Breast-density assessment with hand-held ultrasound: A novel biomarker to assess breast cancer risk and to tailor screening?

Sanabria, Sergio J.; Göksel, Orçun; Martini, Katharina; Forte, Serafino; Frauenfelder, Thomas; Ra, Kubik-Huch; Rominger, Marga B.

doi:10.1007/s00330-017-5287-9

Cited by 31 publications

(35 citation statements)

References 39 publications

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“…For multi-parametric characterization, UA can be an imaging biomarker complementary to speed-of-sound, which may be superior to elastography [6]. The quantification of speed-of-sound was recently proposed for breast density [14] and sarcopenia assessment [12].…”

Section: Resultsmentioning

confidence: 99%

Attenuation Imaging with Pulse-Echo Ultrasound Based on an Acoustic Reflector

Rau

Unal

Schweizer

et al. 2019

Lecture Notes in Computer Science

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Ultrasound attenuation is caused by absorption and scattering in tissue and is thus a function of tissue composition, hence its imaging offers great potential for screening and differential diagnosis. In this paper we propose a novel method that allows to reconstruct spatial attenuation distribution in tissue based on computed tomography, using reflections from a passive acoustic reflector. This requires a standard ultrasound transducer operating in pulse-echo mode, thus it can be implemented on conventional ultrasound systems with minor modifications. We use calibration with water measurements in order to normalize measurements for quantitative imaging of attenuation. In contrast to earlier techniques, we herein show that attenuation reconstructions are possible without any geometric prior on the inclusion location or shape. We present a quantitative evaluation of reconstructions based on simulations, gelatin phantoms, and ex-vivo bovine skeletal muscle tissue, achieving contrast-to-noise ratio of up to 2.3 for an inclusion in ex-vivo tissue.

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Section: Resultsmentioning

confidence: 99%

Attenuation Imaging with Pulse-Echo Ultrasound Based on an Acoustic Reflector

Rau

Unal

Schweizer

et al. 2019

Lecture Notes in Computer Science

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“…The patient characteristics are listed in Tables 1 and 2. The SoS of the tumors (n = 20) of this study were compared with the SoS of breast tissue segments (retromamillary, inner, and outer) of 106 healthy women. 35 Speckles-based 2D SoS-US images as well as mammographic breast density categories (A, almost entirely fatty; B, scattered areas of fibroglandular density; C, heterogeneously dense; and D, extremely dense) according to the American College of Radiology (ACR) Breast Imaging Reporting and Data System (BIRADS) fifth edition 37 were acquired in 318 tissue segments.…”

Section: Methodsmentioning

confidence: 99%

“…34 External reflectors in combination with hand-held US probes have been used to measure SoS (external reflector-based method). 35,36 Sanabria et al 34 have shown the potential of tissue reflections and scattering (speckles) to serve as internal reflector and timing references, which leads to even easier measurement operability for SoS imaging by hand-held probes.…”

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confidence: 99%

Breast Cancer Assessment With Pulse-Echo Speed of Sound Ultrasound From Intrinsic Tissue Reflections

et al. 2019

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The aim of this study was to differentiate malignant and benign solid breast lesions with a novel ultrasound (US) technique, which measures speed of sound (SoS) using standard US transducers and intrinsic tissue reflections and scattering (speckles) as internal reference. MATERIALS AND METHODS This prospective, institutional review board-approved, Health Insurance Portability and Accountability Act-compliant prospective comparison study was performed with prior written informed consent from 20 women. Ten women with histological proven breast cancer and 10 with fibroadenoma were measured. A conventional US system with a linear probe was used for SoS-US (SonixTouch; Ultrasonix, Richmond, British Columbia, Canada). Tissue speckle reflections served as a timing reference for the US signals transmitted through the breasts. Relative phase inconsistencies were detected using plane wave measurements from different angular directions, and SoS images with 0.5-mm resolution were generated using a spatial domain reconstruction algorithm. The SoS of tumors were compared with the breast density of a larger cohort of 106 healthy women. RESULTS Breast lesions show focal increments ΔSoS (meters per second) with respect to the tissue background. Peak ΔSoS values were evaluated. Breast carcinoma showed significantly higher ΔSoS than fibroadenomas ([INCREMENT]SoS > 41.64 m/s: sensitivity, 90%; specificity, 80%; area under curve, 0.910) and healthy breast tissue of different densities (area under curve, 0.938; sensitivity, 90%; specificity, 96.5%). The lesion localization in SoS-US images was consistent with B-mode imaging and repeated SoS-US measurements were reproducible. CONCLUSIONS Using SoS-US, based on conventional US and tissue speckles as timing reference, breast carcinoma showed significantly higher SoS values than fibroadenoma and healthy breast tissue of different densities. The SoS presents a promising technique for differentiating solid breast lesions.

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“…A large clinical comparison study between SWS and SoS for breast lesion differentiation is yet not available. Nevertheless, it was shown in several individual studies that SoS is able to discriminate between adipose and fibrous tissues, and has been applied in several clinical contexts such as breast density classification (Sak et al 2015, Sanbria et al 2018, diagnosis of liver steatosis (Imbault et al 2017) and assessment of fatty musculoskeletal degeneration (Qu et al 2017).…”

Section: Introductionmentioning

confidence: 99%

Spatial domain reconstruction for imaging speed-of-sound with pulse-echo ultrasound: simulation and in vivo study

et al. 2018

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Despite many uses of ultrasound, some pathologies such as breast cancer still cannot reliably be diagnosed in either conventional B-mode ultrasound imaging nor with more recent ultrasound elastography methods. Speed-of-sound (SoS) is a quantitative imaging biomarker, which is sensitive to structural changes due to pathology, and hence could facilitate diagnosis. Full-angle Ultrasound Computed Tomography (USCT) was proposed to obtain spatially-resolved SoS images, however, its water-bath setup involves practical limitations. To increase clinical utility and for widespread use, recently, a limited-angle Fourier-domain SoS reconstruction was proposed, however, it suffers from significant image reconstruction artifacts. In this work, we present a SoS reconstruction strategy, where the forward problem is formulated using differential time-of-flight measurements based on apparent displacements along different ultrasound wave propagation paths, and the inverse problem is solved in spatial-domain using a proposed total-variation scheme with spatially-varying anisotropic weighting to compensate for geometric bias from limited angle imaging setup. This is shown to be robust to missing displacement data and easily allow for incorporating any prior geometric information. In numerical simulations, SoS values in inclusions are accurately reconstructed with 90% accuracy up to a noise level of 50%. With respect to Fourier-domain reconstruction, our proposed method improved contrast ratio from 0.37 to 0.67 for even high noise levels such as 50%. Numerical fullwave simulation and our preliminary in-vivo results illustrate the clinical applicability of our method in a breast cancer imaging setting. Our proposed method requires single-sided access to the tissue and can be implemented as an add-on to conventional ultrasound equipment, applicable to a range of transducers and applications.

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Breast-density assessment with hand-held ultrasound: A novel biomarker to assess breast cancer risk and to tailor screening?

Cited by 31 publications

References 39 publications

Attenuation Imaging with Pulse-Echo Ultrasound Based on an Acoustic Reflector

Attenuation Imaging with Pulse-Echo Ultrasound Based on an Acoustic Reflector

Breast Cancer Assessment With Pulse-Echo Speed of Sound Ultrasound From Intrinsic Tissue Reflections

Spatial domain reconstruction for imaging speed-of-sound with pulse-echo ultrasound: simulation and in vivo study

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