Although breast cancer screening and improvements in treatment have reduced breast cancer mortality by 30%, this disease still kills over 600,000 women yearly worldwide. To further reduce its morbidity and mortality, new and improved imaging modalities that improve the detection, diagnosis, and treatment of breast cancer are needed.
Over the last two decades, advances in digital imaging technology have revolutionized x-ray-based breast imaging. New digital detectors made feasible the introduction of advanced imaging methods, including dedicated breast computed tomography, or breast CT. Breast CT images the breast from all angles, resulting in a 3-dimensional image that shows the internal breast tissue in its true form and distribution. In a separate project, we improved further upon 3D breast CT to create 4D breast CT. The fourth dimension in this case is time. With 4D breast CT, we create a 3D movie, in which not only the breast tissue is shown, but also the movie shows how blood flows in and out of breast tumors. This information may help the physicians design the best treatment for each individual breast cancer patient, increasing the rate of cure and therefore reducing breast cancer mortality.
However, 3D and 4D breast CT involve too much radiation to be used for screening for breast cancer on all women of screening age. The continued use of the x-ray tube as the source of x rays restricts the reduction in dose and the quantitative accuracy achievable with advances in the rest of the system. Very recently, however, a new monochromatic x-ray source has been developed that provides the necessary flux, x-ray energy, field of view, and portability, to be used in x-ray breast imaging devices.
In MONOBREAST, we aimed to lower the radiation used in breast CT by replacing the traditional x-ray source in these systems by a completely new technology. X-ray source technology has remained essentially unchanged for the last 100 years, but only recently a new type of source, that emits x rays all of the same type, has been developed. This new capability, called monochromatic x-ray emission, could allow for reducing the dose in breast CT considerably. A monochromatic breast CT system would be applicable to every stage in the breast cancer chain, from screening with 3D breast CT at doses equivalent to those of current screening imaging, to 4D breast CT for treatment personalization.
