US strain imaging can facilitate improved classification of benign and malignant breast masses. However, interobserver variability and image quality influence observer performance.

Results suggest that US strain imaging has the potential to aid diagnosis of breast lesions. However, manually tracing lesion boundaries for size ratio differentiation in a busy clinical setting did not match the diagnostic performance levels previously reported. Focusing on measurements of lesion width, along with additional observer training or automated processes, may yield a suitable method for routine clinical application.

Presurgical mapping of the sensory motor cortex is a potentially useful clinical application of functional MR imaging.

Purpose To assess 12-month outcomes and safety of clinical magnetic resonance (MR)–guided focused ultrasound (US) treatments of uterine leiomyomas. Materials and Methods Between March 2005 and December 2009, 150 women with symptomatic uterine leiomyomas were clinically treated with MR-guided focused US at a single institution; 130 patients completed treatment and agreed to have their data used for research purposes. Patients were followed through retrospective review of medical records and phone interviews conducted at 3-, 6-, and 12-month intervals after treatment to assess additional procedures and symptom relief. Outcome measures and treatment complications were analyzed for possible correlations with the appearance of the tumors on T2-weighted imaging. Results The cumulative incidence of additional tumor-related treatments 12 months after MR-guided focused US was 7.4% by the Kaplan–Meier method. At 3-, 6-, and 12-month follow-up, 86% (90 of 105), 93% (92 of 99), and 88% (78 of 89) of patients reported relief of symptoms, respectively. No statistically significant correlation between tumor appearance on T2-weighted imaging and 12-month outcome was found. Treatment-related complications were observed in 17 patients (13.1%): 16 patients had minor complications and one had a major complication (deep vein thrombosis). All complications were resolved within the 12-month follow-up period. Conclusions MR-guided focused US is a noninvasive treatment option that can be used to effectively and safely treat uterine leiomyomas and delivers significant and lasting symptom relief for at least 12 months. The incidence of additional treatment during this time period is comparable with those in previous reports of uterine artery embolization.

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Abstract. Evaluation of flat-panel angiography equipment through conventional image quality metrics is limited by the scope of standard spatial-domain image quality metric(s), such as contrast-to-noise ratio and spatial resolution, or by restricted access to appropriate data to calculate Fourier domain measurements, such as modulation transfer function, noise power spectrum, and detective quantum efficiency. Observer models have been shown capable of overcoming these limitations and are able to comprehensively evaluate medical-imaging systems. We present a spatial domain-based channelized Hotelling observer model to calculate the detectability index (DI) of our different sized disks and compare the performance of different imaging conditions and angiography systems. When appropriate, changes in DIs were compared to expectations based on the classical Rose model of signal detection to assess linearity of the model with quantum signal-to-noise ratio (SNR) theory. For these experiments, the estimated uncertainty of the DIs was less than 3%, allowing for precise comparison of imaging systems or conditions. For most experimental variables, DI changes were linear with expectations based on quantum SNR theory. DIs calculated for the smallest objects demonstrated nonlinearity with quantum SNR theory due to system blur. Two angiography systems with different detector element sizes were shown to perform similarly across the majority of the detection tasks.

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Ultrasonography (US) has been used in medical imaging for over half a century. Current US scanners are based largely on the same basic principles used in the initial devices for human imaging. Modern equipment uses a pulse-echo approach with a brightness-mode (B-mode) display. Fundamental aspects of the B-mode imaging process include basic ultrasound physics, interactions of ultrasound with tissue, ultrasound pulse formation, scanning the ultrasound beam, and echo detection and signal processing. Recent technical innovations that have been developed to improve the performance of modern US equipment include the following: tissue harmonic imaging, spatial compound imaging, extended field of view imaging, coded pulse excitation, electronic section focusing, three-dimensional and four-dimensional imaging, and the general trend toward equipment miniaturization. US is a relatively inexpensive, portable, safe, and real-time modality, all of which make it one of the most widely used imaging modalities in medicine. Although B-mode US is sometimes referred to as a mature technology, this modality continues to experience a significant evolution in capability with even more exciting developments on the horizon.