OPTIMAM Objectives

"Optimisation of breast cancer detection using digital X-ray technology"

Illustration of how a mathematical model of the breast may be used to simulate mammograms. (Courtesy of Kristina Bliznakova, University of Patras, Greece)

OPTIMAM's objectives are to optimise the adoption of new X-ray technology for detecting breast cancers and thereby improve early detection of breast cancers in the NHS Screening Programme.

Breast cancer mortality has declined substantially over the last twenty years due to a combination of earlier detection (mainly due to mammography screening) and improved treatments. Despite this success it is recognised that cancer detection by mammography suffers from a number of serious limitations. The advent of new digital X-ray technology holds the prospect of solving some of these problems and improving early detection. The first phase of these technologies replaces analogue film with a variety of digital detectors yielding a digital projection image (2D). More sophisticated techniques are being developed that provide 3D information as slices through the breast. Clinical trials have shown that there may be substantial advantages in using these systems but their relative merits and how best to use them remains unclear. Clinical trials are too expensive and time consuming to enable detailed comparisons between multiple systems or ways of operating those systems and another approach is needed to ensure that the new technologies are adopted in the most appropriate way.

Two examples of micro-calcification clusters inserted into a digital mammogram.

OPTIMAM is developing a framework based on physical measurements on imaging systems to simulate breast images initially for 2D mammography and later for 3D mammography. The appearance of cancers in these images will also be simulated using a 3D breast model in order to measure the performance of radiologists and computer aided detection systems in detecting cancers when different systems, radiation doses, beam qualities, and image processing are employed. This will enable the introduction of digital breast imaging technologies in a way that optimises cancer detection while maintaining radiation doses at acceptable levels. There is considerable potential for an improvement in breast cancer detection rates – particularly for younger women and for women with dense breasts. Such an improvement should lead to a greater mortality reduction and reduced anxiety from unnecessary recalls after initial screening.