3D Breast Tomosynthesis Provides Superior Sensitivity for Architectural Distortions and Masses

A new breast tomosynthesis system is a three-dimensional (3D) imaging technology that uses a low-dose short X-ray sweep around the compressed breast with only nine exposures. The new system provides very high sensitivity for architectural distortions and masses, providing more clinical effectiveness while delivering the same amount of radiation dose as a digital mammography acquisition of the same view.

The SenoClaire system, powered by ASiR (adaptive statistical iterative reconstruction) digital breast tomosynthesis (DBT) and developed by GE Healthcare (Chalfont St, Giles, UK), enhances mammographic specificity by improving lesion margin visibility. Because of its low dose and non-inferior clinical accuracy, SenoClaire has the potential to replace digital mammography exams in screening at half the dose to help in the identification of breast cancer. An additional craniocaudal (CC) view, as part of the learning curve process may be considered along with the 3D mediolateral-oblique (MLO) view, which will help radiologists become more comfortable with reviewing only the 3D MLO sequence in the near future.

SenoClaire enables optimized characterization of malignant and benign findings by providing a 3D MLO view that has excellent detection for architectural distortions and masses when compared with 2D full field digital mammography (FFDM). Clinical findings have demonstrated that the recall rate after a 3D MLO examination is lower than the recall rate after a 2D FFDM exam.

The detector offers high detective quantum efficiency (DQE) at a low dose for visualizing microcalcifications without binning, a process that regroups pixels for faster readout speeds and improved signal-to-noise ratios, but with reduced image quality. Step-and-shoot tube motion maintains microcalcification sharpness and avoids image blur, because the tube makes a complete stop for each of the nine exposures. This provides higher peak contrast for microcalcifications than conventional continuous tube motion.

An antiscatter solution designed for tomosynthesis, the SenoClaire grid in 3D reduces scattered radiation and improves detectability in 3D for breasts of above-average thickness, while preserving dose and performance. The system uses ASiRDBT, an iterative reconstruction algorithm that generates FFDM-like images and positively impacts microcalcification conspicuity versus the conventional filtered back projection (FBP) algorithm.

Because GE builds the Senographe with upgradability in mind, the system can easily be expanded as the department needs and capabilities grow. SenoClaire 3D breast tomosynthesis, stereotaxy, or SenoBright contrast-enhanced spectral mammography are fully compatible with any Senographe Essential and Senographe Care. The system’s images are compatible with major picture archiving and communication system (PACS) providers (with local variability), allowing integration into an existing setting, making optimal use of the investment.

With the IDI MammoWorkstation, radiologists can easily navigate through the DBT dataset using customized 2D/3D hanging protocols and specific ergonomic features: clear-cut visual identification of all series of tomosynthesis planes and slabs; dedicated tools to review tomosynthesis data sets: cine loop, bookmarks, breast localizer, breast height ruler; and V-Preview reconstructed images from tomosynthesis.

A requirement of dose performance entails that patient X-ray dose is kept as low as reasonably acceptable. A single MLO view of SenoClaire, powered by ASiRDBT, provides clinical non-inferiority when compared to two-view digital mammography. The system provides half the dose, with one single compression. SenoClaire’s ASiRDBT iterative reconstruction algorithm provides FFDM-like images and effectively impacts microcalcification conspicuity versus the conventional filtered back projection (FBP) algorithm.

SenoClaire’s 3D MLO sequence requires only nine exposures with an even distribution of the dose. The SenoClaire grid in 3D reduces scattered radiation and improves detectability in 3D for breasts of above-average thickness, while preserving dose and performance.

The dual-track X-ray tube (Mo/Rh) delivers optimal X-ray spectra to penetrate the breast based on breast density and compressed breast thickness. Automatic optimization of parameters (AOP) helps in the identification of the densest breast regions and automatically selects the correct anode, filter, kV, and mAs to ensure repeatable image quality at optimized radiation dose.

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