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The aim of this work is to study the radiation doses delivered to a group of patients that underwent a stereotactic breast biopsy (SBB) procedure. Mean glandular doses (MGD) were estimated from the air-kerma measured at the breast surface entrance multiplying by specific conversion coefficients (DgN) that were estimated using Monte Carlo simulations. DgN were calculated for the 0° and  ±15° projections used in SBB and for the particular beam quality. Data on 61 patients were collected showing that a typical SBB procedure is composed by ten images. MGD was on average (4  ±  2) mGy with (0.38  ±  0.06) mGy per image. The use of specific conversion coefficients instead of typical DgN for mammography/tomosynthesis yields to obtain MGD values for SBB that are around a 65% lower on average.

Harmonic motion microwave Doppler imaging (HMMDI) is a novel imaging modality for imaging the coupled electrical and mechanical properties of body tissues. In this paper, we used two experimental systems with different receiver configurations to obtain HMMDI images from tissue-mimicking phantoms at multiple vibration frequencies between 15 Hz and 35 Hz. In the first system, we used a spectrum analyzer to obtain the Doppler data in the frequency domain, while in the second one, we used a homodyne receiver that was designed to acquire time-domain data. The developed phantoms mimicked the elastic and dielectric properties of breast fat tissue, and included a [Formula: see text] mm cylindrical inclusion representing the tumor. A focused ultrasound probe was mechanically scanned in two lateral dimensions to obtain two-dimensional HMMDI images of the phantoms. The inclusions were resolved inside the fat phantom using both experimental setups. The image resolution increased with increasing vibration frequency. The designed receiver showed higher sensitivity than the spectrum analyzer measurements. The results also showed that time-domain data acquisition should be used to fully exploit the potential of the HMMDI method.

To develop tables of normalized glandular dose coefficients D(g)N for a range of anode-filter combinations and tube voltages used in contemporary breast imaging systems. Previously published mono-energetic D(g)N values were used with various spectra to mathematically compute D(g)N coefficients. The tungsten anode spectra from TASMICS were used; molybdenum and rhodium anode-spectra were generated using MCNPX Monte Carlo code. The spectra were filtered with various thicknesses of Al, Rh, Mo or Cu. An initial half value layer (HVL) calculation was made using the anode and filter material. A range of the HVL values was produced with the addition of small thicknesses of polymethyl methacrylate (PMMA) as a surrogate for the breast compression paddle, to produce a range of HVL values at each tube voltage. Using a spectral weighting method, D(g)N coefficients for the generated spectra were calculated for breast glandular densities of 0%, 12.5%, 25%, 37.5%, 50% and 100% for a range of compressed breast thicknesses from 3 to 8 cm. Eleven tables of normalized glandular dose (D(g)N) coefficients were produced for the following anode/filter combinations: W + 50 μm Ag, W + 500 μm Al, W + 700 μm Al, W + 200 μm Cu, W + 300 μm Cu, W + 50 μm Rh, Mo + 400 μm Cu, Mo + 30 μm Mo, Mo + 25 μm Rh, Rh + 400 μm Cu and Rh + 25 μm Rh. Where possible, these results were compared to previously published D(g)N values and were found to be on average less than 2% different than previously reported values.Over 200 pages of D(g)N coefficients were computed for modeled x-ray system spectra that are used in a number of new breast imaging applications. The reported values were found to be in excellent agreement when compared to published values.

The impact of tissue heterogeneity and interseed attenuation is studied in post-implant evaluation of five clinical permanent breast (103)Pd seed implants using the Monte Carlo (MC) dose calculation method. Dose metrics for the target (PTV) as well as an organ at risk (skin) are used to visualize the differences between a TG43-like MC method and more accurate MC methods capable of considering the breast tissue heterogeneity as well as the interseed attenuation. PTV dose is reduced when using a breast tissue model instead of water in MC calculations while the dose to the skin is increased. Furthermore, we investigate the effect of varying the glandular/adipose proportion of the breast tissue on dose distributions. The dose to the PTV (skin) decreases (increases) with the increasing adipose proportion inside the breast. In a complete geometry and compared to a TG43-like situation, the average PTV D(90) reduction varies from 3.9% in a glandular breast to 35.5% when the breast consists entirely of adipose. The skin D(10) increases by 28.2% in an entirely adipose breast. The results of this work show the importance of an accurate and patient-dependent breast tissue model to be used in the dosimetry for this kind of low energy implant.

It is hoped that x-ray phase contrast imaging (XPCi) will provide a generational improvement in the effectiveness of mammography. XPCi is sensitive to the refraction which x-rays undergo as a result of the variation in x-ray propagation speeds within an object. XPCi is, however, seldom used in clinical applications owing mainly to a lack of suitable systems. The radiation physics group at UCL has previously designed and built an XPCi system sensitive to phase gradients in one dimension for application in security inspection. We present here the design methodology and final design of a prototype XPCi system sensitive to phase gradients in two directions for use in mammography. The technique makes efficient use of the flux available from a laboratory x-ray source, thus making it suitable for clinical use.

