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Breast cancer imaging: A perspective for the next decade
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Breast imaging is largely indicated for detection, diagnosis, and
clinical management of breast cancer and for evaluation of the integrity of breast implants. In this
work, a prospective view of techniques for breast cancerdetection and
diagnosis is provided based on an assessment of current trends. The potential role of
emerging techniques that are under various stages of research and development is also
addressed. It appears that the primary imaging tool for breast cancer screening in the next
decade will be high-resolution, high-contrast, anatomical x-ray imaging with or without
depth information. MRI and ultrasonography will have an increasingly important adjunctive role for
imaging high-risk patients and women with dense breasts. Pilot studies
with dedicated breast CT have demonstrated high-resolution three-dimensional
imaging capabilities, but several technological barriers must be
overcome before clinical adoption. Radionuclide based imaging
techniques and x-ray
imaging with intravenously injected contrast offer substantial
potential as a diagnostic tools and for evaluation of suspicious lesions. Developing
optical and electromagnetic imaging techniques hold significant
potential for physiologic information and they are likely to be of most value when
integrated with or adjunctively used with techniques that provide anatomic information.
Experimental studies with breast specimens suggest that phase-sensitive x-ray imaging techniques can
provide edge enhancement and contrast improvement but more research is needed to evaluate their
potential role in clinical breast imaging. From the technological
perspective, in addition to improvements within each modality, there is likely to be a
trend towards multi-modality systems that combine anatomic with physiologic information.
We are also likely to transition from a standardized screening, where all women undergo
the same imaging exam (mammography), to selection of a screening modality
or modalities based an individual-risk or other classification.
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