Advances in Breast Imaging - Technical Background and Image Quality of a Wide-angle DBT Online Training

Continue Continue Introduction 1 Technical Background and Image Quality of a Wide-angle DBT Online Training This training module covers tomosynthesis (wa-DBT) technology so that you’ll better understand its impact on image quality. Completion time: 75 min. System Parameters 1 Image Storage and Monitors 4 Synthetic Mammogram 3 Postprocessing and Artifacts 2 Master Template HOOD05162003052540 | Effective Date: 26-Nov-2019 Welcome Srechertext: Welcome to our Web-based training “Advances in breast imaging.” To better understand the value of tomosynthesis as an imaging modality in clinical practice, it makes sense to first learn a bit about its technology. The first module, “Technical background and image quality of wide-angle digital breast tomosynthesis,” covers the acquisition parameters of tomosynthesis systems and their post-processing. It pays special attention to the synthetic mammogram and briefly touches on the topics of image storage and monitors. Prof. Chantal Van Ongeval has been collaborating with medical physicists at her university to explore this complex topic, which you’ll learn about over the next 60 minutes. Introduction Prof. Dr. Chantal Van Ongeval University Hospital Leuven, Belgium Introduction System Parameters System Parameters Prof. Dr. Chantal Van Ongeval University Hospital Leuven, Belgium System Parameters Which image best illustrates the effect of the angular range of a wide-angle digital breast tomosynthesis system (DBT) on depth resolution: Knowledge Check Select the applicable image. Knowledge Check Incorrect That is the correct picture: Incorrect That is the correct picture: Correct Explanation of the Correct Answer Continue The wider the angle, the better the in-depth (z-) resolution and the better overlapping structures can be distinguished from each other. Explanation of the Correct Answer ... lower than for a digital mammography examination. ... always more than double the dose of a comparable digital mammography examination. ... too high to ever use DBT in breast screening programs. ... below the achievable value (2.0 mGy) defined by the European protocol. Fulfill the sentence correctly: At an average breast compression thickness of 4.5 cm, the mean glandular dose (MGD) for digital breast tomosynthesis (DBT) examinations is ... Knowledge Check Select the best answer. Knowledge Check Correct Incorrect The solution: ... below the achievable value (2.0 mGy) defined by the European protocol. Incorrect The solution: ... below the achievable value (2.0 mGy) defined by the European protocol. Correct The solution: ... below the achievable value (2.0 mGy) defined by the European protocol. Explanation of the Correct Answer Continue In tomosynthesis systems, the dose is usually pre-adjusted via the Automatic Exposure Control and is approximately 1.5 to a maximum of twice the dose of a corresponding FFDM exposure. Explanation of the Correct Answer Postprocessing and Artifacts Postprocessing and Artifacts Prof. Dr. Chantal Van Ongeval University Hospital Leuven, Belgium Postprocessing and Artifacts An FFDM reconstruction algorithm that improves contrast and lowers image noise. The biopsy workflow of the wa-DBT system. A wa-DBT reconstruction algorithm that improves contrast and lowers image noise. Which of the following statements describes EMPIRE best? Knowledge Check Select the best answer. Knowledge Check Correct Incorrect The solution is: A wa-DBT reconstruction algorithm that improves contrast and lowers image noise. Incorrect The solution is: A wa-DBT reconstruction algorithm that improves contrast and lowers image noise. Explanation of the Correct Answer Continue “EMPIRE” stands for Enhanced Multiple Parameter Iterative Reconstruction, the reconstruction algorithm used for wide-angle DBT. Explanation of the Correct Answer Synthetic Mammogram Synthetic Mammogram Prof. Dr. Chantal Van Ongeval University Hospital Leuven, Belgium Synthetic Mammogramm A Synthetic Mammogram Study Prof. Dr. Chantal Van Ongeval University Hospital Leuven, Belgium A Synthetic Mammogram Study Case Discussions 1 1 1 2 2 2 3 3 3 4 4 4 Select the steps below or the images on the right to watch the case discussions. Case Discussions Case Discussion 4 IDC in a heterogeneously dense breast Case Discussion 3 IDC with DCIS in a heterogeneously dense breast Case Discussion 2 DCIS in a scattered breast Case Discussion Tubular carcinoma in a fatty breast 1 If a synthetic mammogram is calculated from tomosynthesis data, this DBT images don’t need to be further reviewed. Because Insight 3D offers insight into rotating breast volume, it can be reviewed instead of the DBT slices. The synthetic mammogram Insight 2D can replace digital mammography as an