DIEurope Nov 20: Breast CT - a ground-breaking innovation
4Pages

BREAST IMAGING Breast CT - a ground-breaking innovation With a total of thirteen separate clinics, the private radiology practice of “MVZ Prof. Dr. Uhlenbrock & Partner” provides an important clinical imaging service to the Ruhr area of Germany and has a high reputation for clinical excellence and technological innovation. In keeping with its tradition of investing in clinically relevant state-of-the-art technology, the group has recently installed an innovative CT system specifically designed for breast imaging. We wanted to find out more about the radiology practice in general and the new breast CT system in particular, so we spoke to Dr. Karsten Ridder, radiologist in charge of breast imaging. Before we get on to the new breast CT system, please give us a brief background to the MVZ Prof. Dr. Uhlenbrock practice. Where are the individual clinics located –all in North Rhine Westphalia? The practice was founded in 1993 by Prof. Detlev Uhlenbrock and since then has grown and established a reputation as being one of the leading medical centres in the Ruhr area in Westphalia, Germany. As you mentioned in your introduction the practice is composed of 13 individual clinics, most of which are associated with, and linked to, a hospital. Right from its foundation, the mission of the practice has been to offer efficient out-patient facilities but also to cultivate fruitful collaborations with hospitals. In total the practice has more than 450 employees providing services in radiology, radiotherapy, nuclear medicine and laboratory diagnostics, which represent our core competences. Some of these are bundled —for example interventional procedures are only provided at three locations. Each year we see more than 290 000 patients of whom three-quarters are out-patients. We are equipped with a complete range of modern equipment offering all imaging modalities ranging from DR X-Ray to high-end cardiac CT, from plain ultrasound up to PET-CT; and from MSK-MRI up to 3Tesla neuro-imaging. Our philosophy has always been to be ready to take advantage of the latest technologies, provided always that there is a clinical benefit. The installation of the Mamma-CT is a perfect example of this type of thinking and is just the latest of many state-of-the-art innovations we have introduced throughout our history. However it’s not just technology for technology’s sake — we also put a great emphasis on the continuous education and competence of our staff who use the technology. 18 Dr. Karsten Ridder, Breast radiologist in the practice of MZV Prof Dr. Uhlenbrock & Partner. e-mail k.ridder@mvz-uhlenbrock.de Now let’s focus in on breast imaging in your practice. Of all our imaging modalities, mammography was in fact the last to go digital with the acquisition in 2000 of our digital Mammo-System (Siemens CR-System). Since then we have continuously updated and have become a reference-site for Siemens over the last 20 years. Thus, we were the second site world-wide to install digital breast tomosynthesis and were the first clinical practice to implement Contrast-Enhanced Mammography (CEM) a few years ago and, more recently, the titanium-filtered variant of CEM (Ti-CEM). However we are not wedded to any one specific vendor – for example, the four MRI systems in my practice in Dortmund are from Phillips. The nu:view Mamma-CT system was developed and is produced by the German company AB-CT - Advanced Breast CT. The design of the new scanner allows compression-free imaging of one breast at a time. To do this, the breast CT system uses a rotating gantry on which the X-ray tube and photoncounting detector are mounted. During the image acquisition process, the gantry rotates around the breast in a downwards-oriented spiral trajectory. In the course of a single scan up to 12,000 projection images are acquired. A full spiral scan takes as little as 7 – 12 seconds.

But back to breast imaging — we see about 55000 women each year of whom 55% are screening cases (we are now the leading screening center in the Dortmund area). The other 45% of women we see are referred by our local gynecologists or from the clinics we work with. Together all these collaborators form a strong local network which we actively encourage, for example by giving conferences and supporting workshops/webinars, etc., on top of the “normal” daily workload. Thanks to the reputation we have built up in the Ruhr area, nearly 85% of our patients come from the local region. However since...

BREAST IMAGING the world, there have been absolutely no signs of “start of series” hitches or any teething troubles. The system has been robust, stable and reliable ever since its installation which was completed in mid-April. After all technical controls and regulatory compliance aspects were verified, we actually started scanning and examining patients in May 2020. The whole set-up process went extremely smoothly, since in principle it is “plug and play” where all primary reconstructions of the 3D-dataset are carried out on the machine’s software and the DICOM headers and images are...

women undergoing mammography report the pain as “ very strong” – so it’s no surprise that most screening programs do not reach anywhere near 90% participation-rate. So, all in all, how do you sum up your impression so far of the nuview system? How do you see the future ? Performance characteristics of conventional breast imaging modalities compared with the nu:view Mamma- CT system and spectral 3D-CT of the breast are entirely feasible next steps and would bring a whole new dimension to breast diagnostics. I n practice, what criteria do you use to decide which women should be examined using...