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Background on: Breast Cancer, X-Ray and MRI Mammography. Ernesto Coto Vienna University of Technology Institute of Computer Graphics and Algorithms Computer Graphics Group. Introduction. First stage of a research about the State of the Art on Mammography for Breast Cancer Detection - PowerPoint PPT Presentation
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Ernesto Coto - Institute of Computer Graphics and Algorithms
Background on: Breast Cancer, X-Ray and MRI Mammography
Ernesto CotoVienna University of TechnologyInstitute of Computer Graphics and AlgorithmsComputer Graphics Group
Ernesto Coto - Institute of Computer Graphics and Algorithms
Introduction
First stage of a research about the State of the Art on Mammography for Breast Cancer Detection
Focuses on the background knowledge about Breast Cancer, X-Ray and MRI Mammography
Ernesto Coto - Institute of Computer Graphics and Algorithms
Background: Breast Cancer
Cancer is a general term that is used to describe a group of more than 100 diseases that cause cells in the body to divide and reproduce abnormally without control
These cells may join together to form a mass of extra tissue known as a tumor. Tumors can be malignant or benign
Malignant tumors can break away from tumors and travel, or metastasize
Breast cancer refers to a malignant tumor that has developed from breast cells
Ernesto Coto - Institute of Computer Graphics and Algorithms
Background: Breast Cancer
The female breast has two main components: glandular tissue and connective tissue
There are two general categories
of breast cancer
Non-invasive (or in situ) cancer confined to lobules or ducts
Invasive cancer spread to fatty connective tissue
Ernesto Coto - Institute of Computer Graphics and Algorithms
Background: Breast Cancer
When breast cancer is detected before it has spread to lymph nodes or to other parts of the body, the 5-year survival rate is 97%
Early detection and early treatment can improve the chances of surviving breast cancer. Currently, mammography is the best tool available to detect the earliest warning signs of breast cancer
Ernesto Coto - Institute of Computer Graphics and Algorithms
Background: X-Ray Mammography
A mammogram is an x-ray examination of the breasts, used to detect and diagnose breast diseases
Screening mammography is used as a preventive measure for women who have no symptoms of breast disease
Diagnostic mammography involves additional x-rays of the breast to provide different views of the suspicious area, if an abnormality is detected during screening mammography, or in women with breast complaints
The x-rays can be taken at different angles tailored to the specific area of abnormality. In addition, magnification views or spot compression can be used to make the area easier to evaluate
Ernesto Coto - Institute of Computer Graphics and Algorithms
Background: X-Ray Mammography
Mammography procedure Special x-ray machines developed exclusively for breast
imaging are used to produce mammography films. These machines use very low doses of radiation and produce high-quality x-rays
Ernesto Coto - Institute of Computer Graphics and Algorithms
Background: X-Ray Mammography
Mammography procedure1. The patient wears an open wrap and undress above the
waist
Ernesto Coto - Institute of Computer Graphics and Algorithms
Background: X-Ray Mammography
Mammography procedure2. Compressing the breast is necessary to obtain the best
image
Ernesto Coto - Institute of Computer Graphics and Algorithms
Background: X-Ray Mammography
Mammography procedure3. When the breast is positioned and compression is
complete, the technologist will leave the room or step behind a screen and turn on the x-ray source
Ernesto Coto - Institute of Computer Graphics and Algorithms
Background: X-Ray Mammography
Mammography procedure4. Magnification views or spot compression
could be performed too
Ernesto Coto - Institute of Computer Graphics and Algorithms
Background: X-Ray Mammography
Results Calcifications are tiny calcium deposits within the breast
tissue. Calcifications are classified as microcalcifications (< 1/50 inchs) or macrocalcifications (larger)
Masses Can be solid or liquid (Cyst)
Ernesto Coto - Institute of Computer Graphics and Algorithms
Background: X-Ray Mammography
Staging Staging is the process used to determine the extent a cancer has
spread beyond the primary site The system used to describe staging is the Staging System of the
American Joint Committee on Cancer (or TNM system), it evaluates three components to determine the stage of a cancer:
T = The extent of the tumor, expressed in a numerical value from 0 to 4. Higher T numbers indicates a larger tumor or more extensive spread
N = the extent to which the cancer has spread to lymph nodes near the breast and the degree to which the affected nodes are fixed to other structures under the arm. It is expressed in a numerical value from 0 to 3, with the higher number denoting more extensive spread
M = the extent to which the cancer has metastasized to distant organs or to lymph nodes that are not next to the breast. It is shown in a numerical value from 0 to 1, with 1 indicating the most extensive spread
Ernesto Coto - Institute of Computer Graphics and Algorithms
Background: X-Ray Mammography
Mammography cannot determine whether an abnormal area is cancer, but it can provide guidance for further screening or diagnostic tests.
