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Rationale and objectives To evaluate the semi-automatic image registration accuracy of X-ray-mammography (XR-M) with high-resolution high-field (3.0 T) MR-mammography (MR-M) in an initial pilot study. Material and methods MR-M was acquired on a high-field clinical scanner at 3.0 T (T1-weighted 3D VIBE ± Gd). XR-M was obtained with state-of-the-art full-field digital systems. Seven patients with clearly delineable mass lesions >10 mm both in XR-M and MR-M were enrolled (exclusion criteria: previous breast surgery; surgical intervention between XR-M and MR-M). XR-M and MR-M were matched using a dedicated image-registration algorithm allowing semi-automatic non-linear deformation of MR-M based on finite-element modeling. To identify registration errors (RE) a virtual craniocaudal 2D mammogram was calculated by the software from MR-M (with and w/o Gadodiamide/Gd) and matched with corresponding XR-M. To quantify REs the geometric center of the lesions in the virtual vs. conventional mammogram were subtracted. The robustness of registration was quantified by registration of X-MRs to both MR-Ms with and w/o Gadodiamide. Results Image registration was performed successfully for all patients. Overall RE was 8.2 mm (1 min after Gd; confidence interval/CI: 2.0–14.4 mm, standard deviation/SD: 6.7 mm) vs. 8.9 mm (no Gd; CI: 4.0–13.9 mm, SD: 5.4 mm). The mean difference between pre- vs. post-contrast was 0.7 mm (SD: 1.9 mm). Conclusion Image registration of high-field 3.0 T MR-mammography with X-ray-mammography is feasible. For this study applying a high-resolution protocol at 3.0 T, the registration was robust and the overall registration error was sufficient for clinical application.

aDepartment of Neuroradiology, University of Erlangen-Nurnberg, Schwabachanlage 6, D-91054, Germany bDepartment of Radiology, Division of Molecular and Gender Imaging, Medical University Vienna, Wahringer Gurtel 18–20, A-1090, Vienna, Austria c Karlsruhe Institute of Technology (KIT), Institute for Data Processing and Electronics, Postfach 3640, D-76021 Karlsruhe, Germany d Institute of Diagnostic and Interventional Radiology I, Friedrich-Schiller-University Jena, Erlanger Allee 101, D-07740 Jena, Germany

Summary A promising candidate for imaging of breast cancer is ultrasound computer tomography (USCT). The main advantages of a USCT system are simultaneous recording of reproducible reflection, attenuation and speed of sound volumes, high image quality, and fast data acquisition. The here presented 3D USCT prototype realizes for the first time the full potential of such a device. It is ready for a clinical study. Full volumes of a breast can be acquired in four minutes. In this paper images acquired with a clinical breast phantom are presented. The resolution and imaged details of the reflectivity reconstruction are comparable to a 3 tesla MRI volume of the phantom. Image quality and resolution is isotropic in all three dimensions, confirming the successful implementation experimentally.