Advances in Mammography

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Advances in Mammography

• By PAWAN KUMAR POPLI
• DEPT.OF RADIO-DIAGNOSIS
• AIIMS, NEW DELHI

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Mammography
Tube
cone
Breast Stand
Past Present
Similar equipments were are still being used,
these can be called as old fashioned equipments
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Mammography
In digital mammography screen-film system has
been replaced by Detectors to give the digital
images
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Mammography
CCD camera
Work station
Present future
Equipments look like this
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Mammogram
These digital mammograms are surely better in
resolution details
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Interventions
Mammographic interventions basically are of two
types
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Biopsy
Biopsies can be acquired in various ways
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Biopsy
Girded plate
Used to guide the biopsies hook wire placements
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Biopsy
Stereo images
Stereo tactic
Method is the latest way to acquire biopsies with
high accuracy
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Stereo tactic Biopsy
The various steps involved are
Mammography
10 degree - views taken
Mark target on both images

• Trigonometric calculations by computer

Computer guided steriotectic device
Insert biopsy needle - confirm position
Take biopsy
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Hook-wire Placement
Hook wire
Hook wire
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
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Imaging !
Imaging in various planes is possible with the
latest equipments
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MRI
Special Coils
Facilitate high quality MR Images of breast
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MRI-IMAGES
Implant
It is of much use in young females where
mammography is contraindicated For evaluation of
breast implants As complement to mammography
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US
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
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US
Panoramic View
Looking at whole breast in single image is
possible on US
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CTLM
or
Computerized Tomography Laser Mammography
In this

• 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

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CTLM
Computerised Tomography Laser Mammography
Equipment comprises essentially two rings to
emit receive LASER
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CTLM

Normal mammogram
CTML
The Images appear like this
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CTLM

More of CTML images
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CTLM
It is possible to rotate and see the images in
3D form by rotating it
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Nuclear 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.

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Nuclear Medicine
Normally Nuclear Medicine images look like these
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Scintimammography
With latest equipments such images are possible
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Scintimammography
Camera
Now cameras are smaller more flexible to use
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Nuclear Medicine

• 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

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T-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

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T-Scan
Receptor
Current source
Equipment looks like this Patient holds the
source in her hand and Radiologist holds the
receptor
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CTI

• Computerized Thermal imaging
• Or
• Digital 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

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Thermal Camera
Looks like this
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CTI
Patient just stands in front of camera image is
obtained
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CTI
Images look like these
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CTI
Dedicated cameras are also available
Image from dedicated camera
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CTI

• 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

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Optical 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.

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Optical Imaging
This is how optical Imaging works
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Optical Imaging
Breast cup
The Equipment
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Optical Images
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Optical Image
Mammograms
3 D Optical Image Animated
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Optical Tomo
Optical tomography can also be done
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Optical Image
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Optical Biopsy-imaging
Transducer for Biopsy
Biopsy is also possible Equipment is like this
one
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CAD

• Computer aided detection
• It is designed to help radiologists
• Reduce interpretative errors
• Two level reporting

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CAD
Mammography work station
Image Storage
The CAD modules
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How CAD works
Computers marks the areas of more interest
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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

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Thank you
Talk about this session with your friends. It
will add to your knowledge
pkpopli_at_hotmail.com
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Notice

• This presentations was prepared with the help of
  pictures taken from various related web sites
  other sources. Author takes no credit for such
  pictures.