Towards clinical grating-interferometry mammography

  • Carolina ArboledaEmail author
  • Zhentian Wang
  • Konstantins Jefimovs
  • Thomas Koehler
  • Udo Van Stevendaal
  • Norbert Kuhn
  • Bernd David
  • Sven Prevrhal
  • Kristina Lång
  • Serafino Forte
  • Rahel Antonia Kubik-Huch
  • Cornelia Leo
  • Gad Singer
  • Magda Marcon
  • Andreas Boss
  • Ewald Roessl
  • Marco Stampanoni



Grating-interferometry-based mammography (GIM) might facilitate breast cancer detection, as several research works have demonstrated in a pre-clinical setting, since it is able to provide attenuation, differential phase contrast, and scattering images simultaneously. In order to translate this technique to the clinics, it has to be adapted to cover a large field-of-view within a clinically acceptable exposure time and radiation dose.


We set up a grating interferometer that fits into a standard mammography system and fulfilled the aforementioned conditions. Here, we present the first mastectomy images acquired with this experimental device.

Results and conclusion

Our system performs at a mean glandular dose of 1.6 mGy for a 5-cm-thick, 18%-dense breast, and a field-of-view of 26 × 21 cm2. It seems to be well-suited as basis for a clinical-environment device. Further, dark-field signals seem to support an improved lesion visualization. Evidently, the effective impact of such indications must be evaluated and quantified within the context of a proper reader study.

Key Points

• Grating-interferometry-based mammography (GIM) might facilitate breast cancer detection, since it is sensitive to refraction and scattering and thus provides additional tissue information.

• The most straightforward way to do grating-interferometry in the clinics is to modify a standard mammography device.

• In a first approximation, the doses given with this technique seem to be similar to those of conventional mammography.


Mammography Phase contrast Interferometry 



Digital breast tomosynthesis




Differential phase-contrast




Grating interferometry


Grating-interferometry-based mammography


Mean glandular dose


Magnetic resonance imaging




X-ray phase-contrast imaging


Signal-to-noise ratio





The authors thank Gordan Mikuljan for his help during setup commissioning.


This study has received funding by the ERC grant ERC-2012-StG 310005 “PhaseX,” the SNF-Sinergia CRS112-154472 “MedXPhase” and SNF-Sinergia CRSII5_183568 “GI-BCT” grants, and the SNF R’Equip grant 206021_177036 “Displacement Talbot Lithography for micro and nanopatterning.”

Compliance with ethical standards


The scientific guarantor of this publication is Prof. Dr. Marco Stampanoni.

Conflict of interest

The authors of this manuscript declare relationships with the following companies: Philips.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional Review Board approval was obtained.


