EP2242425A1 - Installation de mammographie et procédé d analyse sonographique et radiographique d une poitrine - Google Patents

Installation de mammographie et procédé d analyse sonographique et radiographique d une poitrine

Info

Publication number
EP2242425A1
EP2242425A1 EP09711669A EP09711669A EP2242425A1 EP 2242425 A1 EP2242425 A1 EP 2242425A1 EP 09711669 A EP09711669 A EP 09711669A EP 09711669 A EP09711669 A EP 09711669A EP 2242425 A1 EP2242425 A1 EP 2242425A1
Authority
EP
European Patent Office
Prior art keywords
breast
compression
ultrasonic transducer
examination
plate
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
EP09711669A
Other languages
German (de)
English (en)
Inventor
Daniel Fischer
Thomas Mertelmeier
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Siemens AG
Original Assignee
Siemens AG
Siemens Corp
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Siemens AG, Siemens Corp filed Critical Siemens AG
Publication of EP2242425A1 publication Critical patent/EP2242425A1/fr
Withdrawn legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/44—Constructional features of the ultrasonic, sonic or infrasonic diagnostic device
    • A61B8/4483—Constructional features of the ultrasonic, sonic or infrasonic diagnostic device characterised by features of the ultrasound transducer
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
    • A61B6/50—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment specially adapted for specific body parts; specially adapted for specific clinical applications
    • A61B6/502—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment specially adapted for specific body parts; specially adapted for specific clinical applications for diagnosis of breast, i.e. mammography
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/08—Clinical applications
    • A61B8/0825—Clinical applications for diagnosis of the breast, e.g. mammography
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
    • A61B6/04—Positioning of patients; Tiltable beds or the like
    • A61B6/0407—Supports, e.g. tables or beds, for the body or parts of the body
    • A61B6/0414—Supports, e.g. tables or beds, for the body or parts of the body with compression means
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
    • A61B6/44—Constructional features of apparatus for radiation diagnosis
    • A61B6/4417—Constructional features of apparatus for radiation diagnosis related to combined acquisition of different diagnostic modalities

