Application of Imaging Technologies in Breast Cancer Detection: A Review Article

Abstract

One of the techniques utilised in the management of cancer in all stages is multiple biomedical imaging. Imaging as an important part of cancer clinical protocols can provide a variety of information about morphology, structure, metabolism and functions. Application of imaging technics together with other investigative apparatus including in fluids analysis and vitro tissue would help clinical decision-making. Mixed imaging techniques can provide supplementary information used to improve staging and therapy planning. Imaging aimed to find minimally invasive therapy to make better results and reduce side effects. Probably, the most important factor in reducing mortality of certain cancers is an early diagnosis of cancer via screening based on imaging. The most common cancer in women is breast cancer. It is considered as the second major cause of cancer deaths in females, and therefore it remained as an important medical and socio-economic issue. Medical imaging has always formed part of breast cancer care and has used in all phases of cancer management from detection and staging to therapy monitoring and post-therapeutic follow-up. An essential action to be performed in the preoperative staging of breast cancer based on breast imaging. The general term of breast imaging refers to breast sonography, mammography, and magnetic resonance tomography (MRT) of the breast (magnetic resonance mammography, MRM). Further development in technology will lead to increase imaging speed to meet physiological processes requirements. One of the issues in the diagnosis of breast cancer is sensitivity limitation. To overcome this limitation, complementary imaging examinations are utilised that traditionally includes screening ultrasound, and combined mammography and ultrasound. Development in targeted imaging and therapeutic agents calls for close cooperation among academic environment and industries such as biotechnological, IT and pharmaceutical industries.

Keywords: Breast Imaging; Breast Scintimammography; Cancer detection; Mammography; Ultrasonography MRI.

Figure 1

The role of Imaging in cancer management [4]

Figure 2

Map of translational research based on practice. (The working model of bench-to-bedside translational research is described in this diagram); Forward Translation: Molecular explorations translated into the clinical application; Reverse Translation: Scientific questions arise from relevant clinical findings resulted in research progress

Figure 3

Time/severity curves of breast MR contrast uptake (derived from; Riham H. et al., [48])

Figure 4-1

An instance case of metastatic breast cancer; A) The anterior and posterior projections of the patient, focal zones of hot uptake at D1, L2 and right aspect of the manubrium sterni are shown in a bone scan; B) Sagittal T1W image of the dorsolumbar spine. A sizable hypointense marrow lesion can be seen in the right posterolateral aspect of the L2 vertebra. Further, a pedicle with expansion and extra-osseous soft tissue component are demonstrated; C) Axial T2W image at L2 level. Right sided infiltrative process with intra and retrospinal soft tissue extensions are shown; D) Sagittal T1W image of the cervical spine. Hypointense metastatic lesions at C5 and D1 are demonstrated

Figure 4-2

The previous case of metastatic breast cancer; A) WB-MRI coronal T1W image. The primary breast lesion can be seen at upper inner quadrant of the right breast. It is showed by dark signal and irregular outlines; B) Corresponding axial inverted DWI. Breast lesion are shown as a flared out zone of evident diffusion restriction. The mean ADC value of the zone is 0.91 x 10-3 mm2/sec; C) & D) Axial inverted DWI at different levels. The pulmonary nodules are shown as rounded focal zones of diffusion restriction at lateral segment of right middle lung lobe C) and posterior segment of left lower lung lobe D) giving a low mean ADC value ranging between 0.97 and 1.03 x 10-3 mm2/sec

Figure 5

Schematic of receptor targeted nuclear imaging. Ligands can bind those targets that are overexpressed on breast cancer (BC) cells. These ligands can be joint to a chelator, mostly by a linker

Figure 6

Imaging of a breast lesion using MRI anatomic image and proton spectroscopy. (Derived from; Haddadin et al. [69]); A) Magnetic resonance spectroscopy derived from a post-contrast gradient echo MRI of a 51-year-old woman with invasive ductal carcinoma; B) Detected Areas with doubtful masses; C) The resonances of corresponding water and lipid suppressed spectrum acquired

Figure 7

Ductal carcinoma in situ of the left breast, comedo, solid and cribriform type [81]. A) Mammography, medio-lateral projection. Microcalcifications (transparent arrow) behind the nipple; B) Scinti-mammography, left lateral projection: 99m Tc-(V) DMSA at 10 min and 60 min (i-ii)