Cone-beam volume CT breast imaging: Feasibility study

X-ray projection mammography, using a film/screen combination, or digital techniques, has proven to be the most effective imaging modality currently available for early detection of breast cancer. However, the inherent superimposition of structures makes a small carcinoma (a few millimeters in size) difficult to detect when it is occult or in dense breasts, leading to a high false-positive biopsy rate. Cone-beam x-ray-projection-based volume imaging using flat panel detectors (FPDs) may allow obtaining three-dimensional breast images, resulting in more accurate diagnosis of structures and patterns of lesions while eliminating the hard compression of breasts. This article presents a novel cone-beam volume computed tomographic breast imaging (CBVCTBI) technique based on the above techniques. Through a variety of computer simulations, the key issues of the system and imaging techniques were addressed, including the x-ray imaging geometry and corresponding reconstruction algorithms, x-ray characteristics of breast tissue and lesions, x-ray setting techniques, the absorbed dose estimation. and the quantitative effect of x-ray scattering on image quality. The preliminary simulation results support the proposed CVBCTBI modality for breast imaging in respect to its feasibility and practicability. The absorbed dose level is comparable to that of current mammography and will not be a prominent problem for this imaging technique. Compared to conventional mammography, the proposed imaging technique with isotropic spatial resolution will potentially provide significantly better low-contrast detectability of breast tumors and more accurate location of breast lesions. (C) 2002 American Association of Physicists in Medicine.