"Mammograms project all of the structures on top each other, which essentially makes monocular depth cues useless," Held says.

Mammo in 3-D


As Fujifilm explains it, looking at a stereo 3-D image of a mammogram could give you better visualization of masses or microcalcifications hiding behind overlapping tissues, something that might be especially important for women with mammographically dense breasts. "3-D images enable the internal anatomical breast structures to be identified more clearly than in a 2-D image," the company said on its website.

Stereo information also could help you tell if a mass you're looking at is just one mass or actually two regions, with one in front of the other, Held says. "If you're looking at one image, it could be a brighter spot, it looks like one mass, but with stereo, you'd be more likely to resolve if that bright region was one mass or two masses superimposed on each other," he says.

How the Fujifilm system works

So how does Fujifilm's system work?

First, doctors would have to take X-ray images of the breast, using Fujifilm's digital mammography unit, the Aspire HD Plus (known as the Amulet f abroad, not available yet in the U.S., and sold separately from the workstation). In the model described by Fujifilm, the scanner acquires two images of the breast, each image taken about four degrees apart.

The images are then displayed on the workstation, called the Mammoascent Bi-V 3D. This features two screens, one facing the viewer and another jutting out horizontally from its top, as though it were a kind of visor. The screen on the top gets the image for the right eye, while the screen on the bottom for the left eye. Midway between the two screens is what the company calls a half mirror. By looking through this half mirror while wearing the polarized 3D glasses, a stereoscopic image is created, Fujifilm said.

It should be noted the technique does mean exposing women to 1.3 times the dose of a typical Fujifilm 2-D X-ray mammogram and it takes slightly longer to capture the image, the company said. However, Fujifilm said that the average glandular dose, at 1.39 mGy, is actually lower than a typical digital mammogram scan performed in the U.S., at 1.5 mGy. Also, the company says if the product works as planned, it could lead to a reduction in false positives, and thus less of a need to get a follow-up scan.

Proving effectiveness

Even if 3-D mammography, in principle, has certain advantages, how does it work in practice?

Fujifilm says it's busy acquiring clinical evidence. David Hotchkiss, director of product marketing modality solutions with Fujifilm, told DOTmed News in an emailed statement that the company will have three sites collecting images in the U.S. for clinical trials by the middle of this month. Fuji has also already started studies in Japan in 2010 and in Europe, where the device is commercially available.

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