Roni Talukdar, MD.

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Presentation transcript:

Roni Talukdar, MD

Topics New screening recs and rebuttals Tomosynthesis

Screening

US Preventative Task Forces Screening mammogram women ages 50-74 Every other year NO self breast exam NO clinical breast exam 2009

US Preventative Task Forces Screening mammogram women ages 50-74 Every other year NO self breast exam NO clinical breast exam

DO NOT support recommendations: American Cancer Society American College of Gynecologists and Obstetricians American College of Radiologists Society of Breast Imaging Memorial Sloan Kettering MD Anderson

Screening Guidelines: Annual Mammogram at age 40 Clinical Breast Exam Annually at age 40 Every 3 years ages 20 - 39 And continue until less than 5-7 years life expectancy

Who is the USPTF? Very smart group of doctors that represent a “cross-section of doctors” Some MDs, some PhDs, mainly in academics No radiologists, breast surgeons, oncologists. No physician that primarily deals with breast issues

Women Ages 40-50 1 in 6 Breast Cancers occur in this age range Higher percentage of poor genotype cancers

Problems with Canadian trials Not truly blinded Poor image quality Poor quality of interpretation

Tomosynthesis

Why Breast Tomosynthesis (3D mammography)? Tissue superimposition hides pathologies in 2D 20

3D Mammograms June 2015 Digital Mammograms

3D Improves Visibility by Reducing Tissue Superimposition

Generating 3D/2D Images Perform a standard tomosynthesis scan The first step to generating a 2D image is to perform the tomosynthesis scan Click to display bullet & motion of x-ray tube The image represents the x-ray tube moving to produce 15 low-dose projection images.

55 Tomosynthesis Slices* Generating 2D Images 55 Tomosynthesis Slices* Perform a standard tomosynthesis scan Reconstruct tomosynthesis slices Reconstruction Algorithm 15 Projection Images *Average slices based on 5 cm compressed breast After the acquired scan, the projection images will be reconstructed into 1 mm slices. There are an additional 5 slices reconstructed due to paddle tilt. Click to display up arrow & bullet

55 Tomosynthesis Slices* Generating 2D Images 55 Tomosynthesis Slices* Perform a standard tomosynthesis scan Reconstruct tomosynthesis slices Synthesize 2D image Available in any tomosynthesis view Software Algorithm From the reconstructed slices, a software algorithm is applied and it creates the Generated 2D image Click to display down arrow & bullets Generated 2D Images

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