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目的正常组织和肿瘤组织之间较低的对比度是钼靶和CT乳腺成像的一个限制因素。与基于吸收系数的技术相比,相位对比CT(PC-CT)可以提高软组织的对比度。本研究旨在评估基于光栅的PC-CT乳腺成像对于导管原位癌(DCIS)的显示能力。方法采用单色辐射23keV,对具有浸润性导管癌和DCIS的乳腺标本行基于光栅的PC-CT扫描,对相位对比和基于吸收系数的影像进行定性和定量的双盲组织病理学比较。结果基于光栅的PC-CT提高了软组织成分的对比度。在对比噪声比(CNR)为9.6时,PC-CT显示的高相移对比的环状结构与DCIS扩张的导管壁对应;但CNR为0.27时,基于吸收系数的CT影像无法显示这种结构。在PC-CT容积数据中呈高相移的扩张小管结构可以进行DCIS的三维重建。结论结果表明与常规CT不同,基于光栅的PC-CT可以鉴别浸润性导管癌、导管原位癌和正常乳腺组织,并可显示三维的DCIS。要点①相位对比CT应用提高了软组织的对比。②这种方法可以很好地显示乳腺肿瘤的细微结构。③浸润性导管癌和导管原位癌可被鉴别。④通过显示和定量可以进行鉴别诊断。⑤这种方法可提高乳腺癌的早期诊断率。
Objective Lower contrast between normal and tumor tissue is a limiting factor in mammography and CT breast imaging. Phase contrast CT (PC-CT) improves soft tissue contrast compared to absorption coefficient based techniques. The aim of this study was to evaluate the ability of grating-based PC-CT mammography for the display of ductal carcinoma in situ (DCIS). Methods The monolayer radiation of 23 keV was performed on a breast cancer specimen with invasive ductal carcinoma and DCIS by a grating-based PC-CT scan. Qualitative and quantitative double-blind histopathological studies of phase contrast and absorption coefficient-based images were performed. Results The grating-based PC-CT improves the contrast of soft tissue components. At a CNR of 9.6, PC-CT showed a ring-shaped structure with high phase contrast and DCIS-dilated catheter wall. However, CTR based on absorption coefficient did not show this structure at CNR of 0.27. Three-dimensional reconstruction of DCIS can be performed with an expanded tubular structure that is highly phase-shifted in PC-CT volumetric data. Conclusions The results show that, unlike conventional CT, grating-based PC-CT can discriminate invasive ductal carcinoma, ductal carcinoma in situ and normal breast tissue, and can display three-dimensional DCIS. Point ① phase contrast CT application to improve the soft tissue contrast. ② This method can well show the fine structure of breast tumors. ③ invasive ductal carcinoma and ductal carcinoma in situ can be identified. ④ through the display and quantitative diagnosis can be carried out. ⑤ This method can improve the early diagnosis of breast cancer.