Definitions

  • the invention relates to a mammography system and to a method for sonographic and radiographic examination of a breast, as is known, for example, from US Pat. No. 6,574,499 B1.
  • a widely used breast imaging technique is mammography.
  • the breast is positioned and compressed in a mammography system between a bearing plate and a compression plate. Subsequently, a two-dimensional X-ray image of the compressed breast is generated.
  • a further development of mammography is the Tomo synthesis. In this case, a plurality of 2D
  • the 2D projection images are calculated into a tomosynthetic 3D X-ray image.
  • a tosynthetic 3D X-ray image not only consists of a single projection image of the breast but also gives the examination object in a plurality of parallel sectional planes or Layers again.
  • a tomosynthetic 3D X-ray image thus contains a depth information.
  • mammography loses sensitivity to dense breast tissue, which is particularly prevalent in young women, so there is an increased risk that carcinoma-suggesting lesions or calcifications will not be detected.
  • the sensitivity of mammography in women over the age of 50 is around 70% to 95%, but is less than 50% in young women with dense breast tissue (Warren Burhenne, LJ et al., Radiology 215, 554-562, 2000).
  • An alternative method of examining the breast is sonography performed using ultrasound waves.
  • Mammography and sonography are known to be performed in different posture of the patient to be examined. While mammography is usually performed on standing patients with compressed breast, sonographic examination is usually done on the patient lying down with uncompressed breast. In mammography, the compressed breast is irradiated in a direction predetermined by the mammography device. In sonography, the examination is performed with a hand-held ultrasound head. The images obtained with the help of mammography and ultrasonography are therefore difficult to compare. A geometric assignment of visible in both images objects is therefore difficult.
  • Such devices provide an ultrasound examination on a breast compressed between the compression plates of a mammography system.
  • the ultrasound head is guided in a meandering scanning movement over the top of a compression plate.
  • the radiated ultrasound signals must consequently be coupled through the compression plate into the breast to be examined.
  • the coupling of the ultrasound through the compression plate is technically problematic because, in addition, the interfaces of the compression plate are located between the ultrasound source and the examination subject.
  • the ultrasound head must be guided over the chest in a possibly meandering scanning movement, which leads to relatively long examination times.
  • the ultrasound device arranged above the compression plate can also hinder the X-ray examination (mammography).
  • the object of the present invention is to provide a method and a mammography system for ultrasound and X-ray examination of a breast, in which or with which an assignment of sonographic and radiographic image data is possible.
  • the sonographic examination should be improved in terms of the examination speed and the achievable image quality.
  • the object is achieved by a method according to claim 1 and by a mammography system having the features of claim 11 or claim 14.
  • the method according to the invention for examining a breast comprises a radiographic examination and a so-called nographic examination. It does not matter in which order the examinations are carried out.
  • the breast is positioned on a bearing plate of a mammography system and compressed between this and an opposite compression plate. Subsequently, the breast is irradiated to receive a mammographic image in the compressed state. After X-ray examination of the breast, this is usually relieved by the compression plate is raised relative to the bearing plate.
  • the ultrasound examination the breast is compressed in the mammography system between a two-dimensional ultrasound transducer, on the one hand, and the compression or bearing plate, on the other hand, and brought into direct contact with the ultrasound transducer.
  • the ultrasonic transducer comprises a plurality of ultrasonic transducer elements, which are preferably arranged in a planar matrix. Subsequently, a sonographic image of the compressed breast is taken with the aid of the ultrasound transducer.
  • the method according to the invention has the following advantages: At the beginning of the examination, the breast is positioned on a bearing plate. The essentially fixed position of the breast is now retained for both mammography and sonographic examination. In other words, the breast is almost in the same place in both examinations.
  • the breast is preferably compressed to record the mammographic image as well as to record the ultrasound image in a similar manner. Due to the very similar positioning, the mammographic image and the sonographic image are well comparable.
  • Method is the use of a large-area ultrasonic transducer.
  • the ultrasonic transducer is directly with brought into contact with the breast to be examined, preferably the coupling is supported by a well-known coupling medium.
  • the ultrasonic waves are coupled into the breast, no additional boundary surface has to be overcome, as is the case, for example, when coupled in by a compression plate.
  • the large-area ultrasound transducer allows rapid examination of the breast, since in particular no scanning movement of the ultrasound transducer has to be performed.
  • the X-ray examination of the breast before the ultrasound examination. This is particularly useful in cases where, for example in the context of screening tests, a breast is to be examined with a high density. Based on the mammographic image, the density of the breast can be determined. Preferably, an ultrasound examination of the breast is performed only in the case where the density exceeds a predetermined threshold. The entire examination procedure can thus be limited to the necessary partial examinations and thereby accelerated.
  • the sonographic examination is performed before the X-ray examination. Especially in young patients or patients with usually dense breast tissue, a sonographic examination is less revealing than a radiographic. If a finding is found during the ultrasound examination, an X-ray examination may be used to clarify the findings.
  • the procedure described has the advantage that superfluous X-ray exposure can be avoided, especially in young patients with high X-ray sensitivity.
  • the compression plate or the bearing plate is interchanged with another compression or bearing plate. In this case, the further compression or bearing plate on its side facing the breast to an ultrasonic transducer.
