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A computer-assisted system for handheld whole-breast ultrasonography



Breast ultrasonography (US) presents an alternative to mammography in young asymptomatic individuals and a complementary examination in screening of women with dense breasts. Handheld US is the standard-of-care, yet when used in whole-breast examination, no effort has been devoted to monitoring breast coverage and missed regions, which is the purpose of this study.


We introduce a computer-aided system assisting radiologists and US technologists in covering the whole breast with minimum alteration to the standard workflow. The proposed system comprises a standard US device, proprietary electromagnetic 3D tracking technology and software that combines US visual and tracking data to estimate a probe trajectory, total time spent in different breast segments, and a map of missed regions. A case study, which involved four radiologists (two junior and two senior) performing whole-breast ultrasound in 75 asymptomatic patients, was conducted to test the importance and relevance of the system.


The mean process time per breast was \(74\pm 22\,{\mathrm {s}}\), with no statistically significant difference between the left and the right sides, and slightly longer examination time of junior radiologists. The process time density shows that central parts of the breast have better coverage compared to the periphery. Within the central part, missed regions of minimum detectable size of \(0.09\,{\mathrm {cm}}^2\) occur in \(8\%\) of examinations, and non-negligible \(1\,{\mathrm {cm}}^2\) regions occur in \(3\%\) of cases.


The results of the case study indicate that missed regions are present in handheld whole-breast US, which renders the proposed system for tracking the probe position during examination a valuable tool for monitoring coverage.

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We would like to thank J. Kostková and A. Zita for assisting in the clinical study.


This study was supported by the Technological Agency of the Czech Republic (TA04011392) and by the First Faculty of Medicine, Charles University in Prague (Progres Q28/LF1, UNCE 204065).

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Correspondence to Filip Šroubek.

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The authors declare that they have no conflict of interest.

Ethical standard

This prospective study was performed in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study. Data were collected by the Department of Radiology at Charles University, Prague.

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Šroubek, F., Bartoš, M., Schier, J. et al. A computer-assisted system for handheld whole-breast ultrasonography. Int J CARS 14, 509–516 (2019).

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  • Ultrasound
  • Breast
  • Tracking
  • Coverage
  • Cancer
  • Screening