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Gatta G, Somma F, Sardu C, De Chiara M, Massafra R, Fanizzi A, La Forgia D, Cuccurullo V, Iovino F, Clemente A, Marfella R, Grezia GD. Automated 3D Ultrasound as an Adjunct to Screening Mammography Programs in Dense Breast: Literature Review and Metanalysis. J Pers Med 2023; 13:1683. [PMID: 38138910 PMCID: PMC10744838 DOI: 10.3390/jpm13121683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 11/10/2023] [Accepted: 11/23/2023] [Indexed: 12/24/2023] Open
Abstract
Purpose: The purpose of this meta-analysis is to investigate the effectiveness of supplementing screening mammography with three-dimensional automated breast ultrasonography (3D ABUS) in improving breast cancer detection rates in asymptomatic women with dense breasts. Materials and Methods: We conducted a thorough review of scientific publications comparing 3D ABUS and mammography. Articles for inclusion were sourced from peer-reviewed journal databases, namely MEDLINE (PubMed) and Scopus, based on an initial screening of their titles and abstracts. To ensure a sufficient sample size for meaningful analysis, only studies evaluating a minimum of 20 patients were retained. Eligibility for evaluation was further limited to articles written in English. Additionally, selected studies were required to have participants aged 18 or above at the time of the study. We analyzed 25 studies published between 2000 and 2021, which included a total of 31,549 women with dense breasts. Among these women, 229 underwent mammography alone, while 347 underwent mammography in combination with 3D ABUS. The average age of the women was 50.86 years (±10 years standard deviation), with a range of 40-56 years. In our efforts to address and reduce bias, we applied a range of statistical analyses. These included assessing study variation through heterogeneity assessment, accounting for potential study variability using a random-effects model, exploring sources of bias via meta-regression analysis, and checking for publication bias through funnel plots and the Egger test. These methods ensured the reliability of our study findings. Results: According to the 25 studies included in this metanalysis, out of the total number of women, 27,495 were diagnosed with breast cancer. Of these, 211 were diagnosed through mammography alone, while an additional 329 women were diagnosed through the combination of full-field digital mammography (FFDSM) and 3D ABUS. This represents an increase of 51.5%. The rate of cancers detected per 1000 women screened was 23.25‱ (95% confidence interval [CI]: 21.20, 25.60; p < 0.001) with mammography alone. In contrast, the addition of 3D ABUS to mammography increased the number of tumors detected to 20.95‱ (95% confidence interval [CI]: 18.50, 23; p < 0.001) per 1000 women screened. Discussion: Even though variability in study results, lack of long-term outcomes, and selection bias may be present, this systematic review and meta-analysis confirms that supplementing mammography with 3D ABUS increases the accuracy of breast cancer detection in women with ACR3 to ACR4 breasts. Our findings suggest that the combination of mammography and 3D ABUS should be considered for screening women with dense breasts. Conclusions: Our research confirms that adding 3D automated breast ultrasound to mammography-only screening in patients with dense breasts (ACR3 and ACR4) significantly (p < 0.05) increases the cancer detection rate.
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Affiliation(s)
- Gianluca Gatta
- Department of Precision Medicine, Università della Campania “Luigi Vanvitelli”, 80131 Napoli, Italy; (G.G.); (M.D.C.); (A.C.)
| | - Francesco Somma
- U.O.C. Neurodiology, ASL Center Naples 1, P.O. Ospedale del Mare, 80147 Naples, Italy;
| | - Celestino Sardu
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Piazza Luigi Miraglia 2, 80138 Naples, Italy; (C.S.); (R.M.)
| | - Marco De Chiara
- Department of Precision Medicine, Università della Campania “Luigi Vanvitelli”, 80131 Napoli, Italy; (G.G.); (M.D.C.); (A.C.)
| | - Raffaella Massafra
- Department of Breast Radiology, Giovanni Paolo II/I.R.C.C.S. Cancer Institute, 70124 Bari, Italy; (R.M.); (A.F.); (D.L.F.)
| | - Annarita Fanizzi
- Department of Breast Radiology, Giovanni Paolo II/I.R.C.C.S. Cancer Institute, 70124 Bari, Italy; (R.M.); (A.F.); (D.L.F.)
| | - Daniele La Forgia
- Department of Breast Radiology, Giovanni Paolo II/I.R.C.C.S. Cancer Institute, 70124 Bari, Italy; (R.M.); (A.F.); (D.L.F.)
| | - Vincenzo Cuccurullo
- Department of Precision Medicine, Università della Campania “Luigi Vanvitelli”, 80131 Napoli, Italy; (G.G.); (M.D.C.); (A.C.)
| | - Francesco Iovino
- Department of Translational Medical Science, School of Medicine, University of Campania Luigi Vanvitelli, 80138 Naples, Italy;
| | - Alfredo Clemente
- Department of Precision Medicine, Università della Campania “Luigi Vanvitelli”, 80131 Napoli, Italy; (G.G.); (M.D.C.); (A.C.)
| | - Raffaele Marfella
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Piazza Luigi Miraglia 2, 80138 Naples, Italy; (C.S.); (R.M.)
