IOWA SF250 Means to Patients and Providers Arnold Honick, MD Radiology Consultants of Iowa, PLC ahonick@rciowa.com BREAST DENSITY LEGISLATION Nancy
More informationMolecular imaging of breast cancer with 18 F-fluorodeoxyglucose
Blackwell Publishing Inc ORIGINAL ARTICLE DOI: 10.1111/j.1075-122X.2006.00269.x High-Resolution Fluorodeoxyglucose Positron Emission Tomography with Compression ( Positron Emission Mammography ) is Highly
More informationOutline. Lifetime Attributable Risk 10 mgy in 100,000 exposed persons (BEIR VII 2006) SPECT/CT and PET/CT Dosimetry
SPECT/CT and PET/CT Dosimetry Lifetime Attributable Risk 10 mgy in 100,000 exposed persons (BEIR VII 2006) All Solid Tumors Leukemia Frederic H. Fahey DSc Male Female Male Female Children s Hospital Boston
More informationPositron Emission Mammography (PEM)
Applies to all products administered or underwritten by Blue Cross and Blue Shield of Louisiana and its subsidiary, HMO Louisiana, Inc.(collectively referred to as the Company ), unless otherwise provided
More informationContrast-Enhanced Digital Mammography
2015 ARRS Breast Symposium Contrast-Enhanced Digital Mammography John Lewin, M.D. Diversified Radiology of Colorado CEDM - Outline History Technique Literature Review / Cases Clinical Status Inexpensive,
More informationBreast CT and Dosimetry
2013 ICTP/IAEA Training Course on Radiation Protection of Patients Trieste Breast CT and Dosimetry John M. Boone, Ph.D., FAAPM, FSBI, FACR Professor and Vice Chair (Research) of Radiology Professor of
More informationROLE OF MRI IN SCREENING, DIAGNOSIS AND MANAGEMENT OF BREAST CANCER. B.Zandi Professor of Radiology
ROLE OF MRI IN SCREENING, DIAGNOSIS AND MANAGEMENT OF BREAST CANCER B.Zandi Professor of Radiology Introduction In the USA, Breast Cancer is : The Most Common Non-Skin Cancer The Second Leading cause of
More informationTomosynthesis and breast imaging update. Dr Michael J Michell Consultant Radiologist King's College Hospital NHS Foundation Trust
Tomosynthesis and breast imaging update Dr Michael J Michell Consultant Radiologist King's College Hospital NHS Foundation Trust Breast imaging new technology BREAST CANCER FLT PET shows different grades
More informationReal-world application of breast-specific gamma imaging, initial experience at a community breast center and its potential impact on clinical care
The American Journal of Surgery (2008) 195, 631 635 North Pacific Surgical Association Real-world application of breast-specific gamma imaging, initial experience at a community breast center and its potential
More informationBreast Cancer Screening in Women at Higher-Than-Average Risk: Recommendations From the ACR
ORIGINAL ARTICLE CLINICAL PRACTICE MANAGEMENT Breast Cancer Screening in Women at Higher-Than-Average Risk: Recommendations From the ACR Debra L. Monticciolo, MD a, Mary S. Newell, MD b, Linda Moy, MD
More informationMolecular Imaging and Breast Cancer
Molecular Imaging and Breast Cancer Breast cancer forms in tissues of the breast usually in the ducts, tubes that carry milk to the nipple, and lobules, the glands that make milk. It occurs in both men
More informationFinancial Disclosures
Financial Disclosures 3D Mammography: The Latest Developments in the Breast Imaging Arena I have no financial disclosures Dr. Katharine Lampen-Sachar Breast and Body Radiologist Radiology Associates of
More informationBreast-specific gamma imaging as an adjunct modality for the diagnosis of invasive breast cancer with correlation to tumour size and grade
The British Journal of Radiology Published online before print June 28, 2011 The British Institute of Radiology, doi: 10.1259/bjr/34392802 Breast-specific gamma imaging as an adjunct modality for the diagnosis
More informationDiagnostic benefits of ultrasound-guided. CNB) versus mammograph-guided biopsy for suspicious microcalcifications. without definite breast mass
Volume 118 No. 19 2018, 531-543 ISSN: 1311-8080 (printed version); ISSN: 1314-3395 (on-line version) url: http://www.ijpam.eu ijpam.eu Diagnostic benefits of ultrasound-guided biopsy versus mammography-guided
More informationBreast Cancer Screening
Scan for mobile link. Breast Cancer Screening What is breast cancer screening? Screening examinations are tests performed to find disease before symptoms begin. The goal of screening is to detect disease
More informationOutline. Abbreviated MRI and the Dense Breast. 2D Analog Screen Mammography. RCTs of Mammographic Screening
Abbreviated MRI and the Dense Breast Christopher Comstock, MD FACR Breast Imaging Section Department of Radiology Memorial Sloan-Kettering Cancer Center New York, NY Outline History of mammographic screening
More informationThe Future of Breast MRI Improving Outcomes
The Future of Breast MRI Improving Outcomes Connie Lehman MD PhD Professor of Radiology Harvard Medical School Director of Breast Imaging Massachusetts General Hospital Opportunities New technology provides
More informationBREAST CANCER SCREENING IS A CHOICE
BREAST CANCER SCREENING IS A CHOICE by ELAINE SCHATTNER, MD no financial disclosures (ES) American Association for Cancer Research Typical headlines focus on controversy 2 Data: Breast Cancer Incidence
More informationMammography. What is Mammography? What are some common uses of the procedure?
