Breast-CT - discover the third dimension

Overview

Breast-CT Model

Improving the methods for early detection and diagnostic workup of breast cancer through dedicated breast CT is our main project under development. We are proud to be part of the “Medical Valley EMN” excellence cluster with our development of a high-resolution low-dose breast CT being one of the cluster's lead projects. The cluster is supported by the Bundesministerium für Bildung und Forschung (BMBF; German Federal Ministry of Education and Research). With the development of our high-resolution dedicated breast CT system we aim for fully-3D imaging at dose levels common in state-of-the-art mammography systems.

Sensititvity and specifity of today’s mammography systems are limited by tumors being not visible due to glandular tissue superimposing the tumor, especially in dense breasts. Breast CT allows to image single slices of the breast thereby eliminating any superposition from the images. Breast CT is therefore expected to allow detection of smaller tumors than possible today using established methods. Our high-resolution approach is aimed to cover all steps in the diagnostic chain on one device ranging from microcalcification structural analysis, differential diagnostics of lesions using dynamic CT to image-based biopsy.

Features

The goal of our development in the area of high-resolution breast-CT is to provide outstanding image quality at very low dose levels. Key features of the development include:

  • Full 3D imaging capabilities to provide images without tissue overlap even for dense breasts
  • Very high isotropic spatial resolution of better than 100 μm, ideal for the visualization of microcalcifications
  • High soft tissue contrast for the detection of very small tumors
  • Dose levels low enough to conform with mammographic screening regulations through new direct-conversion photon-counting detector technology
  • Excellent coverage of the breast to the thoracic wall
  • Dynamic contrast -enhanced examinations for the differential diagnosis of benign and malignant lesions with high temporal resolution, similar to magnetic resonance tomography
  • High patient comfort due to easy positioning without the painful breast compression common in conventional mammography

Gallery

Breast-CT system
Breast-CT systemSide view of the breast-CT system.
Breast-CT system
Breast-CT system
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Breast-CT with patient
Breast-CT with patient
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Worldwide unique

The breast-CT system shown here is the first lab-system of a complete new generation. We are aiming to boost breast imaging with computed tomography to a breakthrough by using a new direct-conversion photon-counting detector in combination with the spiral CT technique.

Modern in design

The modern and functional design makes the breast-CT system a true eye catcher. The appealing case, kept in white and silver-grey, likely integrates into any clinical environment. The design strategy continues consistently in the elegant user interface.

Clinical Trials

Clinical trials of our concept for “High-resolution CT of the breast at very low dose” at two study sites in Germany are currently in preparation and expected to start in the second half of 2015. Respective joint project proposals by AB-CT - Advanced Breast-CT GmbH and the University Hospitals of Erlangen and Aachen were submitted to DFG (German Research Foundation) and BMBF (Federal Ministry of Education and Research) and were approved by both organizations.

We are proud that Rüdiger Schulz-Wendtland (University of Erlangen) and Christiane Kuhl (University of Aachen), two renowned experts in the field of breast imaging, have joined our efforts to provide better imaging options for future breast-cancer screening and diagnosis. Prof. Schulz-Wendtland is an expert for x-ray-based diagnostics in breast imaging while Prof. Christiane Kuhl is a pioneer in breast MR imaging and an internationally recognized authority.

Prof. Christiane Kuhl has high expectations concerning the potential of high-resolution breast CT as she commented in an interview given during RSNA 2013:

“Breast CT is the combination of the best of two worlds:

  • High resolution morphology as in mammography, but better and in 3D;
  • Functional and angiographic information as in MR, but with improved resolution!”

References

Last revised: 2017/01/12

References regarding the development, validation and application of the AB-CT Breast CT Systems

