A new technology called phase-contrast X-ray imaging may steal mammography's limelight due to its sharper, more detailed and higher-contrast images. Mammography has often been criticized for over-diagnosis, so the new technology might offer a better alternative.

At this year's MEDICA medical trade fair from November 12 to 15 in Dusseldorf, Germany, there will be discussions about these new diagnostic procedures.

Phase-contrast X-ray imaging doesn't only measure the breast to find out how much the tissue absorbs the X-ray radiation like mammography, tomosynthesis and CT do, but it also measures how the tissue laterally deflects the radiation and how it affects the peak-to-valley oscillation of the radiation wave. As a result, its images show structures that would be blurred or unrecognizable with mammography.

Even though full-field digital mammography increases the detection rate of malignant focal lesions by 62 to 82 percent, that rate is still considered fairly low. Additionally, it's not as effective for women with dense breasts and those with a high-risk because of a family history of breast cancer.

Marco Stampanoni, a professor at the Institute for Biomedical Technology at ETH Zurich University, and his team were able to prove that phase-contrast X-ray imaging is able to produce mammograms that can be used to diagnose breast cancer and its preliminary stages with more accuracy than ever before. The hope is that it can make biopsies more precise and improve follow-up exams.

"In comparison to conventional mammography, we hope that the method will better show where a biopsy has to be made within the breast tissue," Dr. Rahel Kubik, professor and head radiologist at the Baden Cantonal Hospital, said in a statement. But she mentions that it still has to be evaluated against a large number of cases before it can do that.

Dr. Susanne Grandl of the Institute for Clinical Radiology at the Hospital of the Ludwig Maximilians University of Munich, states that several studies have proven that phase-contrast imaging techniques have improved breast cancer diagnosis. Microstructures, collagen strands, and microcalcifications were shown with greater sensitivity.

Phase-contrast CT produces high-resolution 3-D image data in a way that was previously only possible within the realm of histology, according to Grandl. Phase-contrast mammography has been shown to provide improved sensitivity and specificity for diagnoses that were previously deemed unclear.

However, whether the technique can be used for breast cancer screening in the future is still to be determined. The only study conducted using phase-contrast mammography in a screening setting did not show that there were any noteworthy benefits regarding sensitivity and recall rate.

But it could be used as an additional option when the diagnosis is unclear for certain scenarios such as for women with dense breasts.

In addition to breast cancer, phase-contrast imaging can be used to stage tumors for oseophagus carcinoma and diagnose focal liver lesions and lung diseases. Researchers at the Helmholtz Center in Munich, the University Hospital of Munich and the Technical University of Munch have recently tested phase-contrast radiography in vivo for the diagnosis of lung diseases for the first time and they found that it can be used to detect diseases early on, such as pulmonary emphysema.

Going forward they are going to evaluate how it can be used in the clinical field to diagnose pulmonary emphysema and lung fibrosis.