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  1. 1. Advances in MammographyAdvances in Mammography By:By: PAWAN KUMAR POPLI DEPT.OF RADIO-DIAGNOSIS AIIMS, NEW DELHI
  2. 2. MammographyMammography Past & Present Similar equipments were & are still being used, these can be called as old fashioned equipments cone Tube Breast Stand
  3. 3. MammographyMammography In digital mammography screen-film system has been replaced by Detectors to give the digital images
  4. 4. MammographyMammography Present & future CCD camera Work station Equipments look like this
  5. 5. MammogramMammogram These digital mammograms are surely better in resolution & details
  6. 6. InterventionsInterventions InterventionsInterventions BiopsyBiopsy Hook-wireHook-wire placementplacement Girded plateGirded plate Stereo tacticStereo tactic Mammographic interventions basically are of two types
  7. 7. BiopsyBiopsy Biopsies can be acquired in various ways
  8. 8. BiopsyBiopsy Girded plate Used to guide the biopsies & hook wire placements
  9. 9. BiopsyBiopsy Stereo tactic Method is the latest way to acquire biopsies with high accuracy Stereo images
  10. 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. 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. 12. Imaging !Imaging ! Imaging in various planes is possible with the latest equipments
  13. 13. MRIMRI Special Coils Facilitate high quality MR Images of breast
  14. 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. 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. 16. USUS Panoramic View Looking at whole breast in single image is possible on US
  17. 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. 18. CTLMCTLM Computerised Tomography Laser Mammography Equipment comprises essentially two rings to emit & receive LASER
  19. 19. CTLMCTLM The Images appear like this Normal mammogramCTML
  20. 20. CTLMCTLM More of CTML images
  21. 21. CTLMCTLM It is possible to rotate and see the images in 3D form by rotating it
  22. 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. 23. Nuclear MedicineNuclear Medicine Normally Nuclear Medicine images look like these
  24. 24. ScintimammographyScintimammography With latest equipments such images are possible
  25. 25. ScintimammographyScintimammography Camera Now cameras are smaller & more flexible to use
  26. 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. 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. 28. T-ScanT-Scan Current source Receptor Equipment looks like this Patient holds the source in her hand and Radiologist holds the receptor
  29. 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. 30. Thermal CameraThermal Camera Looks like this
  31. 31. CTICTI Patient just stands in front of camera & image is obtained
  32. 32. CTICTI Images look like these
  33. 33. CTICTI Dedicated cameras are also available Image from dedicated camera
  34. 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. 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. 36. Optical ImagingOptical Imaging This is how optical Imaging works
  37. 37. Optical ImagingOptical Imaging Breast cup The Equipment
  38. 38. Optical ImagesOptical Images
  39. 39. Optical ImageOptical Image 3 D Optical Image Animated Mammograms
  40. 40. Optical TomoOptical Tomo Optical tomography can also be done
  41. 41. Optical ImageOptical Image
  42. 42. Optical Biopsy-imagingOptical Biopsy-imaging Transducer for Biopsy Biopsy is also possible & Equipment is like this one
  43. 43. CADCAD Computer aided detectionComputer aided detection  It is designed to help radiologists  Reduce interpretative errors  Two level reporting
  44. 44. CADCAD The CAD modules Image Storage Mammography work station
  45. 45. How CAD worksHow CAD works Computers marks the areas of more interest
  46. 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. 47. Thank youThank you Talk about this session with your friends…. It will add to your knowledge
  48. 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.