  1. A.-C. Rößler, W. A. Kalender, D. Kolditz, C. Steiding, V. Ruth, C. Preuss, S. C. Peter, B. Brehm, M. Hammon, R. Schulz-Wendtland, E. Wenkel. Performance of photon-counting breast computed tomography (pcBCT), digital mammography and digital breast tomosynthesis evaluating breast specimens. Academic Radiology, (2016, in press)
  2. W. A. Kalender, D. Kolditz, C. Steiding, V. Ruth, F. Lück, and A.-C. Rößler and E. Wenkel. Technical feasibility proof for high-resolution low-dose photon-counting CT of the breast. Eur. Radiol. (2016, in press)
    http://dx.doi.org/10.1007/s00330-016-4459-3
  3. A. C. Rößler, E. Wenkel, F. Althoff, W. A. Kalender. The Influence of Patient Positioning in Breast CT on Breast Tissue Coverage and Patient Comfort. RöFo, 187(2), 115-122 (2015)
    http://dx.doi.org/10.1055/s-0034-1385208
  4. J. D. Kuttig, C. Steiding, D. Kolditz, M. Hupfer, M. Karolczak, W. A. Kalender. Comparative investigation of the detective quantum efficiency of direct and indirect conversion detector technologies in dedicated breast CT. Physica Medica, 31, 406-413 (2015)
    http://dx.doi.org/10.1016/j.ejmp.2015.03.007
  5. C. Steiding, D. Kolditz, W. A. Kalender. A quality assurance framework for the fully au-tomated and objective evaluation of image quality in cone-beam computed tomogra-phy. Med. Phys., 41, 031901 (2014)
    http://dx.doi.org/10.1118/1.4863507
  6. F. Lück, D. Kolditz, M. Hupfer, C. Steiding, W. A. Kalender. Experimental validation of a single shaped Filter approach for CT using variable source-to-filter distance for examination of arbitrary object diameters. Phys. Med. Biol., 59(19), 5691 (2014)
    http://dx.doi.org/10.1088/0031-9155/59/19/5691
  7. F. Lück, D. Kolditz, M. Hupfer, W. A. Kalender. Effect of shaped filter design on dose and image quality in breast CT. Phys. Med. Biol., 58(21), 4205-4223 (2013)
    http://dx.doi.org/10.1088/0031-9155/58/12/4205
  8. T. Nowak, M. Hupfer, F. Althoff, R. Brauweiler, F. Eisa, C. Steiding, W. A. Kalender. Time-delayed summation as a means of improving resolution on fast rotating computed tomography systems. Med. Phys., 39(4), 2249-2260 (2012)
    http://dx.doi.org/10.1118/1.3697533
  9. W. Chen, D. Kolditz, M. Beister, R. Bohle, W. A. Kalender. Fast on-site Monte Carlo tool for dose calculations in CT applications. Med. Phys., 39(6), 2985-2996 (2012)
    http://dx.doi.org/10.1118/1.4711748
  10. M. Beister, D. Kolditz, W. A. Kalender. Iterative reconstruction methods in x-ray CT. Eur. J. of Med. Phys., 28, 94-108 (2012)
    http://dx.doi.org/10.1016/j.ejmp.2012.01.003
  11. W. A. Kalender, M. Beister, J. M. Boone, D. Kolditz, S. V. Vollmar, M. C. C. Weigel. High-resolution spiral CT of the breast at very low dose: concept and feasibility considerations. Eur. Radiol., 22(1), 1-8 (2012)
    http://dx.doi.org/10.1007/s00330-011-2169-4

Scientific presentations regarding the development, validation and application of the AB-CT Breast CT Systems