  • the breast between the exchanged, further compression or bearing plate on the one hand and the opposite, non-exchanged bearing or compression plate on the other hand is compressed.
  • a sonographic image is recorded.
  • an ultrasound transducer is arranged on the breast-facing side of the compression or bearing plate, as part of the ultrasound examination, which is usually subsequent to the X-ray examination. Subsequently, the breast between the ultrasonic transducer on the one hand and the opposite bearing or
  • Compression plate on the other hand compressed.
  • the ultrasound transducer is likewise brought into direct contact with the breast, and subsequently a sonographic image of the compressed breast is recorded with the aid of the ultrasound transducer.
  • the ultrasonic transducer is located before the start of the sonographic examination at the specified location. Before the X-ray examination is performed, the ultrasonic transducer is removed from this location.
  • the ultrasonic transducer-containing compression plate only the replacement of the compression plate is provided against a further, the ultrasonic transducer-containing compression plate.
  • the ultrasound transducer is arranged on a side of the compression plate facing the breast.
  • the breast remain positioned throughout the examination on the bearing plate, since it is not replaced.
  • the sonography and mammography images are therefore particularly well comparable, as the breast is in almost the same position in both examinations. If, according to a variant of the method, the X-ray examination is carried out before the sonographic examination, the compression plate is exchanged for the further compression plate containing the ultrasonic transducer. If the ultrasound examination is carried out before the X-ray examination, the other compression plate is accordingly exchanged for the compression plate.
  • the compression or bearing plate are moved from such a direction into its position, so that the patient can remain substantially unchanged in its examination position when changing the compression or bearing plate.
  • the ultrasonic transducer is attached to the breast-facing side of the compression or bearing plate.
  • the compression or bearing plate or the ultrasound transducer itself containing the ultrasound transducer are thus moved from such a direction into their position, which faces away from that side of the compression or bearing plate to which the patient faces during the x-ray examination. Since the patient remains in the same posture during the X-ray and sonographic examinations, ie for the entire duration of the examination, optimally reproducible results can be achieved.
  • the image data set of the mammographic image and that of the ultrasound image are registered with each other.
  • Corresponding areas in both images can be identified so that both X-ray and sonographic information can be obtained from a structure identified in the images.
  • the X-ray examination is a tomosynthetic examination.
  • a plurality of different X-ray images are calculated into a tomosynthetic 3D mammographic image.
  • This image in contrast to conventional mammographic images, contains information about superimposed layers of the object in the beam direction.
  • An image obtained as part of an ultrasound examination also always contains depth information about the examined object.
  • the information about the examination object obtained with the aid of such a combined method is, according to a further embodiment, increased in its statement in which the image data set of the 3D mammography and the image data set of the ultrasound are registered with one another.
  • Such registered 3D images allow the easy assignment of objects displayed in both images.
  • the ultrasonic transducer is operated at a frequency of approximately 5 MHz to 15 MHz, preferably at a frequency in the range of 7 MHz to 9 MHz.
  • the abovementioned ultrasound frequencies are particularly suitable for the examination of breast tissue.
  • a mammography system according to the invention for examining a breast comprises a bearing plate and a compression plate, between which the breast can be positioned and compressed during a radiographic examination.
  • the bearing plate and / or the compression plate is interchangeable with another bearing or compression plate.
  • This further bearing or compression plate has, on its side facing the breast, an ultrasound transducer for performing an ultrasound examination.
  • the bearing plate and / or the compression plate on a holder for receiving an ultrasonic transducer.
  • the holder is designed so that a recording of the ultrasonic transducer on the breast-facing side of the bearing or compression plate is possible.
  • the device according to the invention may in particular be an existing mammography system, which is made suitable for sonographic examinations by replacing the compression or bearing plate or by attaching appropriate holders.
  • the compression plate is exchangeable or provided with corresponding holders for receiving the ultrasonic transducer.
  • the breast can remain positioned on the bearing plate during the entire examination, which improves the comparability of the sonographic and radiographic examinations.
  • the mounts present on the mammography system or on the bearing and / or compression plate are designed such that a receptacle of the ultrasound transducer is provided from a direction which faces away from the side of the device which a patient is holding during the directed to X-ray examination.
  • Such an advantageous embodiment of the holder allows the ultrasound transducer to be placed in the holder without the patient having to deviate from the position provided for carrying out the x-ray examination.
  • the device may preferably be configured such that the plates are interchangeable without the patient having to leave his position.
  • the ultrasound transducer is embedded in a breast-facing side of the compression or bearing plate.
  • this advantageously includes a plurality of ultrasonic transducer elements, which are preferably capacitively controlled micro-ultrasonic transducer elements.
  • the resolving power of an ultrasonic transducer constructed of a plurality of ultrasonic transducer elements increases proportionally with the number of ultrasonic transducer elements.
  • Micromachined, preferably lithographically manufactured and capacitively controlled micro-ultrasound transducer elements can be produced in large quantities at low cost and high quality using manufacturing processes known from semiconductor technology.
  • CMUT micro-fabricated ultra-sound transducer
  • FIG. 1 is a mammographic system according to the invention in a schematic schematic diagram