adjunct to a DBT examination. It can be used to compare with prior FFDMs to evaluate the density of the breast and position of lesions in relation to the nipple. Choose the correct answer regarding synthetic mammograms. Knowledge Check Select the best answer. Knowledge Check Correct Incorrect The solution is: The synthetic mammogram Insight 2D can replace digital mammography as an adjunct to a DBT examination. It can be used to compare with prior FFDMs to evaluate the density of the breast. Incorrect The solution is: The synthetic mammogram Insight 2D can replace digital mammography as an adjunct to a DBT examination. It can be used to compare with prior FFDMs to evaluate the density of the breast. Explanation of the Correct Answer Continue The synthetic mammogram Insight 2D can replace the FFDM image, but the DBT image must be evaluated in any way. Explanation of the Correct Answer Image Storage and Monitors Image Storage and Monitors Prof. Dr. Chantal Van Ongeval University Hospital Leuven, Belgium Image Storage and Monitors Conclusion Conclusion Prof. Dr. Chantal Van Ongeval University Hospital Leuven, Belgium Conclusion Course Review Image Storage and Monitors Synthetic Mammogram Postprocessing and Artifacts System Parameters Course Review Here is a brief summary of the content covered in this training. Please select a topic to access the related information. 1 1 1 2 2 2 3 3 3 4 4 4 Course Review Image Storage and Monitors Image data: 1 projection: 20 MB 25 projections: 500 MB Reconstructed volume for 2,000 x 2,500 matrix: 1 slice < 10 MB No. of slices: breast thickness in mm (depending on breast size) Example: 50 mm breast 50 slices: max. 500 MB 2D mammogram: 20 MB A pair of 5 MP (megapixel) monitors is required for all digital breast imaging, including breast tomosynthesis, in order to display the images at the highest possible resolution. Synthetic Mammogram The value of a synthetic mammogram lies in its … comparison with prior 2D FFDMs replacement of FFDM as adjunct to DBT, which results in a 40% dose reduction. visual assessment of breast density spatial overview of the breast (relationship between lesions and position of the nipple). There’s no reduction in reading time, because a DBT image must be evaluated (no vendor currently provides a synthetic 2D image that is a standalone diagnostic image). Postprocessing and Artifacts The reconstruction algorithm has an impact on ... sharpness (spatial resolution) of an image contrast noise The Enhanced Multiple-Parameter Iterative Reconstruction (EMPIRE) algorithm ... improves contrast lowers image noise can reconstruct synthetic mammograms: Insight 2D and Insight 3D System Parameters A wider scan angle with a larger number of projections … provides a better in-depth (z-) resolution. is superior for reducing over- lapping fibroglandular tissue. increases the detectability of masses. provides better 3D information. The total dose from wa-DBT is 1.5 to two times the dose from an FFDM. Following the market introduction in 2009, several clinical studies on Digital Breast Tomosynthesis have proven the value of this technique for breast imaging. For a list of Siemens Healthineers-related reference studies shown in this WBT, please download the PDF file XP_Tomosynthesis_Bibliography.pdf under “Resources” in the upper right corner on this page. The questions and course reviews depicted in this WBT also refer to additional reference studies that are subject of the clinical expert presentations. Reference Studies Reference Studies The herein illustrated statements made by Siemens Healthineers and physicians are based on their own and discrete opinion. The speaker is responsible for obtaining permission to use any previously published figures or tables. The speaker is also responsible for obtaining permission to reproduce any photograph showing recognizable persons. The statements by Siemens Healthineers described herein are based on results that were achieved in the customer's unique setting. Since there is no "typical" setting and many variables exist there can be no guarantee that other customers will achieve the same results. Some products/features (here mentioned) are not necessarily commercially available in all countries. Due to regulatory reasons their availability cannot be guaranteed. Please contact your local Siemens Healthineers organization for further details. Copyright © Siemens Healthcare GmbH 2021 Siemens Healthineers Headquarters | Siemens Healthcare GmbH | Henkestr. 