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Simulations et essais cliniques virtuels pour l'évaluation de la valeur clinique de l'angio-tomosynthèse par rapport à l'angio-mammographie

Abstract : Contrast Enhanced Spectral Mammography (CESM) and Contrast Enhanced Digital Breast Tomosynthesis (CEDBT) are dual-energy X-ray imaging techniques involving the injection of a vascular contrast agent. Both techniques provide information on hypervascularization of lesions through contrast uptake. CESM is a recently introduced imaging application providing a better diagnosis of breast cancer than diagnostic mammography. CEDBT is a promising technique providing three-dimensional information, which may alleviate the limitations of CESM. However, its incremented clinical value, compared to the current CESM exam, is still not well understood. This work aims to assess the performance of each technique to detect and accurately characterize the different contrast uptakes appearing in clinical exams. However, such an evaluation would require a large database of clinical data with a complete representation of diverse contrast uptakes. Instead, the novelty of our proposal lies on the evaluation of both techniques using realistic simulated data. First, we improved the realism of an analytic X-ray simulation tool. Then, we proposed a new model for mass-like contrast uptakes related to breast lesions and natural contrast uptake of the breast anatomy. Finally, we performed a Virtual Clinical Trial evaluating the detectability and characterization performance of CESM and CEDBT using the simulations tools developed in our work. The results obtained show that CEDBT offers a certain added clinical value compared to CESM. As a future work, the clinical results anticipated thanks to the proposed simulation platform should be compared to true clinical evaluations when a real system will be available.
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Submitted on : Monday, September 28, 2020 - 5:54:10 PM
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  • HAL Id : tel-02951607, version 1


Ruben Sanchez de La Rosa. Simulations et essais cliniques virtuels pour l'évaluation de la valeur clinique de l'angio-tomosynthèse par rapport à l'angio-mammographie. Imagerie médicale. Université Paris Saclay (COmUE), 2019. Français. ⟨NNT : 2019SACLT046⟩. ⟨tel-02951607⟩



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