Three-Dimensional (3D) Digital Breast Tomosynthesis (DBT) in the Early Diagnosis and Detection of Breast Cancer

Two-dimensional (2D) mammography plays a most important role in all aspects of breast cancer detection, diagnosis and treatment. Although it is well known that 2D mammography has limitations and it is not capable of detecting all breast cancers, there is no question that mammography is an important imaging technique for detecting and diagnosing breast cancer. Challenges of 2D mammography are structured noise which is created by the overlap of normal dense tissue structures within the breast. This may obscure the findings causing lesions to be missed (reduction of diagnostic sensitivity). Breast tissue may also simulate the presence of a cancer that does not actually exist. This causes a loss of diagnostic specificity. Currently 2D mammography is the only x-ray imaging modality accepted for breast cancer screening, but for years researchers have tried to find improved technologies and new methods to supplement 2D mammography and provide better sensitivity and specificity. Digital breast tomosynthesis (DBT) is a method that was first described many years ago, but could not be easily applied until the development of fast read-out digital detectors. The goal of breast tomosynthesis is to make available a method for screening and diagnostic mammography which provides higher sensitivity and specificity than routine mammography. This study presents digital breast tomosynthesis in diagnostic mammography by comparing digital breast tomosynthesis and screen-film or digital mammograms clinical performance, evaluates Tuned Aperture Computed Tomography (TACT) capability as a 3D breast reconstruction algorithm in the limited angle tomosynthesis system, and demonstrates technical and clinical performance of a real-time amorphous-selenium (a-Se) flat-panel detector (FPD) in full field digital breast tomosynthesis. The analyses of breast tomosynthesis have shown the following clinical benefits: improvement of overall lesion detection and analysis, increased accuracy to either confirm or exclude a suspected abnormality and in particular detection capability of small breast cancers. The results indicate that breast tomosynthesis has the potential to significantly advance diagnostic mammography, as well as screening mammography in the future. Tomosynthesis studies have already shown a promise. Based on this clinical study, tomosynthesis of the breast will increase specificity. Study also suggests that tomosynthesis might facilitate the detection of cancers at an earlier stage and a smaller size than is possible in 2D mammography. Digital breast tomosynthesis is a new breast imaging modality which has proved to have advantages over 2D mammography. Breast tomosynthesis will lead to the earlier breast cancer detection and diagnosis and will keep the false positive rate as low as possible. Keywords: digital breast tomosynthesis (DBT), breast cancer, three-dimensional (3D), tuned aperture computed tomography (TACT), amorphous selenium (a-Se), digital mammography (DM), flat panel detector (FPD)