Low-dose breast CT with monochromatic x-ray sources

Introduction

Although breast cancer screening and improvements in treatment have reduced breast cancer mortality by 30%, this disease still kills over 600,000 women yearly worldwide. To further reduce its morbidity and mortality, new and improved imaging modalities that improve the detection, diagnosis, and treatment of breast cancer are needed.

Advances in Imaging Technology

Over the last two decades, changes in x-ray detector technology have revolutionized x-ray-based breast imaging. Among other developments, new digital detectors made feasible the ERC Consolidator project BREAST4D, during which a new imaging modality, dynamic contrast enhanced dedicated breast computed tomography (4D DCE-BCT), is being developed to personalize treatment of breast cancer.

Limitations of Current X-ray Technology

However, x-ray source technology has remained essentially unchanged for the last 100 years. The continued use of the x-ray tube as the source of x-rays restricts the reduction in dose and the quantitative accuracy achievable with advances in the rest of the system.

Introduction of Monochromatic X-ray Sources

Very recently, a new monochromatic x-ray source has been developed that provides the necessary flux, x-ray energy, field of view, and portability to be used in x-ray breast imaging devices.

Objectives of MONOBREAST

In MONOBREAST, the capabilities, applicability, and innovativeness of BREAST4D will be extended by introducing these monochromatic x-ray sources to breast CT imaging and combining them with the advanced image reconstruction method developed during BREAST4D.

Expected Outcomes

Resulting in a dose reduction of at least two thirds, such a monochromatic breast CT system will be applicable to every stage in the breast cancer chain, including:

1. Screening with non-contrast BCT at doses equivalent to those of current screening with digital mammography and digital breast tomosynthesis.
2. Static CE-BCT for diagnosis.
3. The originally planned 4D DCE-BCT for treatment personalization.

In addition, these new sources will not only result in substantially lower doses but also in substantially higher accuracy with lower algorithmic complexity.