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European Radiology

, Volume 25, Issue 2, pp 410–418 | Cite as

Differentiation of BIRADS-4 small breast lesions via Multimodal Ultrasound Tomography

  • G. Zografos
  • P. Liakou
  • D. Koulocheri
  • I. Liovarou
  • M. Sofras
  • S. Hadjiagapis
  • M. Orme
  • V. MarmarelisEmail author
Breast

Abstract

Purpose

To demonstrate the use of a new 3D diagnostic imaging technology, termed Multimodal Ultrasonic Tomography (MUT), for the detection of solid breast lesions < 15 mm in maximum dimension.

Methods and materials

3D MUT imaging was performed on 71 volunteers presenting BIRADS-4 nodules, asymmetrical densities, and architectural distortions in X-ray mammograms, who subsequently underwent biopsy. MUT involved D tomographic imaging of the pendulant breast in a water bath using transmission ultrasound and constructed multimodal images corresponding to refractivity and frequency-dependent attenuation (calibrated relative to water). The multimodal images were fused into composite images and a composite index (CI) was calculated and used for diagnostic purposes. The composite images were evaluated against results of histopathology on biopsy specimens.

Results

Histopathology revealed 22 malignant and 49 benign lesions. The pixels of 22 malignant lesions exhibited high values in both refractivity and attenuation, resulting in CI values > 1. In contrast, 99.9 % of benign lesions and normal tissue pixels exhibited lower values of at least one of the attributes measured, corresponding to CI values < 1.

Conclusions

MUT imaging appears to differentiate small malignant solid breast lesions as exhibiting CI values >1, while benign lesions or normal breast tissues exhibit CI values <1.

Key Points

MUT was able to detect all 22 biopsy-confirmed malignant lesions.

MUT was able to differentiate the malignant from the benign lesions.

Additional MUT detections outside the biopsy area must be evaluated prospectively.

Keywords

Breast cancer detection Ultrasound tomography Multimodal ultrasound Lesion differentiation 3D breast imaging 

Abbreviations

MUT

Multimodal Ultrasound Tomography

BIRADS

Breast Imaging Reporting and Data System

IDC

Invasive ductal carcinoma

DCIS

Ductal carcinoma in situ

CC

Craniocaudal

MLO

Mediolateral oblique

Notes

Acknowledgments

The scientific guarantor of this publication is Professor George Zografos. The authors of this manuscript declare relationships with the following companies: Mastoscopia SA. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Approval, as required, was obtained by the Research Committee of the Hippokration University Hospital, which acts as the institutional review board. Written informed consent was obtained from all subjects (patients) in this study. Methodology: retrospective, observational, performed at one institution.

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Copyright information

© European Society of Radiology 2014

Authors and Affiliations

  • G. Zografos
    • 1
  • P. Liakou
    • 1
  • D. Koulocheri
    • 2
  • I. Liovarou
    • 3
  • M. Sofras
    • 3
  • S. Hadjiagapis
    • 3
  • M. Orme
    • 3
  • V. Marmarelis
    • 3
    • 4
    Email author
  1. 1.Breast UnitUniversity of Athens School of MedicineAthensGreece
  2. 2.Department of RadiologyHippokration HospitalAthensGreece
  3. 3.Mastoscopia S.A.AthensGreece
  4. 4.Department of Biomedical EngineeringUniversity of Southern CaliforniaLos AngelesUSA

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