Toward High-Contrast Breast CT at Low Radiation Dose

Radiology: Volume 249; Number 1—October 2008

Jani Keyritainen, PhD Manuel Fernandez, PhD Marja-Liisa Karjalainen-Lindsberg, MD, PhD Pekka Virkkunen, MD, PhD Marjut Leidenius, MD, PhD Karl von Smitten, MD, PhD Petri Sipila, MS Stefan Fiedler, PhD HeikkiSuhonen, MS PekkaSuortti, PhD Alberto Bravin, PhD

This study was approved by the local research ethics com-mittee, and patient informed consent was obtained. The purpose of this study was to demonstrate that high-spatial-resolution low-dose analyzer-based x-ray computed to­mography (CT) can substantially improve the radiographic contrast of breast tissue in vitro when compared with that attained by using diagnostic mammography and CT. An excised human breast tumor was examined by using ana­lyzer-based x-ray imaging with synchrotron radiation. The correspondence between analyzer-based x-ray images and diagnostic mammograms, CT images, and histopathologic findings was determined. Calcifications and fine details of soft tissue, which are at the contrast detection limit on diagnostic mammograms, are clearly visible on planar an­alyzer-based x-ray images. Analyzer-based x-ray CT yields high contrast from smoothly varying internal structures, such as tumorous mass lesions, corresponding to informa­tion on actual structures seen at histopathologic analysis. The mean glandular dose of 1.9 mGy in analyzer-based x-ray CT is approximately equivalent to the dose adminis­tered during single-view screening mammography. The improved visibility of mammographically indistinguishable lesions in vitro suggests that analyzer-based x-ray CT may be a valuable method in radiographic evaluation of the breast, thereby justifying further investigations.