Mammography What is Mammography? Mammography is a specific type of imaging that uses a low-dose x-ray system to examine breasts. A mammography exam, called a mammogram, is used to aid in the early detection
More informationI. Cancer staging problem
Instrumentation Lab (Craig Levin) Angela Craig Peter Jin Frezghi Guillem Billie Garry Research interests (by imaging modality) I. High resolution radionuclide imaging : positron emission tomography (PET)
More informationEARLY DETECTION: MAMMOGRAPHY AND SONOGRAPHY
EARLY DETECTION: MAMMOGRAPHY AND SONOGRAPHY Elizabeth A. Rafferty, M.D. Avon Comprehensive Breast Center Massachusetts General Hospital Harvard Medical School Breast Cancer Screening Early detection of
More informationMammography limitations. Clinical performance of digital breast tomosynthesis compared to digital mammography: blinded multi-reader study
Clinical performance of digital breast tomosynthesis compared to digital mammography: blinded multi-reader study G. Gennaro (1), A. Toledano (2), E. Baldan (1), E. Bezzon (1), C. di Maggio (1), M. La Grassa
More informationSenoBright Contrast Enhanced Spectral Mammography Technology. Ann-Katherine Carton Sylvie Saab-Puong Matt Suminski
SenoBright Contrast Enhanced Spectral Mammography Technology Ann-Katherine Carton Sylvie Saab-Puong Matt Suminski White Paper October 2012 SenoBright Contrast Enhanced Spectral Mammography Technology Ann-Katherine
More informationContrast-enhanced Breast MRI RSSA 2013
Contrast-enhanced Breast MRI RSSA 2013 Prof. dr. Maurice van den Bosch University Medical Center Utrecht, the Netherlands Index 1) Breast cancer 2) Why MRI of the breast 3) Technique 4) Interpretation
More informationMammography. What is Mammography?
Scan for mobile link. Mammography Mammography is a specific type of breast imaging that uses low-dose x-rays to detect cancer early before women experience symptoms when it is most treatable. Tell your
More informationGe elastography cpt codes
Ge elastography cpt codes Aetna considers digital mammography a medically necessary acceptable alternative to film mammography. Currently, there are no guideline recommendations from leading medical professional
More informationThe Comparative Clinical Effectiveness and Value of Supplemental Screening Tests Following Negative Mammography in Women with Dense Breast Tissue
TITLE: AUTHORS: The Comparative Clinical Effectiveness and Value of Supplemental Screening Tests Following Negative Mammography in Women with Dense Breast Tissue Jeffrey A. Tice, MD Associate Professor
More informationHigh-Resolution Breast PET
The Leader in Organ-Specific Molecular Imaging High-Resolution Breast PET L0350 Rev 17 MLO PEM Naviscan PET Scanner High (1.6 mm) intrinsic resolution Short 4-10 minute scan time Compact, portable, easy
More informationQuantitative background parenchymal uptake on molecular breast imaging and breast cancer risk: a case-control study
Hruska et al. Breast Cancer Research (2018) 20:46 https://doi.org/10.1186/s13058-018-0973-3 RESEARCH ARTICLE Open Access Quantitative background parenchymal uptake on molecular breast imaging and breast
More informationLook differently. Invenia ABUS. Automated Breast Ultrasound
Look differently. Invenia ABUS Automated Breast Ultrasound InveniaTM ABUS from GE Healthcare offers a view beyond mammography, with breast screening technology that looks differently. 40 % The unseen risk.
More informationFirst Clinical Experience Using Stereotactic Breast Biopsy Guided by 99m Tc-Sestamibi
Nuclear Medicine and Molecular Imaging Original Research Technetium-99m Labeled Sestamibi Guided Stereotactic Breast Biopsy Nuclear Medicine and Molecular Imaging Original Research Angela Collarino 1,2
More information11/1/2014. Radiologic incidentalomas Ordering pitfalls Newer technology and applications
Bilal Tahir, MD Gitasree Borthakur, MD Indiana University School of Medicine Department of Radiology & Imaging Sciences October 31, 2014 ACP 2014 Dr. V. Aaron Nuclear (vaaron@iupui.edu) Dr. S. Westphal
More informationMelissa Hartman, DO Women s Health Orlando VA Medical Center
Melissa Hartman, DO Women s Health Orlando VA Medical Center Most common non-skin cancer and Second deadliest cancer in women Majority are diagnosed by abnormal screening study An approach to breast cancer
More informationThe Radiology Aspects
REQUIREMENTS FOR INTERNATIONAL ACCREDITATION OF BREAST CENTERS/UNITS The Radiology Aspects Miri Sklair-Levy, Israel RADIOLOGY GUIDELINES FOR QUALITY ASSURANCE IN BREAST CANCER SCREENING AND DIAGNOSIS Radiologists
More information