Assessment of intraductal carcinoma in situ (DCIS) using grating-based X-ray phase-contrast CT at conventional X-ray sources: An experimental ex-vivo study

Background The extent of intraductal carcinoma in situ (DCIS) is commonly underestimated due to the discontinuous growth and lack of microcalcifications. Specimen radiography has been established to reduce the rate of re-excision. However, the predictive value for margin assessment with conventional specimen radiography for DCIS is low. In this study we assessed the potential of grating-based phase-contrast computed tomography (GBPC-CT) at conventional X-ray sources for specimen tomography of DCIS containing samples. Materials and methods GBPC-CT was performed on four ex-vivo breast specimens containing DCIS and invasive carcinoma of non-specific type. Phase-contrast and absorption-based datasets were manually matched with corresponding histological slices as the standard of reference. Results Matching of CT images and histology was successful. GBPC-CT showed an improved soft tissue contrast compared to absorption-based images revealing more histological details in the same sections. Non-calcifying DCIS exceeding the invasive tumor could be correlated to areas of dilated bright ducts around the tumor. Conclusions GBPC-CT imaging at conventional X-ray sources offers improved depiction quality for the imaging of breast tissue samples compared to absorption-based imaging, allows the identification of diagnostically relevant tissue details, and provides full three-dimensional assessment of sample margins.

[1]  O. Bunk,et al.  Hard x-ray phase tomography with low-brilliance sources. , 2007, Physical review letters.

[2]  Emmanuel Brun,et al.  High-resolution, low-dose phase contrast X-ray tomography for 3D diagnosis of human breast cancers , 2012, Proceedings of the National Academy of Sciences.

[3]  Franz Pfeiffer,et al.  Assessment of grating-based X-ray phase-contrast CT for differentiation of invasive ductal carcinoma and ductal carcinoma in situ in an experimental ex vivo set-up , 2013, European Radiology.

[4]  Franz Pfeiffer,et al.  X-ray phase imaging with a grating interferometer. , 2005, Optics express.

[5]  Franz Pfeiffer,et al.  Evaluation of phase-contrast CT of breast tissue at conventional X-ray sources - presentation of selected findings. , 2013, Zeitschrift fur medizinische Physik.

[6]  Andy H. Lee,et al.  Epidemiology of ductal carcinoma in situ in Western Australia: implications for surgical margins and management , 2015, Breast Cancer.

[7]  E Castelli,et al.  The mammography project at the SYRMEP beamline. , 2008, European journal of radiology.

[8]  Tim Salditt,et al.  Three-dimensional mouse brain cytoarchitecture revealed by laboratory-based x-ray phase-contrast tomography , 2017, Scientific Reports.

[9]  Guang-Hong Chen,et al.  Quantitative imaging of electron density and effective atomic number using phase contrast CT. , 2010, Physics in medicine and biology.

[10]  Nataly Wieberneit,et al.  A Study on Mastectomy Samples to Evaluate Breast Imaging Quality and Potential Clinical Relevance of Differential Phase Contrast Mammography , 2014, Investigative radiology.

[11]  N. Houssami,et al.  Margins in breast conservation: A clinician's perspective and what the literature tells us , 2014, Journal of surgical oncology.

[12]  Performance of Photon-Counting Breast Computed Tomography, Digital Mammography, and Digital Breast Tomosynthesis in Evaluating Breast Specimens. , 2017, Academic radiology.

[13]  William H. Richardson,et al.  Bayesian-Based Iterative Method of Image Restoration , 1972 .

[14]  S. Fiedler,et al.  Imaging lobular breast carcinoma: comparison of synchrotron radiation DEI-CT technique with clinical CT, mammography and histology. , 2004, Physics in medicine and biology.

[15]  O. Bunk,et al.  Phase retrieval and differential phase-contrast imaging with low-brilliance X-ray sources , 2006 .

[16]  F. Pfeiffer,et al.  X-ray grating-based phase tomography for 3D histology , 2013 .

[17]  Franz Pfeiffer,et al.  Visualizing Typical Features of Breast Fibroadenomas Using Phase-Contrast CT: An Ex-Vivo Study , 2014, PloS one.

[18]  Seyedamir Tavakoli Taba,et al.  X-Ray Phase-Contrast Technology in Breast Imaging: Principles, Options, and Clinical Application. , 2018, AJR. American journal of roentgenology.

[19]  I. Leitman,et al.  Identifying Factors and Techniques to Decrease the Positive Margin Rate in Partial Mastectomies: Have We Missed the Mark? , 2014, The breast journal.