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Vegunta S, Kling JM, Patel BK. Supplemental Cancer Screening for Women With Dense Breasts: Guidance for Health Care Professionals. Mayo Clin Proc 2021; 96:2891-2904. [PMID: 34686363 DOI: 10.1016/j.mayocp.2021.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 05/20/2021] [Accepted: 06/08/2021] [Indexed: 11/16/2022]
Abstract
Mammography is the standard for breast cancer screening. The sensitivity of mammography in identifying breast cancer, however, is reduced for women with dense breasts. Thirty-eight states have passed laws requiring that all women be notified of breast tissue density results in their mammogram report. The notification includes a statement that differs by state, encouraging women to discuss supplemental screening options with their health care professionals (HCPs). Several supplemental screening tests are available for women with dense breast tissue, but no established guidelines exist to direct HCPs in their recommendation of preferred supplemental screening test. Tailored screening, which takes into consideration the patient's mammographic breast density and lifetime breast cancer risk, can guide breast cancer screening strategies that are more comprehensive. This review describes the benefits and limitations of the various available supplemental screening tests to guide HCPs and patients in choosing the appropriate breast cancer screening.
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Affiliation(s)
- Suneela Vegunta
- Division of Women's Health Internal Medicine, Mayo Clinic, Scottsdale, AZ.
| | - Juliana M Kling
- Division of Women's Health Internal Medicine, Mayo Clinic, Scottsdale, AZ
| | - Bhavika K Patel
- Division of Breast Imaging, Mayo Clinic Hospital, Phoenix, AZ
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Dong B, Hu Q, He H, Liu Y. Prediction model that combines with multidisciplinary analysis for clinical evaluation of malignancy risk of solid breast nodules. J Int Med Res 2021; 49:3000605211004681. [PMID: 33845599 PMCID: PMC8047088 DOI: 10.1177/03000605211004681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Objective Few studies have systematically developed predictive models for clinical evaluation of the malignancy risk of solid breast nodules. We performed a retrospective review of female patients who underwent breast surgery or puncture, aiming to establish a predictive model for evaluating the clinical malignancy risk of solid breast nodules. Method Multivariable logistic regression was used to identify independent variables and establish a predictive model based on a model group (207 nodules). The regression model was further validated using a validation group (112 nodules). Results We identified six independent risk factors (X3, boundary; X4, margin; X6, resistive index; X7, S/L ratio; X9, increase of maximum sectional area; and X14, microcalcification) using multivariate analysis. The combined predictive formula for our model was: Z=−5.937 + 1.435X3 + 1.820X4 + 1.760X6 + 2.312X7 + 3.018X9 + 2.494X14. The accuracy, sensitivity, specificity, missed diagnosis rate, misdiagnosis rate, negative likelihood ratio, and positive likelihood ratio of the model were 88.39%, 90.00%, 87.80%, 10.00%, 12.20%, 7.38, and 0.11, respectively. Conclusion This predictive model is simple, practical, and effective for evaluation of the malignancy risk of solid breast nodules in clinical settings.
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Affiliation(s)
- Bin Dong
- Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Qiaohong Hu
- Department of ultrasonography, Zhejiang Provincial People's Hospital & People's Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Hongfeng He
- Department of ultrasonography, Zhejiang Provincial People's Hospital & People's Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Ying Liu
- Department of ultrasonography, Zhejiang Provincial People's Hospital & People's Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, China
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First proof-of-concept evaluation of the FUSION-X-US-II prototype for the performance of automated breast ultrasound in healthy volunteers. Arch Gynecol Obstet 2021; 304:559-566. [PMID: 33970324 PMCID: PMC8277634 DOI: 10.1007/s00404-021-06081-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 04/27/2021] [Indexed: 11/23/2022]
Abstract
Purpose The FUSION-X-US-II prototype was developed to combine 3D-automated breast ultrasound (ABUS) and digital breast tomosynthesis in a single device without decompressing the breast. We evaluated the technical function, feasibility of the examination workflow, image quality, breast tissue coverage and patient comfort of the ABUS device of the new prototype. Methods In this prospective feasibility study, the FUSION-X-US-II prototype was used to perform ABUS in 30 healthy volunteers without history of breast cancer. The ABUS images of the prototype were interpreted by a physician with specialization in breast diagnostics. Any detected lesions were measured and classified using BI-RADS® scores. Image quality was rated subjectively by the physician and coverage of the breast was measured. Patient comfort was evaluated by a questionnaire after the examination. Results One hundred and six scans were performed (61 × CC, 23 × ML, 22 × MLO) in 60 breasts. Image acquisition and processing by the prototype was fast and accurate. Breast coverage by ABUS was approximately 90.8%. Sixteen breast lesions (all benign, classified as BIRADS® 2) were identified. The examination was tolerated by all patients. Conclusion The FUSION-X-US-II prototype allows a rapid ABUS scan with mostly high patient comfort. Technical developments resulted in an improvement of quality and coverage compared to previous prototype versions. The results are encouraging for a test of the prototype in a clinical setting in combination with tomosynthesis.