  1. D. Kolditz, C. Steiding, F. Lück, V. Ruth, and W. A. Kalender. Dosimetry Approaches and Results for Photon-Counting Spiral Breast CT. Annual Meeting of Radiological Society of North America (RSNA) 2016, 27 November - 2 December 2016, Chicago, USA (2016).
    http://archive.rsna.org/2016/16010617.html
  2. A.-C. Roessler, E. Wenkel, C. Steiding, V. Ruth, D. Kolditz, and W. A. Kalender. High-resolution low-dose breast CT performance tests on surgical specimens in comparison with digital mammography and breast tomosynthesis. Annual Meeting of Radiological Society of North America (RSNA) 2016, 27 November - 2 December 2016, Chicago, USA (2016)
    http://archive.rsna.org/2016/16005976.html
  3. V. Ruth, C. Steiding, D. Kolditz, F. Lück, A.-C. Roessler, and W. A. Kalender. Comparative Assessment of Highand Low-Contrast Detectability Performance in Digital Mammography, Breast Tomosynthesis, and Dedicated Photon-Counting Breast Computed Tomography: A Phantom Study. Annual Meeting of Radiological Society of North America (RSNA) 2016, 27 November - 2 December 2016, Chicago, USA (2016)
    http://archive.rsna.org/2016/16007279.html
  4. C. Steiding, D. Kolditz, V. Ruth, and W. A. Kalender. Framework for Objective and Fully Automated Image Quality Control of Dedicated Breast CT Systems. Annual Meeting of Radiological Society of North America (RSNA) 2016, 27 November - 2 December 2016, Chicago, USA (2016)
    http://archive.rsna.org/2016/16044266.html
  5. A. C. Rössler, E. Wenkel, C. Steiding, V. Ruth, S. Kratz, R. Schultz-Wendtland, C. Preuss, D. Kolditz, and W. A. Kalender. Photon-counting breast CT (pcBCT) performance tests on specimens in comparison with digital mammography and breast tomosynthesis. European Congress of Radiology (ECR) 2016, 2 - 6 March 2016, Vienna, Austria (2016)
    http://dx.doi.org/10.1594/ecr2016/C-0367
  6. W. A. Kalender, D. Kolditz, M. Hupfer, A. C. Rößler, R. Schulz-Wendtland, P. Fasching. Dedicated high-resolution breast CT allows imaging micro-calcifications down to 130 µm at screening mammography dose levels. Annual Meeting of Radiological Society of North America (RSNA) 2015, 29 November -4 December 2012, Chicago, USA (2015)
    http://archive.rsna.org/2015/15016704.html
  7. Z. Jiang, M. Beister, C. Steiding, D. Kolditz, W. A. Kalender. Fast Implementation of the Katsevich Reconstruction Algorithm for Dedicated Breast CT. Annual Meeting of Radio-logical Society of North America (RSNA) 2015, 29 November -4 December 2012, Chicago, USA (2015)
    http://archive.rsna.org/2015/15018503.html
  8. W. A. Kalender. Breast CT. Breast Imaging Modalities: Beyond the Conventional. European Congress of Radiology (ECR) 2015, 4 - 8 March 2015, Vienna, Austria (2015)
  9. C. Steiding, D. Kolditz, F. Althoff, W. A. Kalender. Fully Automated Geometric Calibration of a Tiled Directly-converting Single X-ray Photon Counting Detector Array for CT. Annu-al Meeting of Radiological Society of North America (RSNA) 2014, 30 November - 05 De-cember 2014, Chicago, USA (2014)
    http://rsna2014.rsna.org/program/details/?emID=14013411
  10. S. Vollmar, D. Kolditz, M. Hupfer, W. A. Kalender. Dose to Organs and Tissues from Scattered Radiation in Breast CT: Impact on Effective Dose. Annual Meeting of Radiological Society of North America (RSNA) 2014, 30 November - 05 December 2014, Chicago, USA (2014)
    http://rsna2014.rsna.org/program/details/?emID=14003964
  11. J. D. Kuttig, C. Steiding, D. Kolditz, W. A. Kalender. Detective Quantum Efficiency Investigation Demonstrates High Dose Saving Potential for Breast CT Using a Cadmium Telluride Detector. Annual Meeting of Radiological Society of North America (RSNA) 2014, 30 November - 05 December 2014, Chicago, USA (2014)
    http://rsna2014.rsna.org/program/details/?emID=14017066
  12. C. Steiding, D. Kolditz, A. C. Rößler, W. A. Kalender. Quantitative assessment of the spatial dependence of non-stationary high-contrast spatial resolution, low-contrast detect-ability, and noise behaviour in 3D imaging of the breast. European Congress of Radiolo-gy (ECR) 2014, 6 - 10 March 2014, Vienna, Austria (2014)
    https://www.myesr.org/html/img/pool/ECR_2014_FinalProgramme_OnlineVersion.pdf#page=347
  13. A. C. Rößler, C. Steiding, D. Kolditz, E. Wenkel, R. Schultz-Wendtland, W. Kalender. Objective Evaluation of Low-contrast Detectability and High-contrast Resolution for Differ-ent Breast Imaging Modalities by Means of Breast Simulating Phantoms with Arbitrary Positionable Inserts. Annual Meeting of Radiological Society of North America (RSNA) 2013, 1 - 6 December 2013, Chicago, USA (2013)
