Collaboration Drives Advances In Breast Imaging

The RSNA and the American Association of Physicists in Medicine (AAPM) Symposium is an annual event that, in the words of session moderator James M. Kofler, Jr., PhD, assistant professor of medical physics at the Mayo Clinic in Jacksonville, FL, highlights successful collaborations between physicists and clinicians in technical developments and clinical translations in medical imaging.

This year’s session showcased the important role that teamwork has played in the major advances in breast imaging achieved at the University of California (UC), Davis. 

“Looking back over the past two and a half decades, we can credit several factors that have been very important in our synergy and collaboration,” said Shadi Aminolama-Shakeri, MD, chief of the Division of Breast Radiology and professor in the Department of Radiology at UC Davis. “And those are that we, together as physicists, radiologists, technologists and staff, all work toward a common goal by bringing our complementary expertise together.”

From Teamwork to Trailblazing Tech

Dr. Shakeri and medical physicist John M. Boone, PhD, professor of radiology and biomedical engineering at UC Davis, highlighted four major research projects at their institution that have advanced the science of breast imaging.

First, was the NIH-funded Digital Mammography Imaging Screening Trial (DMIST), conducted from 2001 to 2004. The trial showed that, for women with dense breast tissue, digital imaging significantly outperformed film.

Calling the researchers “innovators at the beginning of a new era,” Dr. Boone said, “Our site made a significant contribution to the trial, and in the process, the breast imaging team gained valuable experience in efficiently managing clinical research.” 

“DMIST really modernized the clinical as well as research efforts at UC Davis,” Dr. Shakeri said. “It paved the way for our CT trials because it taught us how to come together and make a trial work.” 

Even as DMIST was underway, Dr. Boone and colleagues pioneered the development of a dedicated breast CT scanner. The research culminated in the first cone-beam breast CT scan on a volunteer in late 2004. Over the next two decades, more than 450 patients were imaged in UC Davis-based clinical trials using four successive prototype scanners. 

“Everybody had input on everything from what type of padding they should use on the tabletop to protocol design, IRB submission and even data entry,” Dr. Shakeri said. “This sustained effort was only possible through the close collaboration of radiologists, physicists, technologists and graduate students who worked together over 25 years.” 

The subsequent development of contrast enhanced breast CT and breast tomosynthesis enabled further advances in breast imaging. The UC Davis team developed multi-X-ray source array technology, a promising approach for breast tomosynthesis that eliminates mechanical source motion, shortens scan time and enhances image quality through a stationary planar 22-source array. 

“The collaborative spirit of the radiologists, technologists, staff, students, physicists and consultants, is what drives this research,” Dr. Boone said.

Access the presentation, “AI-Driven Case Supplementation Augments and Diversifies Resident Training Exposure to Important Pathology: Initial Experience in Precision Education,” (S3B-SPIN-3) on demand at RSNA.org/MeetingCentral.