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Green CA, Goodsitt MM, Roubidoux MA, Brock KK, Davis CL, Lau JH, Carson PL. Deformable mapping using biomechanical models to relate corresponding lesions in digital breast tomosynthesis and automated breast ultrasound images. Med Image Anal 2020; 60:101599. [DOI: 10.1016/j.media.2019.101599] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 10/24/2019] [Accepted: 10/31/2019] [Indexed: 11/25/2022]
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Vaughan CL. Novel imaging approaches to screen for breast cancer: Recent advances and future prospects. Med Eng Phys 2019; 72:27-37. [PMID: 31554573 PMCID: PMC6764602 DOI: 10.1016/j.medengphy.2019.09.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 09/02/2019] [Indexed: 02/04/2023]
Abstract
AIM OF THE STUDY Over the past 50 years, the application of mammography - an X-ray of the breast - to screen healthy women has been a successful strategy to reduce breast cancer mortality. The aim of this study was to review the literature on novel imaging approaches that have the potential to replace mammography. METHODS An online literature search was carried out using PubMed, Google Scholar, ScienceDirect and Google Patents. The search keywords included "breast cancer", "imaging" and "screening", with 51 journal articles and five United States patents being selected for review. Seventeen relevant online sources were also identified and referenced. RESULTS In addition to full-field digital mammography (FFDM), a further nine imaging modalities were identified for review. These included: digital breast tomosynthesis (DBT); breast computed tomography (BCT); automated breast ultrasound (ABUS); fusion of FFDM and ABUS; fusion of DBT and ABUS; magnetic resonance imaging (MRI); optical imaging; radio-wave imaging; and tactile sensor imaging. Important parameters were considered: diagnostic success (sensitivity and specificity), especially in dense breasts; time to acquire the images; and capital cost of the equipment. CONCLUSIONS DBT is rapidly replacing FFDM although it still misses invasive cancers in dense tissue. The fusion of ABUS, either with FFDM or DBT, will lead to sensitivity and specificity approaching 100%. The fusion of opto-acoustic imaging with ultrasound holds considerable promise for the future.
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Affiliation(s)
- Christopher L Vaughan
- Medical Imaging Research Unit, Faculty of Health Sciences, University of Cape Town, Observatory, Western Cape 7925, South Africa; CapeRay Medical (Pty) Ltd, Suite 2, 51 Bell Crescent, Westlake Business Park, Cape Town, Western Cape 7945, South Africa.