[20]  Emilio Quaia,et al.  Mammography with synchrotron radiation: first clinical experience with phase-detection technique. , 2011, Radiology.

[21]  Alberto Bravin,et al.  High-resolution CT by diffraction-enhanced x-ray imaging: mapping of breast tissue samples and comparison with their histo-pathology , 2007, Physics in medicine and biology.

[22]  L. Lucy.  An iterative technique for the rectification of observed distributions , 1974 .

[23]  Franz Pfeiffer,et al.  Low-dose, phase-contrast mammography with high signal-to-noise ratio. , 2016, Biomedical optics express.

[24]  Franz Pfeiffer,et al.  Quantitative phase-contrast tomography of a liquid phantom using a conventional x-ray tube source. , 2009, Optics express.

[25]  M. Morrow,et al.  Relationship Between Margin Width and Recurrence of Ductal Carcinoma In Situ: Analysis of 2996 Women Treated With Breast-conserving Surgery for 30 Years. , 2015, Annals of surgery.

[26]  Franz Pfeiffer,et al.  X-ray phase-contrast tomosynthesis of a human ex vivo breast slice with an inverse Compton x-ray source , 2016 .

[27]  Hongli Shi,et al.  Signs Analysis and Clinical Assessment: Phase-Contrast Computed Tomography of Human Breast Tumours , 2015, PloS one.

[28]  S Auweter,et al.  Quantitative breast tissue characterization using grating-based x-ray phase-contrast imaging , 2014, Physics in medicine and biology.

[29]  Akira Furukawa,et al.  The First Trial of Phase Contrast Imaging for Digital Full-Field Mammography Using a Practical Molybdenum X-Ray Tube , 2005, Investigative radiology.

[30]  A. Giuliano,et al.  Margins: A Status Report from the Annual Meeting of the American Society of Breast Surgeons , 2014, Annals of Surgical Oncology.

[31]  Marcus J Kitchen,et al.  A feasibility study of X-ray phase-contrast mammographic tomography at the Imaging and Medical beamline of the Australian Synchrotron. , 2015, Journal of synchrotron radiation.

[32]  Luigi Rigon,et al.  Breast tomography with synchrotron radiation: preliminary results , 2004, Physics in medicine and biology.

[33]  Alberto Bravin,et al.  Phase-contrast X-ray imaging of breast , 2010, Acta radiologica.

[34]  V Fanti,et al.  Towards breast tomography with synchrotron radiation at Elettra: first images , 2016, Physics in medicine and biology.

[35]  Alberto Bravin,et al.  Visualisation of calcifications and thin collagen strands in human breast tumour specimens by the diffraction-enhanced imaging technique: a comparison with conventional mammography and histology. , 2004, European journal of radiology.

[36]  U. Bick,et al.  Intraoperative Specimen Radiography in Patients with Nonpalpable Malignant Breast Lesions , 2012, Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren.

[37]  Franz Pfeiffer,et al.  Experimental Realisation of High-sensitivity Laboratory X-ray Grating-based Phase-contrast Computed Tomography , 2016, Scientific Reports.

[38]  J Herzen,et al.  X-ray phase-contrast imaging of the breast--advances towards clinical implementation. , 2014, The British journal of radiology.

[39]  Fulvia Arfelli,et al.  High-Resolution X-Ray Phase-Contrast 3-D Imaging of Breast Tissue Specimens as a Possible Adjunct to Histopathology , 2018, IEEE Transactions on Medical Imaging.

[40]  E Brun,et al.  High-resolution breast tomography at high energy: a feasibility study of phase contrast imaging on a whole breast , 2012, Physics in medicine and biology.

[41]  Florian Schmitzberger,et al.  Digital breast tomosynthesis versus full-field digital mammography-Which modality provides more accurate prediction of margin status in specimen radiography? , 2017, European journal of radiology.

[42]  Franz Pfeiffer,et al.  Toward Clinically Compatible Phase-Contrast Mammography , 2015, PloS one.

[43]  T. Berquist.  ARRS Annual Planning Meeting: Process Challenges and Modifications. , 2018, AJR. American journal of roentgenology.

[44]  C. David,et al.  The First Analysis and Clinical Evaluation of Native Breast Tissue Using Differential Phase-Contrast Mammography , 2011, Investigative radiology.

[45]  Andy H. Lee,et al.  Intraoperative assessment of margins in breast conserving therapy: a systematic review. , 2014, Breast.