The genesis for a hands-off breast-imaging advance started with a few simple questions. Duke radiology researcher Martin Tornai, PhD, asked, “Why should a patient undergo an uncomfortable procedure? How can we do this three-dimensionally? How can we do it with lower radiation?”
Tornai combined CT, which creates high-quality 3-D images, with SPECT, a 3-D nuclear imaging scan that identifies tumors illuminated by an injected radioactive molecule. CT shows the structure of organs, while SPECT shows how organs work, he explained.
Together, the 3-D images display clear differences between ragged cancerous tumors and smoother, benign masses. “Because our images have a high level of conspicuity,” he says, referring to their ability to distinguish things, “we can see if a lesion has what looks to be the legs of a crab, which is what ‘cancer’ is named for. We can also determine what’s going on with the metabolism of that suspicious area.” This helps doctors understand how quickly the cancer is growing or spreading to nearby areas.
That level of definition cannot be viewed on a regular X-ray mammogram, although it can, to some degree, with the newest generation of mammography -- tomosynthesis -- which is not-quite CT with X-ray. Tomosynthesis still requires breast compression.