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Green CA, Goodsitt MM, Brock KK, Davis CL, Larson ED, Lau JH, Carson PL. Deformable mapping technique to correlate lesions in digital breast tomosynthesis and automated breast ultrasound images. Med Phys 2018; 45:4402-4417. [PMID: 30066340 DOI: 10.1002/mp.13113] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 07/22/2018] [Accepted: 07/26/2018] [Indexed: 11/06/2022] Open
Abstract
PURPOSE To develop a deformable mapping technique to match corresponding lesions between digital breast tomosynthesis (DBT) and automated breast ultrasound (ABUS) images. METHODS External fiducial markers were attached to the surface of two CIRS multi-modality compressible breast phantoms (A and B) containing multiple simulated lesions. Both phantoms were imaged with DBT (upright positioning with cranial-caudal compression) and ABUS (supine positioning with anterior-to-chest wall compression). The lesions and markers were manually segmented by three different readers. Reader segmentation similarity and reader reproducibility were assessed using Dice similarity coefficients (DSC) and distances between centers of mass (dCOM ). For deformable mapping between the modalities each reader's segmented dataset was processed with an automated deformable mapping algorithm as follows: First, Morfeus, a finite element (FE) based multi-organ deformable image registration platform, converted segmentations into triangular surface meshes. Second, Altair HyperMesh, a FE pre-processor, created base FE models for the ABUS and DBT data sets. All deformation is performed on the DBT image data; the ABUS image sets remain fixed throughout the process. Deformation was performed on the external skin contour (DBT image set) to match the external skin contour on the ABUS set, and the locations of the external markers were used to morph the skin contours to be within a user-defined distance. Third, the base DBT-FE model was deformed with the FE analysis solver, Optistruct. Deformed DBT lesions were correlated with matching lesions in the base ABUS FE model. Performance (lesion correlation) was assessed with dCOM for all corresponding lesions and lesion overlap. Analysis was performed to determine the minimum number of external fiducial markers needed to create the desired correlation and the improvement of correlation with the use of external markers. RESULTS Average DSC for reader similarity ranged from 0.88 to 0.91 (ABUS) and 0.57 to 0.83 (DBT). Corresponding dCOM ranged from 0.20 to 0.36 mm (ABUS) and 0.11 to 1.16 mm (DBT). Lesion correlation is maximized when all corresponding markers are within a maximum distance of 5 mm. For deformable mapping of phantom A, without the use of external markers, only two of six correlated lesions showed overlap with an average lesion dCOM of 6.8 ± 2.8 mm. With use of three external fiducial markers, five of six lesions overlapped and average dCOM improved to 4.9 ± 2.4 mm. For deformable mapping of Phantom B without external markers analysis, four lesions were correlated of seven with overlap between only one of seven lesions, and an average lesion dCOM of 9.7 ± 3.5 mm. With three external markers, all seven possible lesions were correlated with overlap between four of seven lesions. The average dCOM was 8.5 ± 4.0 mm. CONCLUSION This work demonstrates the potential for a deformable mapping technique to relate corresponding lesions in DBT and ABUS images by showing improved lesion correspondence and reduced lesion registration errors with the use of external fiducial markers. The technique should improve radiologists' characterization of breast lesions which can reduce patient callbacks, misdiagnoses and unnecessary biopsies.
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Affiliation(s)
- Crystal A Green
- Department of Nuclear Engineering and Radiological Sciences, University of Michigan, Ann Arbor, MI, 48109, USA.,Department of Radiology, University of Michigan Health System, Ann Arbor, MI, 48109, USA
| | - Mitchell M Goodsitt
- Department of Nuclear Engineering and Radiological Sciences, University of Michigan, Ann Arbor, MI, 48109, USA.,Department of Radiology, University of Michigan Health System, Ann Arbor, MI, 48109, USA
| | - Kristy K Brock
- Department of Nuclear Engineering and Radiological Sciences, University of Michigan, Ann Arbor, MI, 48109, USA.,Imaging Physics, University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | | | - Eric D Larson
- Department of Radiology, University of Michigan Health System, Ann Arbor, MI, 48109, USA
| | - Jasmine H Lau
- Department of Radiology, University of Michigan Health System, Ann Arbor, MI, 48109, USA
| | - Paul L Carson
- Department of Radiology, University of Michigan Health System, Ann Arbor, MI, 48109, USA
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Larson ED, Lee WM, Roubidoux MA, Goodsitt MM, Lashbrook C, Davis CE, Kripfgans OD, Carson PL. Preliminary Clinical Experience with a Combined Automated Breast Ultrasound and Digital Breast Tomosynthesis System. ULTRASOUND IN MEDICINE & BIOLOGY 2018; 44:734-742. [PMID: 29311005 PMCID: PMC5801205 DOI: 10.1016/j.ultrasmedbio.2017.12.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2017] [Revised: 11/29/2017] [Accepted: 12/03/2017] [Indexed: 06/02/2023]
Abstract
We analyzed the performance of a mammographically configured, automated breast ultrasound (McABUS) scanner combined with a digital breast tomosynthesis (DBT) system. The GE Invenia ultrasound system was modified for integration with GE DBT systems. Ultrasound and DBT imaging were performed in the same mammographic compression. Our small preliminary study included 13 cases, six of whom had contained invasive cancers. From analysis of these cases, current limitations and corresponding potential improvements of the system were determined. A registration analysis was performed to compare the ease of McABUS to DBT registration for this system with that of two systems designed previously. It was observed that in comparison to data from an earlier study, the McABUS-to-DBT registration alignment errors for both this system and a previously built combined system were smaller than those for a previously built standalone McABUS system.
