Volumetric x-ray coherent scatter imaging of cancer in resected breast tissue: a Monte Carlo study using virtual anthropomorphic phantoms.

Journal Article (Journal Article)

Breast cancer patients undergoing surgery often choose to have a breast conserving surgery (BCS) instead of mastectomy for removal of only the breast tumor. If post-surgical analysis such as histological assessment of the resected tumor reveals insufficient healthy tissue margins around the cancerous tumor, the patient must undergo another surgery to remove the missed tumor tissue. Such re-excisions are reported to occur in 20%-70% of BCS patients. A real-time surgical margin assessment technique that is fast and consistently accurate could greatly reduce the number of re-excisions performed in BCS. We describe here a tumor margin assessment method based on x-ray coherent scatter computed tomography (CSCT) imaging and demonstrate its utility in surgical margin assessment using Monte Carlo simulations. A CSCT system was simulated in GEANT4 and used to simulate two virtual anthropomorphic CSCT scans of phantoms resembling surgically resected tissue. The resulting images were volume-rendered and found to distinguish cancerous tumors embedded in complex distributions of adipose and fibroglandular breast tissue (as is expected in the breast). The images exhibited sufficient spatial and spectral (i.e. momentum transfer) resolution to classify the tissue in any given voxel as healthy or cancerous. ROC analysis of the classification accuracy revealed an area under the curve of up to 0.97. These results indicate that coherent scatter imaging is promising as a possible fast and accurate surgical margin assessment technique.

Full Text

Duke Authors

Cited Authors

  • Lakshmanan, MN; Harrawood, BP; Samei, E; Kapadia, AJ

Published Date

  • August 21, 2015

Published In

Volume / Issue

  • 60 / 16

Start / End Page

  • 6355 - 6370

PubMed ID

  • 26237265

Electronic International Standard Serial Number (EISSN)

  • 1361-6560

Digital Object Identifier (DOI)

  • 10.1088/0031-9155/60/16/6355


  • eng

Conference Location

  • England