Grating‐based x‐ray dark‐field mammography: Assessing complementary imaging information in simple cystic lesions and typical fibroadenoma.

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Title: Grating‐based x‐ray dark‐field mammography: Assessing complementary imaging information in simple cystic lesions and typical fibroadenoma.
Authors: Hellerhoff, Karin1 (AUTHOR) karinhellerhoff@me.com, Gottwald, Wolfgang2,3 (AUTHOR), Taphorn, Kirsten2,3,4 (AUTHOR), Berthe, Daniel2,3 (AUTHOR), Braun, Michael5 (AUTHOR), Wagner, Kai6 (AUTHOR), Resch, Sandra2,3 (AUTHOR), John, Dominik2,3 (AUTHOR), Heck, Lisa2,3 (AUTHOR), Birnbacher, Lorenz2,3 (AUTHOR), Herzen, Julia2,3 (AUTHOR), Grandl, Susanne1 (AUTHOR)
Source: Medical Physics. Apr2025, Vol. 52 Issue 4, p2145-2154. 10p.
Subjects: Breast imaging, Fibroadenomas, X-rays, Small-angle scattering, Diagnosis, Mammograms, False positive error, Cysts (Pathology)
Abstract: Background: A significant proportion of false positive recalls of mammography‐screened women is due to benign breast cysts and simple fibroadenomas. These lesions appear mammographically as smooth‐shaped dense masses and require the recalling of women for a breast ultrasound to obtain complementary imaging information. They can be identified safely by ultrasound with no need for further assessment or treatment. Purpose: Grating‐based x‐ray dark‐field breast imaging allows contrast formation based on both attenuation and small‐angle x‐ray scattering and provides complementary imaging information in one single acquisition. Methods: Experiments with ex‐vivo mastectomy samples were performed with a three‐grating Talbot‐Lau interferometer using a laboratory‐based polychromatic x‐ray source. Attenuation and dark‐field images were correlated to clinical mammography and complementary diagnostic imaging techniques. Results: Benign breast lesions with homogeneous internal structures such as fibroadenomas and simple fluid‐filled cysts, typically presenting as dense breast lesions in standard mammography, showed a signal drop in the dark‐field image. Complicated cysts provided a higher dark‐field signal. Conclusions: The results presented show that grating‐based x‐ray dark‐field mammography could provide complementary imaging information in one single acquisition, eliminating the need for a second examination to identify harmless cysts and simple fibroadenomas. [ABSTRACT FROM AUTHOR]
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Abstract:Background: A significant proportion of false positive recalls of mammography‐screened women is due to benign breast cysts and simple fibroadenomas. These lesions appear mammographically as smooth‐shaped dense masses and require the recalling of women for a breast ultrasound to obtain complementary imaging information. They can be identified safely by ultrasound with no need for further assessment or treatment. Purpose: Grating‐based x‐ray dark‐field breast imaging allows contrast formation based on both attenuation and small‐angle x‐ray scattering and provides complementary imaging information in one single acquisition. Methods: Experiments with ex‐vivo mastectomy samples were performed with a three‐grating Talbot‐Lau interferometer using a laboratory‐based polychromatic x‐ray source. Attenuation and dark‐field images were correlated to clinical mammography and complementary diagnostic imaging techniques. Results: Benign breast lesions with homogeneous internal structures such as fibroadenomas and simple fluid‐filled cysts, typically presenting as dense breast lesions in standard mammography, showed a signal drop in the dark‐field image. Complicated cysts provided a higher dark‐field signal. Conclusions: The results presented show that grating‐based x‐ray dark‐field mammography could provide complementary imaging information in one single acquisition, eliminating the need for a second examination to identify harmless cysts and simple fibroadenomas. [ABSTRACT FROM AUTHOR]
ISSN:00942405
DOI:10.1002/mp.17603