Alternative Breast Imaging

Medical imaging has been transformed over the past 30 years by the advent of computerized tomography (CT), magnetic resonance imaging (MRI), and various advances in x-ray and ultrasonic techniques. An enabling force behind this progress has been the (so far) exponentially increasing power of computers, which has made it practical to explore fundamentally new approaches. In particular, what our group terms "model-based" modalities-which produce tissue property images from data using nonlinear, iterative numerical modeling techniques-have become increasingly feasible. Alternative Breast Imaging: Four Model-Based Approaches explores our research on four such modalities, particularly with regard to imaging of the breast: (1) MR elastography (MRE), (2) electrical impedance spectroscopy (EIS), (3) microwave imaging spectroscopy (MIS), and (4) near infrared spectroscopic imaging (NIS). Chapter 1 introduces the present state of breast imaging and discusses how our alternative modalities can contribute to the field. Chapter 2 looks at the computational common ground shared by all four modalities. Chapters 2 through 10 are devoted to the four modalities, with each modality being discussed first in a theory chapter and then in an implementation-and-results chapter. The eleventh and final chapter discusses statistical methods for image analysis in the context of these four alternative imaging modalities. Imaging for the detection of breast cancer is a particularly interesting and relevant application of the four imaging modalities discussed in this book. Breast cancer is an extremely common health problem for women; the National Cancer Institute estimates that one in eight US women will develop breast cancer at least once in her lifetime. Yet the efficacy of the standard (and notoriously uncomfortable) early-detection test, the x-ray mammogram, has been disputed of late, especially for younger women. Conditions are thus ripe for the development of affordable techniques that replace or complement mammography. The breast is both anatomically accessible and small enough that the computing power required to model it, is affordable. Alternative Breast Imaging: Four Model-Based Approaches is structured to meet the needs of a professional audience composed of researchers and practitioners in industry. This book is also suitable for graduate-level students in computer science, electrical engineering and biomedical imaging.

Medical imaging has been transformed over the past 30 years by the advent of computerized tomography (CT), magnetic resonance imaging (MRI), and various advances in x-ray and ultrasonic techniques. An enabling force behind this progress has been the (so far) exponentially increasing power of computers, which has made it practical to explore fundamentally new approaches. In particular, what our group terms "model-based" modalities-which produce tissue property images from data using nonlinear, iterative numerical modeling techniques-have become increasingly feasible. Alternative Breast Imaging: Four Model-Based Approaches explores our research on four such modalities, particularly with regard to imaging of the breast: (1) MR elastography (MRE), (2) electrical impedance spectroscopy (EIS), (3) microwave imaging spectroscopy (MIS), and (4) near infrared spectroscopic imaging (NIS). Chapter 1 introduces the present state of breast imaging and discusses how our alternative modalities can contribute to the field. Chapter 2 looks at the computational common ground shared by all four modalities. Chapters 2 through 10 are devoted to the four modalities, with each modality being discussed first in a theory chapter and then in an implementation-and-results chapter. The eleventh and final chapter discusses statistical methods for image analysis in the context of these four alternative imaging modalities. Imaging for the detection of breast cancer is a particularly interesting and relevant application of the four imaging modalities discussed in this book. Breast cancer is an extremely common health problem for women; the National Cancer Institute estimates that one in eight US women will develop breast cancer at least once in her lifetime. Yet the efficacy of the standard (and notoriously uncomfortable) early-detection test, the x-ray mammogram, has been disputed of late, especially for younger women. Conditions are thus ripe for the development of affordable techniques that replace or complement mammography. The breast is both anatomically accessible and small enough that the computing power required to model it, is affordable.