  • a mammography system 2 which is suitable both for X-ray and sonographic examination, is shown by way of example in FIG. 1.
  • An X-ray tube 6 and a detector 8 are rotatably mounted on a pedestal 4 about an axis A.
  • a bearing plate 12 which is likewise fastened to the pedestal 4, and compressed by means of a compression plate 14 which can be moved relative to the bearing plate 12.
  • the bearing plate 12 can be part of the detector housing.
  • the cover plate of the detector simultaneously serves as a bearing plate 12.
  • the fixed between the bearing plate 12 and the compression plate 14 breast 10 is located in the beam path between the X-ray tube 6 and the detector 8.
  • To record a mammographic image is the
  • Breast 10 is examined in the compressed state.
  • the recorded with the help of the detector 8 mammographic image can with Help a processing unit 16, exemplified by a monitor and a keyboard, represented or further processed.
  • the mammography system 2 shown in FIG. 1 is likewise suitable for carrying out tomosynthesis investigations in which 3D mammography images are recorded.
  • 3D mammography images a multiplicity of projection images of the compressed breast 10 are recorded, for example, by rotation of the x-ray tube 6 and the detector 8 about the axis A.
  • the images are processed by the processing unit 16 into a 3D mammographic image.
  • the mammography system 2 can also be designed such that the detector 8, including the bearing plate 12, are firmly mounted on the pedestal 4. To record various projections, only the X-ray tube 6 is moved in such a mammography system.
  • the mammography system 2 is also provided for sonographic examination of the breast 10, except for X-ray examinations.
  • the X-ray examination is carried out before the sonographic examination. This has the advantage that, as part of the X-ray examination, a density of the
  • Breast can be determined by which it can be decided whether a subsequent sonographic examination is useful or not. It is also possible to perform the sonographic examination before the X-ray examination. In such a case, it may be possible to dispense with the subsequent X-ray examination, which reduces the radiation exposure of the patient.
  • the following is an example of the case in which the X-ray examination is performed before the sonographic examination. Before the actual sonographic examination (after the mammogram has been taken), the breast 10 is first of all lifted by lifting the compress. sion plate 14 relieved. The breast 10 essentially remains at the location on the bearing plate 12 at which it was positioned at the beginning of the mammographic examination. The compression plate 14 is now replaced by a further compression plate 18, and the breast 10 is compressed again. If the breast does not remain on the bearing plate 12, it is preferably repositioned before the sonographic examination by the same person, preferably a medical professional.
  • FIG. 2 shows a detailed view of the mammography system 2 retrofitted in this way for ultrasound examination in the region of its bearing and compression plate 12, 18.
  • the further compression plate 18 comprises an ultrasonic transducer 20, with which a sonographic image of the breast 10 is taken in the following ,
  • the ultrasonic transducer 20 is inserted into the breast 10 facing side of the further compression plate 18.
  • the ultrasonic transducer 20 is preferably operated in a frequency range between 5 MHz and 15 MHz, furthermore preferably in a frequency range between 7 MHz and 9 MHz.
  • the abovementioned ultrasound frequencies are particularly suitable for the examination of breast tissue.
  • the large-surface ultrasound transducer 20 is inserted into the side of the further compression plate 18 facing the breast 10, and is in direct contact with the compressed breast 10.
  • customary coupling media for example a gel, can be used.
  • the ultrasonic transducer 20 consists of a plurality of matically arranged, capacitively controlled micro-ultrasonic transducer elements (CMUT). Such a large-area ultrasound transducer 20 allows an examination of the breast 10 without the scanning movements otherwise usual in ultrasound examinations.
  • the examination device 2 can be, in particular, an already existing mammography system, which can be replaced by exchanging the compression plate 14 is made suitable for sonographic examination.
  • the sonographic images recorded with the aid of the ultrasound transducer 20, like the mammography images, are represented with the aid of the processing unit 16 and, if appropriate, further processed.
  • Mammography images and sonography images, or their digital image data sets, can be registered with one another with the aid of the processing unit 16. This allows a simple assignment of the corresponding image areas of the Mammographie instant. Sonography image. Registration of the mammographic image and the sonographic image is of course also possible in the case where the mammographic image is a tomosynthetic 3D mammographic image. The registration is made by the very similar stock of
  • FIG. 3 shows a further exemplary embodiment, according to which the mammography system 2 described generally in connection with FIG. 1 was converted such that the ultrasound transducer 20 is now present on the underside of the breast 10, between the bearing plate 12 and the breast 10 ,
  • the ultrasonic transducer 20 can be received in particular by a guide rail 22 connected to the bearing plate 12.
  • the ultrasonic transducer 20 can be arranged in the same way on the top of the chest 10, ie between the compression plate 14 and the chest 10. It is in any case advantageous if the ultrasonic transducer 20 from a
  • the ultrasound transducer 20 is arranged on the side of the compression plate 18 facing the breast 10, the compression plate 18 is raised briefly, with relief of the breast 10, after the radiographic examination has been carried out; the ultrasound transducer 20, optionally guided by a corresponding holder 22, is inserted; Chest 10 is then compressed again between the ultrasonic transducer 20 and the position plate 12.
  • the breast is preferably positioned by the same person, for example a medical-technical assistant.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Medical Informatics (AREA)
  • Surgery (AREA)
  • Animal Behavior & Ethology (AREA)
  • Radiology & Medical Imaging (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Biophysics (AREA)
  • Molecular Biology (AREA)
  • Physics & Mathematics (AREA)
  • Pathology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Gynecology & Obstetrics (AREA)
  • Dentistry (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • High Energy & Nuclear Physics (AREA)
  • Optics & Photonics (AREA)
  • Apparatus For Radiation Diagnosis (AREA)
  • Ultra Sonic Daignosis Equipment (AREA)

