Breast Cancer

, Volume 23, Issue 2, pp 301–309 | Cite as

Targeted sonography using an image fusion technique for evaluation of incidentally detected breast lesions on chest CT: a pilot study

  • Junko Kousaka
  • Shogo NakanoEmail author
  • Takahito Ando
  • Rie Tetsuka
  • Kimihito Fujii
  • Miwa Yoshida
  • Yukako Shiomi-Mouri
  • Manami Goto
  • Yuko Imai
  • Tsuneo Imai
  • Takashi Fukutomi
  • Eisuke Katsuda
  • Tsuneo Ishiguchi
  • Osamu Arai
Original Article



With increasing use of computed tomography (CT), incidentally detected breast lesions are being encountered more frequently. The aim of our study was to verify the utility of targeted sonography using an image fusion technique, real-time virtual sonography (RVS) that coordinates real-time sonography images with previously obtained CT images using a magnetic position tracking system, for evaluation of incidentally detected breast lesions on chest CT.


Eleven lesions in 11 women with no history of breast cancer who were referred to our unit for assessment of breast lesions incidentally detected on CT were enrolled in this study. To assess the efficacy of targeted sonography using RVS, we analyzed the frequency of sonographic detection of incidentally detected breast lesions and the difference between sonography- and CT-determined diameters.


Using RVS guidance, all 11 lesions were sonographically detected. Ten (91 %) of 11 lesions underwent sonography-guided biopsy, yielding a success rate of 90 % (9/10). The remaining sonography-guided biopsy failure lesion required surgical biopsy for definitive diagnosis; this was performed after RVS was used to mark CT imaging information onto the breast surface. Four (36 %) lesions subsequently proved to be malignant. The mean diameters provided by RVS were 14.9 ± 6.7 mm for sonography and 16.8 ± 7.5 mm for CT (p = 0.538).


Using RVS, a sonographic probe was precisely guided to the lesions. Our results suggest that targeted sonography using RVS is a useful technique for identifying incidentally detected breast lesions on chest CT.


Breast cancer Computed tomography Sonography Real-time virtual sonography Incidentally detected breast lesion 



This study was supported by the Matching Fund Subsidy for Private Universities from the Ministry of Education, Culture, Sports, Science and Technology (MEXT), and Grants-in-Aid for Scientific Research (22591445, 24591922, 25461852, and 25461999) in Japan.

Conflict of interest



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Copyright information

© The Japanese Breast Cancer Society 2014

Authors and Affiliations

  • Junko Kousaka
    • 1
  • Shogo Nakano
    • 1
    Email author
  • Takahito Ando
    • 1
  • Rie Tetsuka
    • 1
  • Kimihito Fujii
    • 1
  • Miwa Yoshida
    • 1
  • Yukako Shiomi-Mouri
    • 1
  • Manami Goto
    • 1
  • Yuko Imai
    • 1
  • Tsuneo Imai
    • 1
  • Takashi Fukutomi
    • 4
  • Eisuke Katsuda
    • 2
  • Tsuneo Ishiguchi
    • 2
  • Osamu Arai
    • 3
  1. 1.Division of Breast and Endocrine Surgery, Department of SurgeryAichi Medical UniversityNagakuteJapan
  2. 2.Department of RadiologyAichi Medical UniversityNagakuteJapan
  3. 3.Medical Systems Engineering Division 2, R&D Section 2 Engineering, R&D Department 1Hitachi Aloka Medical LtdKokubunjiJapan
  4. 4.Department of Breast SurgeryTokyo Saiseikai Central HospitalMinatokuJapan

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