X-ray mammography screening is the current mainstay for early breast cancer detection. It has been proven to detect breast cancer at an earlier stage and to reduce the number of women dying from the disease. However, it has a number of limitations. These current limitations in early breast cancer detection technology are driving a surge of new technological developments, from modifications of x-ray mammography such as computer programs that can indicate suspicious areas, to newer methods of detection such as magnetic resonance imaging (MRI) or biochemical tests on breast fluids. To explore the merits and drawbacks of these new breast cancer detection techniques, the Institute of Medicine of the National Academy of Sciences convened a committee of experts. During its year of operation, the committee examined the peer-reviewed literature, consulted with other experts in the field, and held two public workshops. In addition to identifying promising new technologies for early detection, the committee explored potential barriers that might prevent the development of new detection methods and their common usage. Such barriers could include lack of funding from agencies that support research and lack of investment in the commercial sector; complicated, inconsistent, or unpredictable federal regulations; inadequate insurance reimbursement; and limited access to or unacceptability of breast cancer detection technology for women and their doctors. Based on the findings of their study, the committee prepared a report entitled Mammography and Beyond: Developing Technology for Early Detection of Breast Cancer, which was published in the spring of 2001. This is a non-technical summary of that report.

This book is a comprehensive guide to contrast-enhanced mammography (CEM), a novel advanced mammography technique using dual-energy mammography in combination with intravenous contrast administration in order to increase the diagnostic performance of digital mammography. Readers will find helpful information on the principles of CEM and indications for the technique. Detailed attention is devoted to image interpretation, with presentation of case examples and highlighting of pitfalls and artifacts. Other topics to be addressed include the establishment of a CEM program, the comparative merits of CEM and MRI, and the roles of CEM in screening populations and monitoring of response to neoadjuvant chemotherapy. CEM became commercially available in 2011 and is increasingly being used in clinical practice owing to its superiority over full-field digital mammography. This book will be an ideal source of knowledge and guidance for all who wish to start using the technique or to learn more about it.

The outlook for women with breast cancer has improved in recent years. Due to the combination of improved treatments and the benefits of mammography screening, breast cancer mortality has decreased steadily since 1989. Yet breast cancer remains a major problem, second only to lung cancer as a leading cause of death from cancer for women. To date, no means to prevent breast cancer has been discovered and experience has shown that treatments are most effective when a cancer is detected early, before it has spread to other tissues. These two facts suggest that the most effective way to continue reducing the death toll from breast cancer is improved early detection and diagnosis. Building on the 2001 report Mammography and Beyond, this new book not only examines ways to improve implementation and use of new and current breast cancer detection technologies but also evaluates the need to develop tools that identify women who would benefit most from early detection screening. Saving Women's Lives: Strategies for Improving Breast Cancer Detection and Diagnosis encourages more research that integrates the development, validation, and analysis of the types of technologies in clinical practice that promote improved risk identification techniques. In this way, methods and technologies that improve detection and diagnosis can be more effectively developed and implemented.

This superbly illustrated book provides a thorough, up-to-date overview of diagnostic breast imaging and therapy. Drs. Elizabeth Morris, Michael Fuchsjäger, and Thomas Helbich, three experts in the field, have collaborated with colleagues from their institutions and selected medical centers to share their expertise. The coverage ranges from basic information on imaging technologies and interventional equipment and how to use them optimally to the application of advanced high-end techniques for screening and assessment in any given professional environment. Readers will find clear instruction on the various breast interventional procedures guided by stereotaxis, ultrasound, and magnetic resonance imaging in wide clinical use. The management of patients with ductal carcinoma in situ and high-risk breast cancer is considered separately. Furthermore, the role of minimally invasive therapy is examined, and advice is provided on post-therapy evaluation, including breast implants. A comprehensive diagnostic atlas with hundreds of images completes this volume and addresses the spectrum of various clinical situations.

This open access book focuses on diagnostic and interventional imaging of the chest, breast, heart, and vessels. It consists of a remarkable collection of contributions authored by internationally respected experts, featuring the most recent diagnostic developments and technological advances with a highly didactical approach. The chapters are disease-oriented and cover all the relevant imaging modalities, including standard radiography, CT, nuclear medicine with PET, ultrasound and magnetic resonance imaging, as well as imaging-guided interventions. As such, it presents a comprehensive review of current knowledge on imaging of the heart and chest, as well as thoracic interventions and a selection of "hot topics". The book is intended for radiologists, however, it is also of interest to clinicians in oncology, cardiology, and pulmonology.