Discrimination of sonographically detected breast masses using frequency shift color Doppler imaging in combination with age and gray scale criteria.

Abstract

Frequency shift color Doppler imaging was assessed in conjunction with patient age and gray scale (GS) features for discriminating benign from malignant breast masses. Thirty-eight women with sonographically detected masses scheduled for biopsy were evaluated using a 6-to 13-MHz scan head, and the masses were delineated in ultrasonographic image volumes. Vascularity in and around each mass was quantified using speed-weighted pixel density (SWD). Gray scale features were ranked visually on a linear scale. Combinations of indices were compared with histologic findings (18 benign and 20 malignant). Receiver operating characteristic analysis ranked performance in decreasing order from the SWD-Age-GS index, to SWD-GS, SWD-Age, Age-GS, GS criteria, SWD, and Age. At 100% sensitivity, SWDAge-GS, SWD-GS, and SWD-Age discriminated benign from malignant masses with specificities of 94%, 89%, and 72%, respectively. These results indicate significant improvement in ultrasonographic discrimination of sonographically detected breast masses by combining the vascularity measure SWD with age and GS criteria. Key words: Doppler ultrasonography; image processing; three-dimensional imaging; breast cancer; vascularity; angiogenesis. Abbreviations Az, area under the receiver operating characteristic curve; GS, gray scale; ROC, receiver operating characteristic; ROI, region of interest; ROR, radiologist's region of interest; SWD, speedweighted pixel density; 3D, three-dimensional lthough their benefits far outweigh the risk of modest radiation exposure, mammograms do present some shortcomings. Screening mammograms have sensitivities of 68% to 85% 1 and 32% specificity, 2 resulting in a number of unnecessary biopsies on benign masses. Development of cost-effective, noninvasive adjunctive techniques to mammography for differentiating benign from malignant masses would significantly reduce the number of biopsies yielding negative results.Capitalizing on the high quality of gray scale (GS) images produced by current ultrasonographic equipment, researchers have investigated discrimination techniques based on GS measures. Results describing visual

Malignant and Benign Breast Masses on 3D US Volumetric Images: Effect of Computer-aided Diagnosis on Radiologist Accuracy

“…The 3D US data were acquired with an experimental system that was previously developed and tested at our institution (16,17). The 3D system consisted of a commercially available Logiq 700 (GE Medical Systems, Milwaukee, Wis) US scanner with an M12 linear-array transducer, a mechanical transducer-guiding system, and a computer workstation.…”

Clinical and Radiologic Assessments to Predict Breast Cancer Pathologic Complete Response to Neoadjuvant Chemotherapy

“…For large, highly attenuating lesions, the lower-frequency, wide field of view GE M7, 3-7 MHz, slightly curved matrix array was used. Both whole-volume gray scale and color Doppler image sets were acquired using the methods described by Bhatti et al [30]. The same procedure was performed after four cycles of chemotherapy.…”

“…The same procedure was performed after four cycles of chemotherapy. The radiologist (MAR) selected the mass in each image volume and the volume and vascularity of the masses were computed using the method described previously [30].…”

Spatial registration of temporally separated whole breast 3D ultrasound images

“…41,42 Studies in the past have shown that the efficacy of U.S. for discriminating breast masses is improved by adding the information from color flow Doppler imaging to the B-mode grayscale information than just from B-mode imaging. 43,44 In this study, color flow Doppler scans were performed at each time point to not only quantify the blood flow in and around the lesion, 45 but also to validate IVBaR of the 3D grayscale information in these color flow image volumes by the resulting alignment of the Doppler-imaged blood vessels that were not used in the registration. Previous studies have used information from major blood vessels in Doppler U.S. for fusing with MRI or computed tomography ͑CT͒ images.…”