SenoBright Contrast Enhanced Spectral Mammography Technology Ann-Katherine Carton Sylvie Saab-Puong Matt Suminski White Paper October 2012

SenoBright Contrast Enhanced Spectral Mammography Technology Ann-Katherine Carton Sylvie Saab-Puong Matt Suminski Introduction Women have up to a 1 in 8 (12.5%) lifetime risk of developing breast cancer.1 To improve health outcome, imaging techniques are key in screening, diagnosis and therapy for breast cancer. In a diagnostic setting today, mammography, ultrasound and contrast-enhanced MRI (CE-MRI) are the standard imaging tools to help define suspicious lesions previously seen in screening mammograms. CE-MRI is complementary to mammography and ultrasound since it provides additional functional...

SenoBright is a novel addition to GE Healthcare’s technology solutions delivering a clinically practical CESM technique. The SenoBright functionality is available in a field upgrade on Senographe Essential and Senographe DS. Four key aspects were considered to help support the safety, effectiveness, and practicality of the SenoBright solution: 1. X-ray acquisition spectra to provide high-quality contrastenhanced and morphological images, with highly accurate spatial registration 2. A low patient radiation dose to minimize exposure as much as possible 3. A recombination algorithm to produce images...

3. Recombination algorithm An optimized recombination algorithm on SenoBright is dedicated to process the LE and HE images into iodine images.3 The algorithm, using as input the LE and HE X-ray spectra and the compressed breast thickness, is designed to efficiently suppress the background breast tissue for all breast thicknesses and density patterns, in order to highlight the iodineenhanced areas. The recombination algorithm ensures the visibility of 0.5 mg/cm² iodine areal concentration, corresponding to a lower bound of concentration clinically expected. An iodine image computed with our exclusive...

5. Clinical Summary In the early 1980s, it was shown for the first time that X-ray imaging with an iodinated contrast agent can demonstrate changes in breast vascularity.4,5 Due to the immature technology status, none of the proposed techniques were practical for routine clinical use. Only twenty years later, the advent of digital mammography stimulated interest in contrast-enhanced mammography. Contrast-enhanced digital mammography, using a temporal subtraction technique, was pioneered in 2002 through research collaborations between GE Healthcare and multiple clinical partners.6,7 Images of...

SenoBright Case Study Figure 4a: Original mammography from a 79 y/o patient who presented with palpable mass on left breast. From left: Right cranial-caudal (RCC), Left Cranial-Caudal (LCC), Right Medial-Lateral Oblique (RMLO), and Left Medial-Lateral Oblique (LMLO). No particular findings, but very dense breast tissue. Figure 4b: Ultrasound of the left breast of same patient. Figure 4c: SenoBright Contrast Enhanced Spectral Mammography exam of the same patient. From left: LCC low-energy, LCC Contrast-enhanced, LMLO contrast-enhanced, LMLO low-energy. The contrast-enhanced images clearly localize...

References 1. http://seer.cancer.gov/csr/1975_2009_pops09/results_merged/sect_04_ breast.pdf 2. LW Bassett et al., ACR practice guideline for the performance of screening and diagnostic mammography, 2008 3. S Puong et al., Dual-energy Contrast Enhanced Digital Mammography using a new approach for breast tissue canceling, Proc. SPIE Medical Imaging, vol. 6510, pp. 65102H, 2007 4. LV Ackerman et al. Breast lesions examined by digital angiography. Work in progress. Radiology vol 155, pp.65-68, 1985 5. AC Watt et al. Breast lesions: differential diagnosis using digital subtraction angiography. Radiology,...