Abstract

Cette installation de mammographie (2) pour analyser une poitrine (10) comprend une plaque support (12) et une plaque de compression (14, 18), entre lesquelles la poitrine (10) est positionnée et comprimée pendant une analyse radiographique. Pour l'analyse sonographique de la poitrine (10), celle-ci est comprimée entre un transducteur ultrasonore (20) d'une part, et la plaque support ou la plaque de compression (12, 14) d'autre part. La poitrine est ici, afin d'enregistrer une image sonographique, amenée en contact direct avec le transducteur ultrasonore (20).
EP09711669A 2008-02-20 2009-01-21 Installation de mammographie et procédé d analyse sonographique et radiographique d une poitrine Withdrawn EP2242425A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE102008009967A DE102008009967A1 (de) 2008-02-20 2008-02-20 Mammographieanlage und Verfahren zur sono- und röntgenograpischen Untersuchung einer Brust
PCT/EP2009/050624 WO2009103586A1 (fr) 2008-02-20 2009-01-21 Installation de mammographie et procédé d’analyse sonographique et radiographique d’une poitrine

Publications (1)

Publication Number Publication Date
EP2242425A1 true EP2242425A1 (fr) 2010-10-27

Family

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Family Applications (1)

Application Number Title Priority Date Filing Date
EP09711669A Withdrawn EP2242425A1 (fr) 2008-02-20 2009-01-21 Installation de mammographie et procédé d analyse sonographique et radiographique d une poitrine

Country Status (4)

Country Link
US (1) US20110087098A1 (fr)
EP (1) EP2242425A1 (fr)
DE (1) DE102008009967A1 (fr)
WO (1) WO2009103586A1 (fr)

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US10646180B2 (en) * 2017-01-03 2020-05-12 General Electric Company System and method for breast imaging
CN110996801B (zh) 2017-08-11 2023-10-03 豪洛捷公司 具有接近角部的乳房压迫板
DE202018006903U1 (de) * 2017-08-16 2024-07-29 Hologic Inc. Techniken zur Patientenbewegungsartefaktkompensation bei Brustbildgebung
EP3412207B1 (fr) 2017-12-12 2020-04-01 Siemens Healthcare GmbH Imagerie mammaire
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Also Published As

Publication number Publication date
US20110087098A1 (en) 2011-04-14
WO2009103586A1 (fr) 2009-08-27
DE102008009967A1 (de) 2009-09-17

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