127 | 91052 Erlangen, Germany Telephone: +49 9131 84-0 | siemens-healthineers.com Disclaimer Disclaimer Assessment Assessment This assessment will test your retention of the presented content. A passing score of 80% or higher is required to complete the course and earn your certificate. You may repeat the assessment as many times as needed. Start Assessment Which image best illustrates the effect of the angular range of a wide-angle digital breast tomosynthesis system (DBT) on depth resolution? Question 1 of 5 Select the applicable image. Question Incorrect You did not select the correct image. Incorrect You did not select the correct image. Correct If a synthetic mammogram is calculated from tomosynthesis data, the DBT images don’t need to be further reviewed. Because Insight 3D offers insight into rotating breast volume, it can be reviewed instead of the DBT slices. The synthetic mammogram Insight 2D can replace digital mammography as an adjunct to a DBT examination. It can be compared with prior FFDMs. Which of the following statements is true regarding synthetic mammograms? Question 2 of 5 Select the best answer. The density of the breast cannot be evaluated. Question Incorrect You did not select the correct solution. Correct Incorrect You did not select the correct solution. Incorrect You did not select the correct solution. … is an inferior method for reducing overlapping fibroglandular tissue. … decreases the detectability of masses. … provides a better in-depth (z) resolution. A wider scan angle with a larger number of projections … Question 3 of 5 Select the best answer. Frage Correct Incorrect You did not select the correct solution. Incorrect You did not select the correct solution. … comparison with DBT images from different vendors. … automatic assessment of breast density. … reduction in reading time, because the DBT image doesn’t need to be evaluated. … replacement of FFDM as adjunct to DBT, which results in a 40% dose reduction. The value of a synthetic mammogram lies in its … Question 4 of 5 Select the best answer. Frage Correct Incorrect You did not select the correct solution. Incorrect You did not select the correct solution. Incorrect You did not select the correct solution. DBT can be evaluated on normal monitors; 5 MP monitors are only needed for FFDMs. The larger the breast, the larger the number of projections. The image data from a four-view DBT examination is the same as from an FFDM examination. The larger the breast, the larger the number of slices and therefore the data volume. Which of the following statements is true regarding data volume of and reading monitors for DBT images? Question 5 of 5 Select the best answer. Frage Correct Incorrect You did not select the correct solution. Incorrect You did not select the correct solution. Incorrect You did not select the correct solution. Review Review Retry Assessment Results %Results.ScorePercent%% %Results.PassPercent%% Continue YOUR SCORE: PASSING SCORE: Results Slide You did not pass the course. Take time to review the assessment then select Retry to continue. Congratulations. You passed the course. Exit To access your Certificate of Completion, select the Launch button drop down on the course overview page. You can also access the certificate from your PEPconnect transcript. You have completed the training module no. 1 from training series “Advances in Breast Imaging”. Completion Sprechertext: Thank you for your attention! You have completed the training module no. 2 from training series “Advances in Breast Imaging”. HOOD05162003171396 | Effective Date: 20-APR-2021 XP_Tomosynthesis_Bibliography.pdf 2D Two-dimensional 3D Three-dimensional AI Artificial Intelligence AUC Area Under the Curve BPE Background Parenchymal Enhancement CAD Computer Aided Detection CC Cranio-caudal CEM Contrast Enhanced Mammography CESM Contrast Enhanced Spectral Mammography CNB Core Needle Biopsy DBT Digital Breast Tomosynthesis DCIS Ductal carcinoma in situ DM Digital Mammography FFDM Full Field Digital Mammography FN False Negative FP False Positive i.m. intramuscular IDC Invasive ductal carcinoma ILC Invasive lobular carcinoma IN Insight = Sythetic Mammogram for wide-angle Tomosynthesis IT Information Technology MAG Magnification View MB Megabyte MG Mammogramm ML Medio-lateral MLO Medio-lateral-oblique MP Megapixel MRI Magnetic Resonance Imaging NCB Needle Core Biopsy NPV Negative Predictive Value PPV Positive Predictive Value pRCT Prospective, Randomized, Controlled Trial ROC Receiver Operating Characteristic STX Stereotaxis TiCEM Titanium Contrast Enhanced Mammography TN True Negative TP True Positive US Ultrasound wa-DBT wide-angle Digital Breast Tomosynthesis WBT Web-based Training 1.1 Welcome 1.2 Introduction 2.1 Image Quality Factors: System Parameters 2.2 Knowledge Check 2.4 Knowledge Check 3.1 Image Quality Factors: Postprocessing and Artifacts 3.2 Knowledge Check 4.1 Synthetic Mammogram 4.2 A Synthetic Mammogram Study 4.2 Case Discussions 4.4 Knowledge Check 5.1 Image Storage and Monitors 6.1 Conclusion 7.1 Course Review 7.2 Reference Studies 7.3 Disclaimer 8.1 Assessment 8.8 Completion