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  • 1. Advances in MammographyAdvances in Mammography By:By: PAWAN KUMAR POPLI DEPT.OF RADIO-DIAGNOSIS AIIMS, NEW DELHI
  • 2. MammographyMammography Past & Present Similar equipments were & are still being used, these can be called as old fashioned equipments cone Tube Breast Stand
  • 3. MammographyMammography In digital mammography screen-film system has been replaced by Detectors to give the digital images
  • 4. MammographyMammography Present & future CCD camera Work station Equipments look like this
  • 5. MammogramMammogram These digital mammograms are surely better in resolution & details
  • 6. InterventionsInterventions InterventionsInterventions BiopsyBiopsy Hook-wireHook-wire placementplacement Girded plateGirded plate Stereo tacticStereo tactic Mammographic interventions basically are of two types
  • 7. BiopsyBiopsy Biopsies can be acquired in various ways
  • 8. BiopsyBiopsy Girded plate Used to guide the biopsies & hook wire placements
  • 9. BiopsyBiopsy Stereo tactic Method is the latest way to acquire biopsies with high accuracy Stereo images
  • 10. Stereo tactic BiopsyStereo tactic Biopsy Trigonometric calculations by computer Mammography 10 degree + & - views taken Mark target on both images Computer guided steriotectic device Insert biopsy needle - confirm position Take biopsy The various steps involved are:
  • 11. Hook-wire PlacementHook-wire Placement The same stereo-tactic method can be used to place the hook-wire in the lesion to guide the surgeon to the area of interest during the surgery Hook wireHook wire
  • 12. Imaging !Imaging ! Imaging in various planes is possible with the latest equipments
  • 13. MRIMRI Special Coils Facilitate high quality MR Images of breast
  • 14. MRI-IMAGESMRI-IMAGES Implant It is of much use in: young females where mammography is contraindicated For evaluation of breast implants As complement to mammography
  • 15. USUS Ultra-sound is yet other non-radiating modality, It is used to delineation of fluid pockets from solid masses It is also used to scan the breasts of young females
  • 16. USUS Panoramic View Looking at whole breast in single image is possible on US
  • 17. CTLMCTLM  Breast placed in A scan chamber scanned by laser in 360 degrees at 3mm intervals-3 D image is produced  Allows the radiologist to view image from any plane  Good for comparing contours of two breastsGood for comparing contours of two breasts Computerized Tomography Laser Mammography or In this
  • 18. CTLMCTLM Computerised Tomography Laser Mammography Equipment comprises essentially two rings to emit & receive LASER
  • 19. CTLMCTLM The Images appear like this Normal mammogramCTML
  • 20. CTLMCTLM More of CTML images
  • 21. CTLMCTLM It is possible to rotate and see the images in 3D form by rotating it
  • 22. Nuclear MedicineNuclear Medicine  It involves injecting a radioactive tracer (dye) into the patient. Since the dye accumulates differently in cancerous and non-cancerous tissues, scintimammography can help physicians determine whether cancer is present.  Currently, only the Miraluma Tc-99m sestamibi compound, is approved by FDA for breast imaging in the United States.
  • 23. Nuclear MedicineNuclear Medicine Normally Nuclear Medicine images look like these
  • 24. ScintimammographyScintimammography With latest equipments such images are possible
  • 25. ScintimammographyScintimammography Camera Now cameras are smaller & more flexible to use
  • 26. Nuclear MedicineNuclear Medicine Useful in case of…….Useful in case of…….  Dense breast tissue  Large, palpable (able to be felt) abnormalities that cannot be imaged well with mammography or ultrasound  Breast implants  When multiple tumors are suspected  A lump at the surgical site after mastectomy
  • 27. T-ScanT-Scan  Also known as EIS-electrical impedance scanning  It measures the way low level bio-electrical currents pass through the body, and creates A real time image “map” of breast  Some cancers distort the electric field
  • 28. T-ScanT-Scan Current source Receptor Equipment looks like this Patient holds the source in her hand and Radiologist holds the receptor
  • 29. CTICTI Computerized Thermal imagingComputerized Thermal imaging OrOr Digital Infrared Thermal ImagingDigital Infrared Thermal Imaging  A thermal sensitive camera is used to capture & process the digital image based on heat radiated from body  Pathologies do alter the tissue temperature
  • 30. Thermal CameraThermal Camera Looks like this
  • 31. CTICTI Patient just stands in front of camera & image is obtained
  • 32. CTICTI Images look like these
  • 33. CTICTI Dedicated cameras are also available Image from dedicated camera
  • 34. CTICTI  It is safe & valuable for women  With mastectomies  With breast implants  With sensitive breasts  With dense breasts  During pregnancy •NO  Radiation  •NO  Compression  •NO  Contact •NO  Risks
  • 35. Optical ImagingOptical Imaging  Optical mammography and optical biopsy allow investigators to determine nature of pathology.  An analysis of the spectrum light emitted from optically excited tissue helps to detect physical and chemical changes in tissue and determine whether the tissue is normal, benign or cancerous.
  • 36. Optical ImagingOptical Imaging This is how optical Imaging works
  • 37. Optical ImagingOptical Imaging Breast cup The Equipment
  • 38. Optical ImagesOptical Images
  • 39. Optical ImageOptical Image 3 D Optical Image Animated Mammograms
  • 40. Optical TomoOptical Tomo Optical tomography can also be done
  • 41. Optical ImageOptical Image
  • 42. Optical Biopsy-imagingOptical Biopsy-imaging Transducer for Biopsy Biopsy is also possible & Equipment is like this one
  • 43. CADCAD Computer aided detectionComputer aided detection  It is designed to help radiologists  Reduce interpretative errors  Two level reporting
  • 44. CADCAD The CAD modules Image Storage Mammography work station
  • 45. How CAD worksHow CAD works Computers marks the areas of more interest
  • 46. To Conclude…To Conclude…  Tremendous advances are taking place in this field  We are heading towards non-radiating Mammography which supplements & compliments to regular mammography  Attempts are on to have Mammography completely free of radiation without compromising the information and image quality
  • 47. Thank youThank you Talk about this session with your friends…. It will add to your knowledge
  • 48. NoticeNotice This presentations was prepared with the helpThis presentations was prepared with the help of pictures taken from various related webof pictures taken from various related web sites & other sources. Author takes nosites & other sources. Author takes no credit for such for such pictures.