Breast Tomosynthesis

✍ Scribed by Liane E Philpotts MD FACR, Regina J Hooley MD

• Publisher: Elsevier
• Year: 2017
• Tongue: English
• Leaves: 261
• Edition: 1
• Category: Library

✦ Synopsis

The use of tomosynthesis in breast imaging is growing rapidly due to its superior ability to identify and characterize normal findings, benign lesions, and breast cancer, as well as its optimal performance with dense breast tissue. Providing unparalleled coverage of this breakthrough breast imaging modality, Breast Tomosynthesis explains how this new modality can lead to enhanced interpretation and better patient outcomes. This new reference is an indispensable guide for today's practitioner looking to keep abreast of the latest developments with correlative findings, practical interpretation tips, physics, and information on how tomosynthesis differs from conventional 2D FFDM mammography. Over 900 high-quality images offer visual guidance to effectively reading and interpreting this key imaging modality.

• Includes over 900 high-quality tomosynthesis and mammography images representing the spectrum of breast imaging.
• Features the latest Breast Imaging Reporting and Data System (or BI-RADS) standards updated in February 2014.
• Highlights practical tips to interpreting this new modality and how it differs from 2D mammography.
• Details how integration of tomosynthesis drastically changes lesion work-up and overall workflow in the department.
• "Tomo Tips" boxes offer tips and pitfalls for expert clinical guidance.
• A separate section of Video Case Studies includes mammography images and over 90 tomosynthesis videos referenced online, allowing users to see side-by-side findings, including normal and benign and malignant lesions, and make comparisons using both modalities for the same patient case.
• Expert Consult eBook version included with purchase. This enhanced eBook experience allows you to search all of the text, figures, images, videos, and references from the book on a variety of devices.

✦ Table of Contents

Cover
BREAST TOMOSYNTHESIS
Copyright
Dedication
Contributors
Foreword
Preface
Contents
1 - Introduction
2 - Physics and Development of Breast Tomosynthesis
Development of Tomosynthesis
System Design
Acquisition Angle
Number of Projection Images
X-Ray Source Motion
Acquisition Time
Radiation Dose
Breast Compression
Imaging Views
Synthetic Mammograms
Summary
3 - The Technologist’s Perspective
Training
Radiation Exposure
Performing the Tomosynthesis Mammogram
Additional Views
Artifacts
Skin and Positioning Related Artifacts
Slinky Artifact
Motion Artifact
Additional Tomosynthesis Artifacts
Tomosynthesis Quality Control
Conclusion
4 - Implementation of Digital Breast Tomosynthesis Into Clinical Practice
Introduction
Tomosynthesis Equipment
Early Research With Tomosynthesis
Implementation Considerations
Preparation
Information Technology, Picture Archiving, and Communication System and Workstation Requirements
Hanging Protocols
Radiologist and Technologist Considerations
Tomosynthesis Biopsy Capabilities
Dose Considerations
Community Outreach
Hybrid Conversion: Things to Consider
Summary
5 - Tomosynthesis in Screening Mammography
How to Read Screening Mammograms With Tomosynthesis
How Is Tomosynthesis Reducing Recall Rates
Technical Issues
Asymmetry
Calcifications
Mass
How Is Tomosynthesis Increasing Cancer Detection
Architectural Distortion
Masses
Calcifications
Asymmetries
Using Synthesized (Two-Dimensional) Mammograms
Challenges to Tomosynthesis Screening
Computer-Aided Detection: To Use or Not To Use
Downstream Effects of Tomosynthesis in Screening Mammography
Tomosynthesis Screening in Women With Dense Tissue
Summary
6 - Tomosynthesis in Diagnostic Mammography
Changes in Diagnostic Environment and Outcomes
Abbreviated Diagnostic Work-Up
Improved Accuracy and Shift in Use of BI-RADS Assessment Categories
Diagnostic Work-Up Patterns
Noncalcification Lesions: Masses, Architectural Distortions, and Asymmetries: When Are Additional Views Necessary?
Single-View–Only Lesions
Two-Dimensional Screening Recall: Should the Study Be Repeated With Tomosynthesis
Second Look After Magnetic Resonance Imaging
Tomosynthesis-Detected Lesions With No Ultrasound Correlate
Architectural Distortion
Focal Asymmetry
Microcalcifications
Nipple Discharge
Breast Pain
Summary
7 - Tomosynthesis Interpretation Tips and Pitfalls
Interpretation Tips
Tomosynthesis Case Review
Localization Tips
Assessing Focal Findings
Pitfalls
Pseudolesions
Fat-Containing Lesions
Tomo-Occult Cancers
Summary
8 - Benign Findings
Introduction
What Constitutes a Benign Appearance?
Asymmetries
Masses
Cysts
Fibroadenomas
Phyllodes Tumor
Fat-Containing Lesions
Lymph Nodes
Lipomas and Hamartomas
Galactocele and Lactational Changes
Abscess
Seromas and Hematomas
Architectural Distortion
Calcifications
Characterizing Benign Findings by Multimodality Work-Up
Summary
9 - Malignant Findings
Ductal Carcinoma In Situ
Invasive Carcinoma
Invasive Ductal and Lobular Carcinoma
Multifocal and Multicentric Cancer
Advanced Breast Cancer
Metastases
Summary
10 - Architectural Distortion
Tomosynthesis Features of Architectural Distortion
Pathology of Architectural Distortion
Diagnostic Work-up of Architectural Distortion
The Role of Ultrasound
The Role of Magnetic Resonance Imaging
Management of Architectural Distortion
Potential Pitfalls/Complications
Conclusion
11 - Integrating Tomosynthesis With Multimodality Imaging
Assessment of Tomosynthesis Findings
Targeted Ultrasound to Assess Tomosynthesis Findings
Tomosynthesis and Evaluation of Extent of Disease
Contrast-Enhanced Breast Magnetic Resonance Imaging to Assess Tomosynthesis Findings
Second-Look Tomosynthesis for Ultrasound or Magnetic Resonance Imaging Findings
Correlating Ultrasound Findings With Tomosynthesis
Correlating Magnetic Resonance Findings With Tomosynthesis
Evaluation of Incidental Breast Lesions Seen on Chest Computed Tomography
Patients Presenting With Metastatic Disease: How Tomosynthesis and Other Modalities Can Help
Summary
12 - The Postoperative Breast
General Postoperative Assessment Tips
Needle Biopsy
Surgical Biopsy
Reduction Mammoplasty
Augmentation
Lumpectomy
Radiation Therapy
Post-Mastectomy Reconstruction
Recurrence
Specimen Radiography
Summary
13 - Tomosynthesis in the Male Breast
Imaging the Male Patient
Gynecomastia
Breast Cancer
Other Findings on Tomosynthesis
Summary
14 - Interventional Procedures
Advantages of Tomosynthesis-Guided Biopsy
Calcifications
Cost Effectiveness
Patient Access
Workflow
Limitations of Tomosynthesis-Guided Biopsy
Procedure
Tomosynthesis-Guided Wire and Seed Localizations
Conclusion
Video Case Studies
Chapter 1
Chapter 3
Chapter 5
Chapter 6
Chapter 7
Chapter 8
Chapter 9
Chapter 10
Chapter 11
Chapter 12
Chapter 13
Selected Readings
Index
A
B
C
D
E
F
G
H
I
L
M
N
O
P
Q
R
S
T
U
V
W
X