Non-invasive microwave hyperthermia treatment of breast cancer is investigated using three-dimensional (3D) numerical breast phantoms with anatomical and dielectric-properties realism. 3D electromagnetic and thermal finite-difference time-domain simulations are used to evaluate the focusing and selective heating efficacy in four numerical breast phantoms with different breast tissue densities. Beamforming is used to design and focus the signals transmitted by an antenna array into the breast. We investigate the use of propagation models of varying fidelity and complexity in the design of the transmitted signals. An ideal propagation model that is exactly matched to the actual patient's breast is used to establish a best-performance baseline. Simpler patient-specific propagation models based on a homogeneous breast interior are also explored to evaluate the robustness of beamforming in practical clinical settings in which an ideal propagation model is not available. We also investigate the performance of the beamformer as a function of operating frequency and compare single-frequency and multiple-frequency focusing strategies. Our study suggests that beamforming is a robust method of non-invasively focusing microwave energy at a tumor site in breasts of varying volume and breast tissue density.

Screening mammography is one of the most challenging radiological techniques and this is partly due to the difficulty in detecting microcalcifications (MCs) against an anatomical background of varying mammographic tissue density. Further complicating factors in the detection of MCs include the small size and their resemblance to other bright structures in the breast. A number of different microcalcification simulating materials are available and these are often incorporated in test objects used to study some aspects of an imaging system, for example, optimal beam quality selection in digital mammography. Aluminum (Al) has similar x-ray attenuation properties to MCs and therefore Al is extensively used in test objects. However, to the best of our knowledge, the suitability of Al as a substitute material for MCs has not been studied explicitly. The aim of this study was therefore to demonstrate that spectral optimization studies for MCs can be performed with Al sheets. The approach used was twofold. First, contrasts generated by Al and MCs at several exposure settings were compared, and secondly an optimization study was performed with both Al and MCs as the contrasting target using an amorphous selenium (a-Se) based digital mammography unit. Specimens from stereotactic vacuum-assisted breast biopsies of non-palpable lesions with mammographic evidence of MCs were obtained from clinical routine patients. Contrasts generated by these MCs and by Al sheets were measured for Mo/Mo, Mo/Rh and W/Rh anode/filter combinations, for different polymethylmethacrylate (PMMA) thicknesses at the extremes of the x-ray tube voltages used clinically. A linear regression was then applied between the two measurements of contrast; the ratio of the angular coefficient q obtained from the fitted regression lines for Al and MCs ranged from 0.96 to 0.99 for Mo/Mo and Mo/Rh combinations at 2 and 4 cm PMMA, respectively, and from 0.83 at 4 cm PMMA to 1.14 at 7 cm PMMA for the W/Rh combination. For the optimization study, the signal-difference-to-noise ratio (SDNR) measured using the MCs was plotted as a function of mean glandular dose (MGD) for 4 cm PMMA, for the three different anode/filter combinations. The W/Rh combination always gave the highest SDNR for a given MGD. The SDNR and MGD were then used to define the common figure of merit SNR(2)/MGD; the setting that maximized this measure at 4 cm PMMA was 27 kV and a W/Rh combination. These results demonstrate a close correspondence between the attenuation properties of Al and extracted MC material over the energy range studied for the Mo/Mo, Mo/Rh and W/Rh anode/filter combinations. Furthermore, it was found that the exposure parameters that maximized the figure of merit for the MC specimen agree with results found in studies that used Al sheets as a substitute for the MC.

We have developed a novel phantom material: a solution of polyvinyl alcohol (PVAL) in ethanol and water, freeze-thawed to produce a solid yet elastically compressible gel. The x-ray attenuation and mechanical properties of these gels are compared with published measurements of breast tissue. Gels with PVAL concentrations from 5 to 20% w/v were produced. The linear x-ray attenuation coefficients of these gels range from 0.76 to 0.86 cm(-1) at 17.5 keV, increasing with PVAL concentration. These values are very similar to the published values of breast tissue at this energy, 0.8-0.9 cm(-1). Under compression cancerous breast tissue is approximately ten times stiffer than healthy breast tissue. The Young's moduli of the gels increase with PVAL concentration. Varying the PVAL concentration from 7.5 to 20% w/v produces gels with Young's moduli from 20 to 220 kPa at 15% strain. These values are characteristic of normal and cancerous breast tissue, respectively.

The development of microwave breast cancer detection and treatment techniques has been driven by reports of substantial contrast in the dielectric properties of malignant and normal breast tissues. However, definitive knowledge of the dielectric properties of normal and diseased breast tissues at microwave frequencies has been limited by gaps and discrepancies across previously published studies. To address these issues, we conducted a large-scale study to experimentally determine the ultrawideband microwave dielectric properties of a variety of normal, malignant and benign breast tissues, measured from 0.5 to 20 GHz using a precision open-ended coaxial probe. Previously, we reported the dielectric properties of normal breast tissue samples obtained from reduction surgeries. Here, we report the dielectric properties of normal (adipose, glandular and fibroconnective), malignant (invasive and non-invasive ductal and lobular carcinomas) and benign (fibroadenomas and cysts) breast tissue samples obtained from cancer surgeries. We fit a one-pole Cole-Cole model to the complex permittivity data set of each characterized sample. Our analyses show that the contrast in the microwave-frequency dielectric properties between malignant and normal adipose-dominated tissues in the breast is considerable, as large as 10:1, while the contrast in the microwave-frequency dielectric properties between malignant and normal glandular/fibroconnective tissues in the breast is no more than about 10%.

