X-RAY MAMMOGRAPHY WITH TOMOSYNTHESIS

• US 20130272494A1
• Filed: 05/17/2013
• Published: 10/17/2013
• Est. Priority Date: 11/27/2002
• Status: Active Grant

• Current Assignee: Hologic Incorporated
• Original Assignee: Hologic Incorporated
• Inventors: Ren, Baorui, SHAW, Ian, SMITH, Andrew P., STEIN, Jay A., DeFreitas, Kenneth, RUTH, Christopher
• Granted Patent: US 10,638,994 B2
• Time in Patent Office: Days
• US Class Current: 378/37
• CPC Class Codes: A61B 6/025 Tomosynthesis
• CPC Class Codes: A61B 6/0414 with compression means
• CPC Class Codes: A61B 6/12 Arrangements for detecting or locating foreign bodies
• CPC Class Codes: A61B 6/4291 the detector being combined with a grid or grating
• CPC Class Codes: A61B 6/4441 the rigid structure being a C-arm or U-arm
• CPC Class Codes: A61B 6/464 involving a plurality of displays
• CPC Class Codes: A61B 6/481 involving the use of contrast agents
• CPC Class Codes: A61B 6/482 involving multiple energy imaging
• CPC Class Codes: A61B 6/502 for diagnosis of breast, i.e. mammography

Abstract

A method and system for producing tomosynthetic images of a patient'"'"'s breast. An x-ray source that delivers x-rays through a breast immobilized and compressed between a compression paddle and a breast platform and form an image at a digital x-ray receptor panel. Multiple x-ray images are taken as the x-ray source and the receptor move relative to the immobilized breast. In one preferred embodiment, the x-ray source travels from −15° to +15°. The source can travel in an arc around the breast while the receptor travels linearly while remaining parallel and at the same distance from the breast platform. The sets of x-ray image data taken at different angles are combined to form tomosynthetic images that can be viewed in different formats, alone or as an adjunct to conventional mammograms.

Claims

1-78. -78. (canceled)

79. A method of obtaining x-ray mammogram images, projection tomosynthesis x-ray images, and reconstructed tomosynthesis images x-ray images of a patient'"'"'s breast, comprising:

providing an x-ray source, a flat panel digital x-ray imager, and a breast support and a compression paddle positioned between the source and the imager, said compression paddle configured for compressing the breast against the breast support, and a motion control configured for moving the source relative to a patient'"'"'s breast

compressing the patient'"'"'s breast between the paddle and the breast support and selectively energizing the source to emit x-rays through the breast to the imager at selected angular positions of the source relative to the breast;

controlling the imager to derive therefrom projection x-ray images of the compressed breast when the source is energized at each of said positions, wherein (i) at least one of the projection images is an x-ray mammogram image taken at a same or similar x-ray dose to the breast as a conventional mammogram and (ii) each of a multiplicity of the other projection images is a tomosynthesis projection image taken at an x-ray dose to the breast that is substantially less than that for a conventional mammogram;

computer-processing the multiplicity of the tomosynthesis projection images into one or more reconstructed tomosynthesis images representing a volume of the patient'"'"'s breast and relating to one or more image planes that are selectively the same or different from that of the mammogram image; and

selectively displaying said mammogram image and the reconstructed tomosynthesis images.

80. The method of claim 79 in which said mammogram image and said tomosynthesis projection images are obtained in a single compression of the patient'"'"'s breast.

81. The method of claim 79 further including using an anti-scatter grid positioned between the breast and the imager both when taking the mammogram image and when taking the projection tomosynthesis images.

82. The method of claim 79 further including using an anti-scatter grid positioned between the breast and the imager when taking one but not the other of (i) the mammogram image and (ii) the projection tomosynthesis images.

83. The method of claim 79 in which said displaying comprises concurrently displaying the mammogram image and at least one of the reconstructed tomosynthesis images.

84. method of claim 79 in which said selected angular positions of the source relative to the breast are along an arc centered at the patient'"'"'s breast.

85. The method of claim 79 in which said mammogram image is taken at one or both of the CC and MLO orientations.

86. The method of claim 79 in which the multiplicity of projection tomosynthesis images are taken from angular positions of the source relative to the breast wherein the angular spacing between positions is not the same for all positions.

87. The method of claim 79 in which the angular range or source motion relative to the breast is set at a first value for taking the multiplicity of projection tomosynthesis images of one breast and to a different value for taking the projection tomosynthesis images of another breast.

88. The method of claim 79 in which at least one of the reconstructed tomosynthesis images represents a thickness of breast tissue comparable to the thickness of the compressed breast.

89. The method of claim 79 further including taking a first set of projection tomosynthesis images, then introducing a contrast agent into the breast and taking a second set of projection tomosynthesis images, and using information from the two sets to obtain subtraction images of the breast through a computer-implemented process.

90. The method of claim 79 further including taking two sets of said projection tomosynthesis images, each set being at a different x-ray energy, and subtracting images derived from said two sets to obtain subtraction images of the breast through a computer-implemented process.

91. The method of claim 79 further including selectively changing a distance between the breast support and the x-ray imager to thereby obtain magnification mammogram images or projection tomosynhesis images.

