Integrated PET+DBT for optimization of breast cancer therapy

Building on our previous work, we are proposing an innovative dual-mode breast cancer scanner combining positron emission tomography (PET) and x-ray tomosynthesis (XT). Patient-specific evaluation of breast cancer therapy has become a compelling application of quantitative positron emission tomography (PET) imaging. With the advent of neoadjuvant therapies, it has been shown

repeatedly over the last decade by at least 11 studies that molecular imaging with clinical PET scanners can be used to gauge response of breast tumors to therapies within days. In this approach, a window of opportunity between diagnosis and surgery allows early evaluation of the effectiveness of the planned adjuvant therapy

before breast cancer resection. After a baseline PET image followed by a subclinical dose of the planned therapy, a second PET scan can be used to evaluate treatment response. If there is no response then there is time to test second-line and other alternative therapies and to guide the selection of an effective post-surgical

adjuvant therapy. Dedicated breast-imaging PET scanners have been proposed and evaluated since the late 1980s. Despite the sustained level of interest, clinical breast PET imaging with whole-body (WB) PET scanners has had little adoption, a reflection of the challenges of using breast PET imaging in the diagnostic setting.

Our approach instead is to focus on the quantitative assessment of response to breast cancer therapy, a unique advantage of PET imaging. However, this advantage is lost when imaging small objects (< 2 cm) in whole-body (WB) PET scanners due to limited resolution. This has created a mismatch between current

technological capability and clinical need: WB-PET is accurate down to roughly 2 cm, but lesions