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How can tomo reading be further optimized?

21/11/2017

There are various technologies already available that can help optimize tomo reading. Are there any other solutions in development? What can an outlook into the future predict?

Slabbing

Combining the 1 mm slices of a DBT dataset into thicker 2-7 mm slices is called slabbing. This technique can speed up the reading process especially in fatty breasts and other non-specific finding cases. DBT with 2 mm slabs also improves the visibility of microcalcification clusters without having any negative effect on mass visibility.1 The video first scrolls through the 1mm slices and then through thicker slabs consisting of 3, 6 and 7 mm slices. Take a closer look at the lower part of the breast and watch how the microcalcification becomes more visible in the thicker slices.

3D views

Ritse Mann, MD PhD, from Radboud University Nijmegen, The Netherlands, explains in an interview how breast tomosynthesis is used at his institution and how they have implemented tomo reading. He also talks about which value a 3D synthetic mammogram has for reading in his opinion. Watch the video!

Link-it

A feature that can help reduce reading time is Link-it. It is available with syngo.Breast Care, the universal reading and reporting solution for mammography from Siemens Healthineers. This is is how it works: If you click on a finding in a 2D image (e.g. in the MLO view), the cursor will jump automatically to the corresponding lesion in the other view. This also works between a 2D and a 3D image as well as in a prior-current comparison.
Tomo reading link it 01
Click on a finding in two corresponding views of the mammo image. The area is automatically marked in the relevant tomo slice.
tomo reading link it 02
Click on a finding in the tomo slice. The corresponding area is automatically marked in the two corresponding mammo images.

CAD

Computer-aided detection (CAD) already plays a role in mammography reading. It can help radiologists reduce the reading time needed by pointing out possible masses and microcalcification clusters. In the near future, CAD might play the same role in tomo reading.

Outlook into the future

A technology that might prove useful in breast cancer care is cinematic rendering. Using data from imaging systems, this new type of visualization technology creates photorealistic images and videos that show the inside of the body with unprecedented clarity. At the moment, 3D data from X-ray, CT, and MRI are being used to create these realistic-looking images. They can help improve surgery planning as well as support communication between physicians and patients. The use of cinematic rendering is not yet permitted as a technique for visualizing clinical findings.2
Another technology that might change image reading in breast cancer care in the future could spill over from gaming, computer, and television technologies: autostereoscopy. The method is also called “glasses-free 3D” because it allows seeing 3D on a screen without needing special 3D glasses. Would you like to view your images in real 3D on your monitor?
 

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1
Dustler M, Tingberg A, Zackrisson S, Timberg P. Image Quality of Thick Average Intensity Pixel Slabs Using Statistical Artifact Reduction in Breast Tomosynthesis.
2
For more information, please visit https://www.healthcare.siemens.de/medical-imaging-it/advanced-visualization-solutions/syngo-via-frontier