Diagnostics, and Software Reliability
Soon, three-dimensional (3D) images in actual 3D might help doctors find hidden tumors and more effectively diagnose cancers.
The research dream team is led by Division Director Kyle Myers, a physicist with a Ph.D. in optical sciences. Other team members include Aldo Badano, Ph.D., a world-renowned expert in display evaluation technology, and Brian Garra, M.D., a diagnostic radiologist doing research in regulatory science.
These research scientists are studying how clinicians receive visual information and analyze it to diagnose a disease. A primary focus of their research is breast cancer screening devices, which are making the leap from traditional two-dimensional (2D) imagery such as mammography to 3D breast tomosynthesis, 3D ultrasound and breast computerized tomography (CT).
This technology is very exploratory and years from becoming part of standard practice in a medical setting.
The FDA has approved two state-of-the art 3D alternatives that may eventually replace today's 2D mammography: The Selenia Dimensions 3D System, which provides 3D breast tomosynthesis images for breast cancer diagnosis; and the GE Healthcare SenoClaire, which uses a combination of 2D mammogram images and 3D breast tomosynthesis images.
Tomosynthesis reveals sections of the breast that can be hidden by overlapping tissue in a standard mammogram. Overlapping tissue has been a confounding issue in breast cancer screening, on standard mammograms are not able to correct for.
"And compounding the problem is overlapping tissue that can look like cancer but isn't," Myers says. "The new technologies we're studying overcome these barriers."
Also, compared to mammography, 3D breast tomosynthesis can more accurately pinpoint the size and location of cancer tumors in dense breast tissue. With 3D breast tomosynthesis, doctors can detect abnormalities earlier and better see small tumors because the images are clearer and have greater contrast.
"Clinical studies have shown that 3D breast tomosynthesis can increase the cancer detection rate, reduce the number of women sent for biopsy who don't have cancer, or achieve some balance of these two goals of this new screening technology," Myers says.
There's also a lot of research and development in 3D ultrasound, which can improve cancer detection in women with dense breast tissue. 3D ultrasound automatically scans the breast and generates 3D data that can be sliced and examined from any direction.
"Both 3D breast tomosynthesis and 3D ultrasound detect breast cancer," says Garra, who is a leader in this area of research. "But for radiologists and other doctors, there are many more images to examine, and that can reduce the speed at which studies can be interpreted."
Another promising technology—the dedicated breast CT system—creates a full 3D representation of the breast. The scan is taken while the patient lies face down on a bed with her breast suspended through a cup and the X-ray machine rotates around it. For patients, the procedure is more comfortable than regular mammography because the breast isn't compressed. Also, there's less radiation exposure than during a CT exam of the entire chest because only the breast is exposed to X-rays.
There's a learning curve for diagnosticians who will eventually use this technology. They have to learn how to read and interpret hundreds of high-resolution images produced by the scanner. The task is made easier by the simple fact that the images have less distortion than mammography, and the system is optimized to differentiate between the breast's soft tissue and cancer tissue. All of these technologies give doctors a tremendous leap forward in how they see the interior of the breast and their ability to evaluate the structure of the breast.
But where fun and fantasy in a 3D movie or virtual reality game is the expectation, accuracy and clarity are the gold standard for applying the technology to medical uses—the specifications are high because the stakes are high and very real.
"As people have experienced in movie theaters and when playing videogames, 3D displays have problems, including the image resolution and added noise. When wearing 3D glasses, the brain needs to separate the images from the left eye and the right eye and reconstruct a 3D object," Badano says. "In the lab, we're doing experiments to see how different technologies handle these tradeoffs."
To Learn More:
Karen M. Rider, M.A. is a freelance writer with special interests in wellness, health psychology, healthcare news and integrative medicine.
