title: 2D/3D image fusion of X-ray mammograms with breast MRI: visualizing dynamic contrast enhancement in mammograms.
abstract: OBJECTIVE
  Breast cancer is the most common cancer among women. The established screening method to detect breast cancer is X-ray mammography. Additionally, MRI is used for diagnosis in clinical routine. Due to complementary diagnostic information, both modalities are often read in combination. Yet, the correlation is challenging due to different dimensionality of images and different patient positioning. In this paper, we describe a method to fuse X-ray mammograms with DCE-MRI. The present study was conducted to evaluate the feasibility of the approach.
  
  
  METHODS
  For the combination of information from both modalities, the images have to be registered using a compression simulation based on a patient-specific biomechanical model. The registered images can be compared directly. The contrast enhancement in the DCE-MRI volume is evaluated using parametric enhancement maps. A projection image of the contrast enhancement is created. The image fusion combines it with X-ray mammograms for intuitive multimodal diagnosis.
  
  
  RESULTS
  The image fusion was evaluated using 11 clinical datasets. For 10 of 11 datasets, a good accuracy of the image registration was achieved. The overlap of contrast-enhanced regions with marked lesions in the mammogram is 61%. Lesions are clearly differentiable from surrounding tissue by the DCE-MRI projection in 10 of 11 cases.
  
  
  CONCLUSIONS
  The described preliminary results are promising, thus we expect the visualization of quantitative information from dynamic MRI together with mammograms to be beneficial for multimodal diagnosis. Because of the use of clinical standard modalities, no additional image acquisition is needed.
authors.affiliation: Karlsruhe Institute of Technology, Institute for Data Processing and Electronics, Hermann-von-Helmholtz-Platz 1, 76344, Eggenstein-Leopoldshafen, Karlsruhe, Germany. torsten.hopp@kit.edu
authors.forename: Torsten
authors.initials: T
authors.lastname: Hopp
authors.forename: Pascal
authors.initials: P
authors.lastname: Baltzer
authors.forename: Matthias
authors.initials: M
authors.lastname: Dietzel
authors.forename: Werner A
authors.initials: WA
authors.lastname: Kaiser
authors.forename: Nicole V
authors.initials: NV
authors.lastname: Ruiter
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis*; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008279:Magnetic Resonance Imaging; D008327:Mammography / Q000379:methods*; D008875:Middle Aged; D015203:Reproducibility of Results
chemical_list: D003287:Contrast Media