乳房デジタルトモシンセシス、 3Dマンモグラフィ：臨床現 …

1 3D . Breast Tomosynthesis, Three-Dimensional X-Ray Breast Imaging Systems : Current Clinical Relevance Yukio Koibuchi Hiroki Odawara . X . 2D . 2D 3D . 2 . Mammogram has been recognized as the best modality to detect early breast cancer. It has been well known that some breast cancers could not be detected in the mammogram by physicians, because the overlap tissues made no different den- sity between breast cancer and normal breast tissues. Without increasing quantity of being exposed to radiation too much, breast tomosynthesis increased the information of the mammogram substantially, especially in the recognition of fine border image and the distribution of microcalcifications.

2 Key Words: Breast Tomosynthesis, Breast Cancer, Digital Mammography, 3D Image 1 . X . 3 HOLOGIC Selenia Dimensions System . 2011 4 . 1 . FDA . 2011 2 . 1 2 . 2010 10 . Selenia Dimensions System .. X . 3 . X 2D. 1 3D .. FBP . 2D.. MEDIX 23. Gur 1 . 2D 2D . 3D 2 5 .. 2 Selenia Dimensions System . 3D .. 2D .. Selenia Dimensions Sys- tem . 3 . 2D . 2D . window width . window level post processing . FDA .. FDA . 1 . 2D FAD . 2D . 2 . MLO . 5 10 . FDA 3 . CC . HOLOGIC 2 . 12 316 4 . MLO . 2D 3D 2D MLO . 2D 3D 2D .. 7 recall 2D .. rate 43 3 Poplack . 2D 3D recall rate 2D.

3 1 .. 40 4 . 3D . 62 . 32 / 52 .. 23 . 12 / 52.. 3D . Gur 2D 3D . recall rate 30 2D 3D . 5 . 2D 3D .. 3D .. 300 premature data 2D . 3D 10 . 2D 3D 1 . 3D 2D MLO. 10 3 . 3D MLO 2D . 2D 3D . 2D 3D . 24 MEDIX . 5 . CC . 2D CC 3D 2D . 6 . 2D . 3D . 7 . 2 MLO CC 2D . 2 .. CAD 2D .. 4 . 2D . 2D .. 3 .. spicula 2D .. 3 4 . pick up . 3D spicula 5 .. 2D 3 4 5 .. X .. 2D .. 1 1 . 2D . 3D . 2D . 3D . 1 2 . 3D 2D .. 3 2D 3D . 2D 2D spicula C-3 4 3D .. spicula C-5 . 2 4 2D 3D . 3D 2D C-3 3D .. spicula C-4 5 . MEDIX 25.. focal asymmetric density FAD .. 7 . 8 9 . 3D . FAD 2D 2D spicula retraction.

4 3D FAD .. FAD .. 6 .. 3D . 2D . 2D .. 1 . spicula . 7 spicula 2D 3D .. spicula C-4 . 5 4 . spicula 8 Architectural distortion 2D 3D .. C-4 . 6 FAD . 2D L FAD C-3 3D .. 9 8 . C-1 spicula . 26 MEDIX . distortion 3D .. spicula .. FBP . X .. Selenia .. 2D 3D .. 3D . 1 Niklason LT, Christian BT, Niklason LE, et al. : Digi- tal tomosynthesis in breast imaging. Radiology, 3D , 1997. 2 Dobbins JT , Godfrey DJ : Digital x-ray tomosynthe- 1 sis ; Current state of the art and clinical potential. Phys. Med. Biol., 48. 19, R 65-106, 2003. 3 Raffetly, EA, Niklason LT, Halpern E, et al.

5 : Assess- . 10 . ing Radiologist Performance Using Combined Full- 2 Field Digital Mammography and Breast Tomosynthe- 3D sis Versus Full-Field Digital Mammography Alone;. over diag- Results of a Multi-Center, Multi-Reader Trial. Ses- nosis 3D sion SSE 26-02, RSNA, 2007. CAD 4 Poplack SP, Tosteson TD, Kogel CA, et al. : Digital Breast Tomosynthesis : Initial Experience in 98. Women with Abnormal Digital Screening Mammogra- phy. AJR 189, 616-623, 2007. 5 Gur D, Abrams GS, Chough DM, et al. : Digital Breast Tomosynthesis : Observer Performance Study. AJR. 193, 586-591, 2009.

6 10 . 2D . 3D .. 5 .. MEDIX 27.