Mammography Tomosynthesis Using a Coupled Source And
MAMMOGRAPHY TOMOSYNTHESIS USING A COUPLED SOURCE AND DETECTOR IN A C-ARM CONFIGURATION JOSEPH TOBIAS RAKOWSKI MEDICAL COLLEGE OF OHIO 2004 ACKNOWLEDGEMENTS I want to express my gratitude to my advisor, Michael J. Dennis, for his guidance; to Patti McCann and Richard Lane in the Department of Anatomy for providing the specimens; to Diane Ammons for editing my dissertation; to the members of my dissertation committee; and to the Medical College for providing this opportunity. I dedicate this to my family who taught me the value of education, and to my loving and patient wife, Linda, and my super son, Joseph Aaron. ii TABLE OF CONTENTS Acknowledgements ii Table of Contents iii Introduction 1 Literature 6 Materials 8 Methods 10 Results 32 Discussion 99 Summary 109 Conclusions 111 Bibliography 112 Appendix A 120 Appendix B 133 Abstract 145 iii INTRODUCTION Mammography is, by far, the best diagnostic tool for detecting early stage breast cancer (Baker, 1982). Tabar et al. (1987) demonstrated the importance of early detection in saving lives (Tabar, 1987). However, despite the technological and quality improvements in recent years, 10 - 30% of breast cancers are not detected, while other cancers are not detected early enough to allow effective treatment (Bassett et al., 1987; Baines et al., 1986; Haug et al., 1987). The primary reason for missed diagnosis is that the cancer is often obscured by fibroglandular breast tissue that is radiographically dense (Holland et al., 1982, 1983; Martin et al., 1979; Feig et al., 1977; Ma et al.,1992; Jackson et al., 1993; Bird et al., 1992; Mandelson et al., 2000; White, 2000; Boyd et al., 1998; Rosenberg et al., 1998; van Gils et al., 1998).
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