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Affiliation(s)
- Eric D Larson
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA.
| | - Won-Mean Lee
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | | | | | - Chris Lashbrook
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Oliver D Kripfgans
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Paul L Carson
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
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Padia K, Douglas TS, Cairncross LL, Baasch RV, Vaughan CL. Detecting Breast Cancer with a Dual-Modality Device. Diagnostics (Basel) 2017; 7:E17. [PMID: 28335472 PMCID: PMC5373026 DOI: 10.3390/diagnostics7010017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 03/09/2017] [Accepted: 03/16/2017] [Indexed: 11/16/2022] Open
Abstract
Although mammography has been the gold standard for the early detection of breast cancer, if a woman has dense breast tissue, a false negative diagnosis may occur. Breast ultrasound, whether hand-held or automated, is a useful adjunct to mammography but adds extra time and cost. The primary aim was to demonstrate that our second-generation Aceso system, which combines full-field digital mammography (FFDM) and automated breast ultrasound (ABUS) in a single platform, is able to produce improved quality images that provide clinically meaningful results. Aceso was first tested using two industry standards: a Contrast Detail Mammography (CDMAM) phantom to assess the FFDM images, and the CIRS 054GS phantom to evaluate the ABUS images. In addition, 25 women participated in a clinical trial: 14 were healthy volunteers, while 11 were patients referred by the breast clinic at Groote Schuur Hospital. The CDMAM phantom results showed the FFDM results were better than the European Reference (EUREF) standard of "acceptable" and were approaching "achievable". The ABUS results showed a lateral and axial spatial resolution of 0.5 mm and an adequate depth penetration of 80 mm. Our second-generation Aceso system, with its improved quality of clinical FFDM and ABUS images, has demonstrated its potential for the early detection of breast cancer in a busy clinic.
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Affiliation(s)
- Kamila Padia
- Department of Radiology, 2 Military Hospital, Hospital Street, Wynberg 7800, South Africa.
| | - Tania S Douglas
- Medical Imaging Research Unit, University of Cape Town, Observatory 7925, South Africa.
- CapeRay Medical (Pty) Ltd, 51 Bell Crescent, Westlake Business Park 7945, South Africa.
| | - Lydia L Cairncross
- Department of Surgery, Groote Schuur Hospital and University of Cape Town, Observatory 7925, South Africa.
| | - Roland V Baasch
- CapeRay Medical (Pty) Ltd, 51 Bell Crescent, Westlake Business Park 7945, South Africa.
| | - Christopher L Vaughan
- Medical Imaging Research Unit, University of Cape Town, Observatory 7925, South Africa.
- CapeRay Medical (Pty) Ltd, 51 Bell Crescent, Westlake Business Park 7945, South Africa.
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O'Connor MK, Morrow MM, Tran T, Hruska CB, Conners AL, Hunt KN. Technical Note: Development of a combined molecular breast imaging/ultrasound system for diagnostic evaluation of MBI-detected lesions. Med Phys 2017; 44:451-459. [PMID: 28133745 DOI: 10.1002/mp.12043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 10/31/2016] [Accepted: 11/15/2016] [Indexed: 11/10/2022] Open
Abstract
PURPOSE The purpose of this study was to perform a pilot evaluation of an integrated molecular breast imaging/ultrasound (MBI/US) system designed to enable, in real-time, the registration of US to MBI and diagnostic evaluation of breast lesions detected on MBI. METHODS The MBI/US system was constructed by modifying an existing dual-head cadmium zinc telluride (CZT)-based MBI gamma camera. The upper MBI detector head was replaced with a mesh panel, which allowed an ultrasound probe to access the breast. An optical tracking system was used to monitor the location of the ultrasound transducer, referenced to the MBI detector. The lesion depth at which ultrasound was targeted was estimated from analysis of previously acquired dual-head MBI datasets. A software tool was developed to project the US field of view onto the current MBI image. Correlation of lesion location between both modalities with real-time MBI/US scanning was confirmed in a breast phantom model and assessed in 12 patients with a breast lesion detected on MBI. RESULTS Combined MBI/US scanning allowed for registration of lesions detected on US and MBI as validated in phantom experiments. In patient studies, successful registration was achieved in 8 of 12 (67%) patients, with complete registration achieved in seven and partial registration achieved in one patient. In 4 of 12 (37%) patients, lesion registration was not achieved, partially attributed to uncertainty in lesion depth estimates from MBI. CONCLUSION The MBI/US system enabled successful registration of US to MBI in over half of patients studied in this pilot evaluation. Future studies are needed to determine if real-time, registered US imaging of MBI-detected lesions may obviate the need to proceed to more expensive procedures such as contrast-enhanced breast MRI for diagnostic workup or biopsy of MBI findings.
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Affiliation(s)
| | | | - Thuy Tran
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | | | - Amy L Conners
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Katie N Hunt
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
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