Manipulation of interstitial fluid pressure (IFP) has a clinical potential when used in conjunction with near-infrared spectroscopy for the detection of breast cancer. In order to better interpret how the applied pressure alters the vascular space and interstitial water volumes in breast tissue, a study on tissue-mimicking, gelatin phantoms was carried out to mimic the translation of external force into internal pressures. A complete set of three-dimensional (3D) pressure maps were obtained for the interior volumes of phantoms as an external force of 10 mmHg was applied, using mixtures of elastic moduli 19 and 33 kPa to simulate adipose and fibroglandular values of breast tissue. Corresponding linear elastic finite element analysis (FEA) cases were formulated. Shear stress, nonlinear mechanical properties, gravity and tissue geometry were all observed to contribute to internal pressure distribution, with surface shear stresses increasing internal pressures near the surface to greater than twice the applied external pressure. Average pressures by depth were predicted by the linear elastic FEA models. FEA models were run for cases mimicking a 93 kPa tumor inclusion within regions of adipose, fibroglandular tissue, and a composite of the two tissue types to illustrate the localized high fluid pressures caused by a tumor when an external force is applied. The conclusion was that external contact forces can generate potentially clinically useful fluid pressure magnitudes in regions of sharp effective elastic modulus gradients, such as tumor boundaries.

Near infrared tomography (NIR) is a novel imaging technique that can be used to reconstruct tissue optical properties from measurements of light propagation through tissue. More specifically NIR measurements over a range of wavelengths can be used to obtain internal images of physiologic parameters and these images can be used to detect and characterize breast tumour. To obtain good NIR measurements, it is essential to have good contact between the optical fibres and the breast which in-turn results in the deformation of the breast due to the soft plasticity of the tissue. In this work, a tissue deformation model of the female breast is presented that will account for the altered shape of the breast during clinical NIR measurements. Using a deformed model of a breast, simulated NIR data were generated and used to reconstruct images of tissue absorption and reduced scatter using several assumptions about the imaging domain. Using either a circular or irregular 2D geometry for image reconstruction produces good localization of the absorbing anomaly, but it leads to degradation of the image quality. By modifying the assumptions about the imaging domain to a 3D conical model, with the correct diameter at the plane of NIR measurement, significantly improves the quality of reconstructed images and helps reduce image artefacts. Finally, assuming a non-deformed breast shape for image reconstruction is shown to lead to poor quality images since the geometry of the breast is greatly altered, whereas using the correct deformed geometry produces the best images.

Over the past decade, several methods have been proposed to image tissue elasticity based on imaging methods collectively called elastography. While progress in developing these systems has been rapid, the basic understanding of tissue properties to interpret elastography images is generally lacking. To address this limitation, we developed a system to measure the Young's modulus of small soft tissue specimens. This system was designed to accommodate biological soft tissue constraints such as sample size, geometry imperfection and heterogeneity. The measurement technique consists of indenting an unconfined small block of tissue while measuring the resulting force. We show that the measured force-displacement slope of such a geometry can be transformed to the tissue Young's modulus via a conversion factor related to the sample's geometry and boundary conditions using finite element analysis. We also demonstrate another measurement technique for tissue elasticity based on quasi-static magnetic resonance elastography in which a tissue specimen encased in a gelatine-agarose block undergoes cyclical compression with resulting displacements measured using a phase contrast MRI technique. The tissue Young's modulus is then reconstructed from the measured displacements using an inversion technique. Finally, preliminary elasticity measurement results of various breast tissues are presented and discussed.

Historically, increased mechanical stiffness during tissue palpation exams has been associated with assessing organ health as well as with detecting the growth of a potentially life-threatening cell mass. As such, techniques to image elasticity parameters (i.e., elastography) have recently become of great interest to scientists. In this work, a new method of elastography will be introduced within the context of mammographic imaging. The elastography method proposed represents a non-rigid iterative image registration algorithm that varies material properties within a finite element model to improve registration. More specifically, regional measures of image similarity are used within an objective function minimization framework to reconstruct elasticity images of tissue stiffness. Numerical simulations illustrate: (1) the encoding of stiffness information within the context of a regional image similarity criterion, (2) the methodology for an iterative elastographic imaging framework and (3) elasticity reconstruction simulations. The real strength in this approach is that images from any modality (e.g., magnetic resonance, computed tomography, ultrasound. etc) that have sufficient anatomically-based intensity heterogeneity and remain consistent from a pre- to a post-deformed state could be used in this paradigm.