The Impact of the Angular Range - Case 1

Alright, a woman came to our center with heterogeneously dense breast tissue which is. Makes our job of finding breast cancers a little more difficult. an A 7 millimeter mass was detected near her left nipple. We took a image using the narrow angle tomography and then subsequently took a wide angle tomography image a day or two later. If I can show you on the screen the. Left side shows the narrow angle tomography that was originally done. I'm going to scroll up and down different tomographic slices. And at about this slice, I'd like to point out that the mass is fairly well visualized with margins. The upper margins are clearly seen, the lower margins are somewhat unsharp and difficult to assess. You can see this mass. Superimposed on. Other glandular tissue, and therefore you have to appreciate this mass in the setting of other white blobs that we're always trying to read through on the right side. We have the same patient image almost at the same time, and already I have the slice up that shows this mass, and I think you can see that the margin of this mass is now much clearly seen. You can see that the mass has a. Sharp margin with a little micro lobulation in this area here and here you can see that the mass actually blends into surrounding glandular tissue very intimately as I scroll up and down. I think you can appreciate three dimensionally that this lesion does pop out of the background. Why is that? Because this background glandular density, which is partially obscuring it on the low on the narrow angle tomography is now. Suppressed somewhat, and therefore the continuity of the lesion is more bright. In addition to seeing the lesion, the key is that the margins, which is the most important feature for determining whether a lesion is benign and malignant, is exquisitely scene on this. Wide angle tomography, you can see my collaboration. You can see the exact size and distribution of this mass an it's exact location to surrounding tissue, and by the way, there is a second lesion that is seen on the wide angle, a second rounded lesion clearly seen. Here in the back of the breast and that was not appreciated on the original narrower angle. In retrospect, if you go back, you can make it out, possibly here, but. In real time that was not seen on the narrow angle, so the advantage is seen on the white angle. Here is the detectability of the lesions. There is a pop out effect with suppressed background structural noise and even more importantly, the margins are exquisitely outlined and characterized on this wide angle.

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