Results of mammograms are reported using a standardized system called the Breast Imaging Reporting and Data System (BIRADS)
Results range from “Assessment incomplete” to “Highly Suggestive of Malignancy”
Ernesto Coto - Institute of Computer Graphics and Algorithms
Background: X-Ray Mammography
Despite Mammography is acknowledged to be the most effective method of screening for breast cancer, the interpretation of screening mammograms is challenging
The combination of viewing a large number of cases, radiologist fatigue and the complex image structure of the breast on a mammogram can result in false negative mammogram readings
Several retrospective studies have shown that 20% to 40% of breast cancer goes undetected at the screening stage
In addition, finding cancer does not always mean saving lives
Ernesto Coto - Institute of Computer Graphics and Algorithms
Background: X-Ray Mammography
Less common diagnostic proceduresMagnetic Resonance Imaging (MRI)Digital Mammography Positron Emission Tomography Ultrasound
Ernesto Coto - Institute of Computer Graphics and Algorithms
Background: MRI Mammography
Magnetic Resonance Imaging (MRI) can be used to obtain three dimensional images of the inner parts of the human body, without using X-rays
MRI breast imaging is a supplemental tool, in addition to mammography, to help diagnose breast cancer
MRI advantages over X-ray or CAT No radiation The ability to generate arbitrary three-dimensional views of an
object of interest The possibility to generate images of “soft“ body structures
Ernesto Coto - Institute of Computer Graphics and Algorithms
Background: MRI Mammography
MRI Mammography Procedure The main component of most MRI systems is a large tube-shaped or
cylindrical magnet The patient has to wears a wrap and give away any metal object
Ernesto Coto - Institute of Computer Graphics and Algorithms
Background: MRI Mammography
MRI Mammography Procedure To begin the MRI exam, the patient is positioned on a special table
inside the MRI system opening. A breast coil is used.
Ernesto Coto - Institute of Computer Graphics and Algorithms
Background: MRI Mammography
Contrast Enhanced MRI The method is based on the fact that a carcinoma is usually well
vascularized due to its strong growth. Thus a contrast medium will quickly accumulate in the tumor
The evaluation essentially consists of finding suspicious regions in the images, calculating the absorption of contrast-medium in those regions, and deriving the diagnosis from that data
Without contrast
With contrast
Ernesto Coto - Institute of Computer Graphics and Algorithms
Background: MRI Mammography
Benefits of Breast MRI
Can image breast implants and ruptures Highly sensitive to small abnormalities Used effectively in dense breasts Can evaluate inverted nipples for evidence of cancer Can evaluate the extent of breast cancer Can help determine what type of surgery is indicated (lumpectomy or
mastectomy) May detect breast cancer recurrences and residual tumors after
lumpectomy Can locate primary tumor in women whose cancer has spread to
axillary (armpit) lymph nodes Can spot or characterize small abnormalities missed by
mammography May be useful in screening women at high risk for breast cancer,
according to recent studies
Ernesto Coto - Institute of Computer Graphics and Algorithms
Background: MRI Mammography
Limitations of Breast MRI
MRI takes 30-60 minutes compared to 10-20 minutes for screening mammography
The cost of MRI is several times the cost of mammography MRI requires the use of a contrast agent MRI patients must tolerate any claustrophobia MRI can be non-specific; often cannot distinguish between
cancerous and non-cancerous tumors Minimally invasive breast biopsy techniques need to be further
developed to evaluate abnormalities detected with MRI Advanced MRI techniques are often not available at most centers
(currently available at research centers)
Ernesto Coto - Institute of Computer Graphics and Algorithms
Further work
CAD Systems and Techniques for Mammography
RegistrationSegmentationVisualization