    http://rsna2013.rsna.org/pdf/PDFFiles/13044232.pdf
  14. W. Kalender, D. Kolditz, A. C. Rößler, C. Steiding, E. Wenkel, R. Schultz-Wendtland. Dedi-cated High-resolution Breast CT Can Outperform Digital Mammography and Breast Tomosynthesis at Equivalent Dose Levels. Annual Meeting of Radiological Society of North America (RSNA) 2013, 1 - 6 December 2013, Chicago, USA (2013)
    http://rsna2013.rsna.org/pdf/PDFFiles/13021617.pdf
  15. R. Hendrych, M. Beister, W. A. Kalender. Design and Evaluation of an Interactive MPR Viewer for Real-time Filtering of Large High-resolution Breast CT Data. Annual Meeting of Radiological Society of North America (RSNA) 2013, 1 - 6 December 2013, Chicago, USA (2013)
    http://rsna2013.rsna.org/pdf/PDFFiles/13027387.pdf
  16. F. Lück, D. Kolditz, M. Hupfer, W. A. Kalender. Experimental Validation of Shaped Filter Design with Variable Source-to-Filter Distance for Breast CT with Respect to Image Quality and Dose. Annual Meeting of Radiological Society of North America (RSNA) 2013, 1 - 6 December 2013, Chicago, USA (2013)
    http://rsna2013.rsna.org/pdf/PDFFiles/13019559.pdf
  17. W. A. Kalender. Concepts for High-Resolution Low-Dose CT of the Breast. Physikalisch-Medizinische Sozietät Erlangen (2013)
  18. W. A. Kalender. Concepts for High-Resolution Low-Dose CT of the Breast. Annual Meeting of Radiological Society of North America (RSNA) 2012, 25 - 30 November 2012, Chi-cago, USA (2012)
  19. J. Wilhelmy, J. Vaupel, W. A. Kalender. CT Raw Image Data Compression Using Wavelet Transformation on FPGAs for High Speed Data Transfer. Annual Meeting of Radiological Society of North America (RSNA) 2012, 25 - 30 November 2012, Chicago, USA (2012)
  20. W.A. Kalender. Low-dose high-resolution CT of the breast. 14th Annual International Symposium on MDCT, 17 - 20 June 2012, San Francisco, USA (2012)
  21. W.A. Kalender. Future prospects for CT - How far can CT technology be developed? BIR Sylvanus Thompson Memorial Lecture, April 25, 2012, London, UK (2012)
  22. W.A. Kalender. Spiral-CT of the breast: technique and diagnostic options. Universitäts-spital Bern, January 28 2012, Bern, Switzerland (2012)
  23. W.A. Kalender. CT-Technik - State of the art and future perspective. 7. Internationales Symposium, 11 - 14 January 2012, Garmisch-Partenkirchen, Germany (2012)
  24. W. A. Kalender. Breast CT - coming soon. EUSOBI 2012, 12 - 13 October 2012, Barcelona, Spain (2012)
  25. W. A. Kalender. CT of the Breast: a real innovation? 6th Int. Congress on MRM, 27 - 29 September 2012, Jena, Germany (2012)
  26. W. A. Kalender. Übersichtsvortrag: Aktuelle Trends in der Computertomographie. 43. Jahrestagung der Deutschen Gesellschaft für Medizinische Physik, 26 – 29 September 2012, Jena, Germany (2012)
  27. W. A. Kalender. Verbesserte Brustkrebserkennung und -diagnostik mit CT. Wissen-schaftstag der Metropolregion Nürnberg, 20 July 2012, Erlangen, Germany (2012)
  28. W. A. Kalender 3D-Hochauflösungs-CT. Neue Entwicklungen für die Brustkrebsdiagnostik FAPS Fachseminar 2011, Erlangen, Germany (2011)
  29. W. A. Kalender Verbesserte Brustkrebsfrüherkennung mit CT: Ein neues Gerätekonzept mit hoher Auflösung und sehr niedriger Dosis. Medica 2011, Düsseldorf, Germany (2011)
  30. F. Lück, M. Weigel, D. Kolditz, S. Vollmar, M. Hupfer, W. A. Kalender. Effect of Shaped Filters Designed for Breast CT on Dose and Image Quality. Annual Meeting of Radiological Society of North America (RSNA) 2011, 27 November - 2 December 2011, Chicago, USA (2011)
    http://archive.rsna.org/2011/11010918.html
  31. D. Kolditz, M. Beister, W. A. Kalender. Volume-of-Interest Imaging for High Image Quality at Reduced Dose in Dedicated Female Breast CT. Annual Meeting of Radiological Society of North America (RSNA) 2011, 27 November - 2 December 2011, Chicago, USA (2011)
    http://archive.rsna.org/2011/11008972.html
  32. M. Beister, R. Hendrych, D. Kolditz, W. A. Kalender Dose Efficient Model-based Iterative Reconstruction for a Dedicated Female Breast CT Scanner. Annual Meeting of Radiologi-cal Society of North America (RSNA) 2011, 27 November - 2 December 2011, Chicago, USA (2011)
    http://archive.rsna.org/2011/11005205.html
  33. W.A. Kalender Concepts for High-Resolution Low-Dose CT of the Breast. Annual Meeting of Radiological Society of North America (RSNA) 2011, 27 November - 2 December 2011, Chicago, USA (2011)
  34. W. A. Kalender. Latest development in Breast CT. Symposium Mammographicum Conference 2010. The British Institute of Technoloy (2010)
    http://www.birpublications.org/doi/pdf/10.1259/conf-symp.2010