Abstract
The twinkling artifact is well known as a color Doppler artifact but it is still an unresolved phenomenon [Rahmouni et al., Radiology 1996;199:269–271 ; Atan et al., Astas Urol Esp 2001;35:396–402; Kamaya et al., AJR 2003;80:215–222]. Many factors affect the appearance of the twinkling artifact, such as the surface roughness of stones creating multiple reflections and a form of intrinsic noise known as clock jitter within the Doppler circuitry of the ultrasound equipment. However, no studies have reported on the twinkling artifact of breast microcalcifications. While considering these premises, I detected microcalcifications in the breast using twinkling artifacts that could not be detected on B-mode imaging. The twinkling artifact is a well-defined but not well-understood phenomenon that may assist in the detection of calcified foci. The phenomenon of the twinkling artifact is discussed here with regard to prospectively and retrospectively studied cases including experiments with a new ultrasound modality called multidetector-ultrasonography (MD-US). MD-US using detectability of the twinkling artifact in microcalcifications of the breast may play an important role in breast screening.
References
Rahmouni A, Bargoin R, Herment A, et al. Color Doppler twinkling artifact in hyperechoic regions. Radiology. 1996;199:269–71.
Atan C, Hocoglu H, Hosar S, et al. Role of twinkling artifact in characterization of urinary calculi. Astas Urol Esp. 2001;35:396–402.
Kamaya A, Tuthill T, Rubin JM. Twinkling artifact on color Doppler sonography: dependence on machine parameters and underlying cause. AJR. 2003;80:215–22.
Brannon B. Understand the effects of clock jitter and phase noise on sampled systems. EDN (http://www.edn.com) 2004:87–96.
Gao J, Hentel K, Rubin JM. Correlation between twinkling artifact and color Doppler carrier frequency: preliminary observation in renal calculi. Ultrasound Med Biol. 2012;38:1534–9.
Ikedo Y, Fukuoka D, Hata T, et al. Development of a fully automatic scheme for detection of masses in whole breast ultrasound images. Med Phys. 2007;34:4378–88.
Wojcinski S, Farrokh A, Hille U, et al. The automated breast volume scanner (ABVS): initial experiences in lesion detection compared with conventional handheld B-mode ultrasound: a pilot study of 50 cases. Int J Womens Health. 2011;3:337–46.
Ashizawa K, Kato S, Kumi T, et al. Anthropometrical data of Japanese female students obtained in parallel with Moiré topography. J Human Ergol. 1986;15:167–9.
Nakagomi H, Furuya K, Ohmori M, et al. Proposal of an appropriate interval for screening mammography based on tumor doubling time. J Jpn Assoc Breast Cancer Screen. 2012;21:185–90.
Acknowledgments
The author wishes to acknowledge Kouji Nomura, MD, and Tateo Hanaoka, MD, for having offered clinical cases, and Nami Ishikawa, RMS, Toshihiko Tsuboya, RMS, Kouko Tanabe, RMS, Satoshi Shirakura, RMS, Misaki Fukawa, RMS, Miho Takagi, RMS, Nozomi Kuwahara, RMS, Nomura Hospital in Tokyo, Japan, and Masaru Sakurai, RMS, Takanori Okamura, RMS, Junko Miyamoto, RMS, St. Marianna University Hospital Ultrasound Center, Kawasaki, Japan, for their technical assistance.
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Tsujimoto, F. Microcalcifications in the breast detected by a color Doppler method using twinkling artifacts: some important discussions based on clinical cases and experiments with a new ultrasound modality called multidetector-ultrasonography (MD-US). J Med Ultrasonics 41, 99–108 (2014). https://doi.org/10.1007/s10396-013-0476-x
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DOI: https://doi.org/10.1007/s10396-013-0476-x