  1. 1.
    Independent UK Panel on Breast Cancer Screening (2012) The benefits and harms of breast cancer screening: an independent review Lancet 380(9855):1778–1786Google Scholar
  2. 2.
    Boyd NF, Guo H, Martin LJ et al (2007) Mammographic density and the risk and detection of breast cancer. N Engl J Med 356:227–236CrossRefGoogle Scholar
  3. 3.
    Slanetz PJ, Freer PE, Birdwell RL (2015) Breast density legislation-practical considerations. N Engl J Med 372:593–595CrossRefPubMedGoogle Scholar
  4. 4.
    Ho JM, Jaerjee N, Covarrubias GM, Ghesani M, Handler B (2014) Dense breasts: a review of reporting legislation and available supplemental screening options. AJR Am J Roentgenol 203(2):449–456CrossRefPubMedGoogle Scholar
  5. 5.
    Lee CI, Cevik M, Alagoz O et al (2015) Comparative effectiveness of combined digital mammography and tomosynthesis screening for women with dense breasts. Radiology 274(3):772–780CrossRefPubMedGoogle Scholar
  6. 6.
    Gweon HM, Cho N, Kim SY et al (2017) Management for BI-RADS category 3 lesions detected in preoperative breast MR imaging of breast cancer patients. Eur Radiol 27:3211–3216CrossRefPubMedGoogle Scholar
  7. 7.
    Kopans DB (2013) Digital breast tomosynthesis: a better mammogram. Radiology 267(3):968–969CrossRefPubMedGoogle Scholar
  8. 8.
    Stampanoni M, Wang Z, Thüring T et al (2011) The first analysis and clinical evaluation of native breast tissue using differential phase-contrast mammography. Invest Radiol 46(12):801–806Google Scholar
  9. 9.
    Hauser N, Wang Z, Kubik-Huch R et al (2013) A study on mastectomy samples to evaluate breast imaging quality and potential clinical relevance of differential phase contrast mammography. Invest Radiol 49(3):131–137CrossRefGoogle Scholar
  10. 10.
    Anton G, Bayer F, Beckmann MW et al (2013) Grating-based dark-field imaging of human breast tissue. Z Med Phys 23(3):228–235CrossRefPubMedGoogle Scholar
  11. 11.
    Scherer K, Willer K, Gromann L et al (2015) Toward clinically compatible phase-contrast mammography. PLoS One 10(6):e0130776CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Munro PR, Ignatyev K, Speller RD, Olivo A (2010) Design of a novel phase contrast X-ray imaging system for mammography. Phys Med Biol 55:4169–4185CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Olivo A, Gkoumas S, Endrizzi M et al (2013) Low-dose phase contrast mammography with conventional X-ray sources. Med Phys 40(9):090701Google Scholar
  14. 14.
    Perry N, Broeders M, De Wolf C, Törnberg S, Holland R, Von Karsa L (2006) European guidelines for quality assurance in breast cancer screening and diagnosis, fourth edition, European communitiesGoogle Scholar
  15. 15.
    Roessl E, Daerr H, Koehler T, Martens G, van Stevendaal U (2014) Clinical boundary conditions for grating-based differential phase-contrast mammography. Philos Trans A Math Phys Eng Sci 372:20130033Google Scholar
  16. 16.
    Koehler T, Daerr H, Martens G et al (2015) Slit-scanning differential X-ray phase-contrast mammography: proof-of-concept experimental studies. Med Phys 42(4):1959–1965CrossRefPubMedGoogle Scholar
  17. 17.
    Arboleda C, Wang Z, Koehler T et al (2017) Sensitivity-based optimization for the design of a grating interferometer for clinical X-ray phase contrast mammography. Opt Express 25(6):6349–6364CrossRefPubMedGoogle Scholar
  18. 18.
    Kagias M, Wang Z, Guzenko VA, David C, Stampanoni M, Jefimovs K (2019) Fabrication of Au gratings by seedless electroplating for X-ray grating interferometry. Mater Sci Semicond Process 92:73–79Google Scholar
  19. 19.
    Revol V, Kottler C, Kaufmann R et al (2011) X-ray interferometer with bent gratings: towards larger fields of view. Nucl Instrum Methods Phys Res Sect A 648:S302–S305CrossRefGoogle Scholar
  20. 20.
    Roessl E, Koehler T, van Stevendaal U et al (2012) Image fusion algorithm for differential phase contrast imaging. Proc. SPIE 8313. Medical Imaging 2012: Physics of Medical Imaging 831354Google Scholar
  21. 21.
    Stahl M, Aach T, Dippel S (2000) Digital radiography enhancement by nonlinear multiscale processing. Med Phys 27(1):56–65CrossRefPubMedGoogle Scholar
  22. 22.
    Scherer K (2016) Microcalcification assessment with dark-field mammography. In: Scherer K (ed) Grating-based X-ray phase-contrast mammography, 77–93, SpringerGoogle Scholar
  23. 23.
    Wang Z, Hauser N, Singer G et al (2014) Non-invasive classification of microcalcifications with phase contrast X-ray mammography. Nat Commun 5:3797CrossRefPubMedGoogle Scholar
  24. 24.
    Wang Z, Hauser N, Singer G et al (2016) Correspondence: reply to ‘Quantitative evaluation of X-ray dark-field images for microcalcification analysis in mammography’. Nat Commun 7:10868CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Fredenberg E, Dance DR, Willsher P et al (2013) Measurement of breast-tissue x-ray attenuation by spectral mammography: first results on cyst fluid. Phys Med Biol 58(24):8609CrossRefPubMedGoogle Scholar
  26. 26.
    Genaro G, Bernardi D, Houssami N (2018) Radiation dose with digital breast tomosynthesis compared to digital mammography: per-view analysis. Eur Radiol 28(2):573–581CrossRefGoogle Scholar

Copyright information

© European Society of Radiology 2019

Authors and Affiliations

  • Carolina Arboleda
    • 1
    • 2
    Email author
  • Zhentian Wang
    • 1
    • 2
  • Konstantins Jefimovs
    • 1
    • 2
  • Thomas Koehler
    • 3
  • Udo Van Stevendaal
    • 4
  • Norbert Kuhn
    • 3
  • Bernd David
    • 3
  • Sven Prevrhal
    • 3
  • Kristina Lång
    • 1
    • 2
  • Serafino Forte
    • 5
  • Rahel Antonia Kubik-Huch
    • 5
  • Cornelia Leo
    • 6
  • Gad Singer
    • 7
  • Magda Marcon
    • 8
  • Andreas Boss
    • 8
  • Ewald Roessl
    • 3
  • Marco Stampanoni
    • 1
    • 2
  1. 1.ETH ZurichZurichSwitzerland
  2. 2.Paul Scherrer InstituteVilligenSwitzerland
  3. 3.Philips Research HamburgHamburgGermany
  4. 4.HAW HamburgHamburgGermany
  5. 5.Department of RadiologyKantonsspital BadenBadenSwitzerland
  6. 6.Interdisciplinary Breast CenterKantonsspital BadenBadenSwitzerland
  7. 7.Department of PathologyKantonsspital BadenBadenSwitzerland
  8. 8.Institute for Diagnostic and Interventional RadiologyUniversitätspital ZurichZurichSwitzerland

Personalised recommendations