92. The method of claim 79 further including applying computer aided detection to one or both of (i) the projection tomosynthesis projection images and (ii) the reconstructed tomosynthesis images.

93. The method of claim 79 further including providing fiducial markers at the compression paddle and taking at least some of said mammogram images and projection tomosynthesis images through the fiducial markers for use in mechanical calibration.

94. The method of claim 79 in which said selectively displaying step comprises displaying at any one time one but not the other of (i) the mammogram image and (ii) the reconsructed tomosyinthesis images.

95. A method of acquiring and displaying tomosynthesis x-ray projection images and reconstructed tomosynthesis images of a patient'"'"'s breast, comprising:

providing an x-ray source, a flat panel x-ray imager, and a breast support positioned between the source and the imager;

immobilizing the patient'"'"'s breast on the breast support;

moving the x-ray source relative to the immobilized patient'"'"'s breast and selectively energizing the source to emit x-rays passing through the breast to the imager, and selectively causing the imager to output image data for positions at which the source is energized, thereby causing the imager to acquire projection tomosynthesis images;

wherein the projection tomosynthesis images for each of a multiplicity of said positions is taken at an x-ray dose to the breast that is substantially less than that for a conventional mammogram image;

computer-processing the projection tomosynthesis images to thereby obtain one or more reconstructed tomosynthesis images each representing a volume of the immobilized breast that has a selected thickness and is at a selected orientation relative to the breast support; and

selectively displaying said projection tomosynthesis images and said one or more one or more reconstructed tomosynthesis images.

96. The method of claim 95 further including compressing the breast on said breast support and selectively taking, while the breast remains compressed, both said projection tomosynthesis images and a mammogram image taken at an x-ray dose to the breast that is higher than that for one of the projection tomosynthesis images.

97. The method of claim 96 in which both said projection tomosynthesis images and said mammogram image are taken during the same breast compression.

98. The method of claim 96 further including taking both said projection tomosynthesis images and said mammogram image with an anti-scatter grid positioned between the breast and the x-ray imager.

99. The method of claim 96 further including taking, with an anti-scatter grid positioned between the breast and the x-ray imager, one but not the other of (i) said projection tomosynthesis images and (ii) said mammogram image.

100. The method of claim 96 in which said selectively displaying step comprises concurrently displaying both (i) the mammogram image and (ii) the one or more reconstructed tomosyinthesis images.

101. The method of claim 96 in which said selectively displaying step comprises displaying at any one time one but not the other of (i) the mammogram image and (ii) the one or more reconstructed tomosynthesis images.

102. The method of claim 95 in which the projection tomosynthesis images are taken from angular positions of the source relative to the breast wherein the angular spacing between positions is not the same for all positions.

103. The method of claim 95 in which the source moves relative to the breast over an angular range that has a first value for taking the projection tomosynthesis images of one breast but a different value for taking the projection tomosynthesis images of another breast.

104. The method of claim 95 further including taking a first set of the projection tomosynthesis images, then introducing a contrast agent into the breast and taking a second set of the projection tomosynthesis projection images, and using information from the two sets to obtain subtraction images of the breast through a computer-implemented process.

105. The method of claim 95 further including taking two sets of the projection tomosynthesis images, each set being at a different x-ray energy, and using information derived from said two sets to obtain subtraction images of the breast through a computer-implemented process.

106. The method of claim 95 further including selectively changing a distance between the breast support and the x-ray imager to thereby obtain magnification images.

107. The method of claim 95 further including applying computer aided detection (CAD) to one or both of the projection tomosynthesis images and the reconstructed tomosynthesis images.

108. The method of claim 95 further including providing fiducial markers between the source and the breast and taking at least some of said projection tomosynthesis images through the fiducial markers for use in mechanical calibration.

109. The method of claim 95 in which at least one of the reconstructed tomosynthesis images represents a thickness of breast tissue comparable to the thickness of the compressed breast.

110. The method of claim 95 in which each of the reconstructed tomosynthesis images represents a respective breast thickness that is significantly less than that of the breast being imaged.

111. A method of selectively using the same x-ray equipment to take, process and display (i) a mammogram image and (ii) projection tomosynthesis images, comprising;

providing an x-ray source that selectively moves relative to a patient'"'"'s breast while the breast remains compressed, and a flat panel x-ray imager receiving x-rays from the source through the breast when the source is energized;

compressing the patient'"'"'s breast in a position between the source and the imager;

selecting one of a mammogram operating mode in which the imager obtains a mammogram image while the source, breast and imager are in a fixed position with respect to each, and a tomosynthesis mode of operation in which the imager obtains plural projection tomosynthesis images of the breast taken from different positions of the source relative to the breast;

selectively operating the equipment in one or both of the mammogram mode and the tomosynthesis mode to obtain, respectively, at least one mammogram image, or plural projection tomosynthesis images, or both at least on mammogram age and plural projection tomosynthesis images;

computer-processing the obtained images to selectively form display images including one or more reconstructed tomosynthesis images representing a selected thickness of breast tissue that is at a selected orientation relative to the compressed breast; and

selectively displaying the display images.

112. The method as in claim 111 in which the displaying comprises concurrently displaying both one or more mammogram images and one or more reconstructed tomosynthesis images.