British Journal of Radiology (2004) 77, S201-S208
© 2004 British Institute of Radiology
doi: 10.1259/bjr/66587930
Fusion of contrast-enhanced breast MR and mammographic imaging data
C P Behrenbruch, PhD1,3,6,
K Marias, PhD1,2,
P A Armitage, PhD1,
M Yam, PhD1,
N R Moore, MD, FRCP, FRCR3,
R E English4,
P J Clarke, MD, FRCS5,
F J Leong, MD, PhD, ARPS6 and
J M Brady, PhD, FRS, FREng1
1 Medical Vision Laboratory, Engineering Science, Oxford University, Parks Road, Oxford OX1 3PJ, 2 Department of Surgery, Royal Free and University College Medical School, UCL, London NW3 2QG, 3 Magnetic Resonance Imaging Centre, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, 4 Breast Care Unit and 5 Department of Surgery, Churchill Hospital, Oxford OX3 7LJ and 6 Mirada Solutions Ltd, Level 1, 23–38 Hythe Bridge Street, Oxford OX1 2ET, UK
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Figure 1. (a) A 3D shape reconstruction based on the two uncompressed mammogram views (elliptical volume interpolation between views). Due to the fact that both the cranial-caudal and medial lateral oblique planes are compressed, the shape appears somewhat cylindrical. (b) A shape reconstruction based on the technique described in [4]. (c) The shape of the breast based on the two mammograms registered to the MRI volume projections.
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Figure 2. (A) and (D) are the original cranial-caudal and medial-lateral oblique mammograms, respectively. (B) and (E) show the segmented MRI functional projections. (C) and (F) depict the original mammograms registered to the MRI projections based on the shape of Figure 1c .
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Figure 3. Initial assessment of the mammograms with the suspected region of interest highlighted by the clinician in the lateral mammogram (b) along with a corresponding region in a slice of the contrast-entranced MRI volume (c). No lesion was obviously apparent in the cranial–caudal mammogram (a).
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Figure 4. Registration results between both mammogram views and the MRI projection with corresponding region of interest location highlighted.
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Figure 5. The initial clinical assessment of the extended cranial-caudal mammogram (a) did not reveal any suspicious regions of interest. The medial-lateral oblique mammogram (b) was determined to have a slightly denser region (circled) but did not reveal any pathology with needle biopsy. After registration with the contrast-entranced MRI projections, the centroid of the region visible in the MRI was projected back onto the mammograms (indicated by +). Biopsy of this region tested positive for malignancy.
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Figure 6. 4 years of patient mammograms registered using the techniques described in [9]. At year 4, three clusters of calcifications are visible in both the cranial-caudal (top row) and medial-lateral oblique (bottom row) mammograms. Comparing the location of cluster "1" to the surgical excision area (circled regions in the mammograms of year 2) suggests calcification due to surgical scarring rather than malignancy.
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Figure 7. 3D visualizations of the location of the three calcification clusters in the reference frame of the MRI volume (labelled according to the previous figure).
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Figure 8. A rendering of the MRI volume (post-contrast sagittal acquisition) with the region corresponding to calcifications in the mammograms indicated by arrows. In terms of understanding the pathology, 3D morphology is much more meaningful than a slice-based representation. Additionally, models such as this may provide the surgeon with a useful location reference during excision.
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Copyright © 2004 by the British Institute of Radiology.
