Quantitative Assessment of Breast Density: Transmission Ultrasound is Comparable to Mammography with Tomosynthesis

Abstract

Elevated breast density is among the strongest independent predictors of breast cancer. Breast density scores are critical inputs in models used to calculate a patient's lifetime risk of developing breast cancer. Today, the only FDA-cleared technology for assessing breast density uses mammography. An alternative modality for breast density quantification is 3D transmission ultrasound (TU). In this retrospective study, we compared automated breast density calculations derived from TU using quantitative breast density (QBD) and mammography with tomosynthesis using VolparaDensity 3.1 for 225 breasts. Pearson correlation coefficients (r) and intraclass correlation coefficients were compared. Subset analyses of extremely dense breasts, premenopausal, and postmenopausal breasts were also performed. Comparative analysis between radiologist-derived density assessment and objective automated scores was performed. Calculations from TU and mammography with tomosynthesis for breast density, total breast volume (TBV), and fibroglandular volume (FGV) were strongly correlated (r ¼ 0.91, 0.92, and 0.67, respectively). We observed moderate absolute agreement for FGV and breast density, and strong absolute agreement for TBV. A subset of 56 extremely dense breasts showed similar trends, however with lower breast density agreement in the subset than in the full study. No significant difference existed in density correlation between premenopausal and postmenopausal breasts across modalities. QBD calculations from TU were strongly correlated with breast density scores from VolparaDensity. TU systematically measured higher FGV and breast density compared with mammography, and the difference increased with breast density.Impact: TU of the breast can accurately quantify breast density comparable with mammography with tomosynthesis.

Bayesian Approach for a Robust Speed-of-Sound Reconstruction Using Pulse-Echo Ultrasound

“…Through-transmission techniques reconstruct the spatial distribution of SoS by analysing US transmitted through the tissue from various different angles. Breast ultrasound tomography demonstrates impressively the diagnostic potential of through transmission SoS imaging on the example of breast cancer diagnosis [14]- [17]. Although breast UCT yields quantitative SoS images with high spatial and contrast resolution, it requires a bulky stand-alone system and an acoustically transparent target, which limits it's application mainly to the female breast, even though its use has recently been demonstrated for orthopedic and myopatic imaging of the leg [18].…”

Full wave 3D inverse scattering transmission ultrasound tomography in the presence of high contrast

“…That algorithm maintains the projection-like geometry of Radon and diffraction tomography but includes nonlinear and extended refraction and diffraction effects. This algorithm, first proved in the context of the breast [51][52][53] , is extended to include bone by the careful choice of alternative frequencies and iteration counts at each frequency. This extension of the algorithm to these more difficult cases involving bone, is analogous to the use of different 'sequences' in MR imaging.…”

First-in-human diagnostic study of hepatic steatosis with computed ultrasound tomography in echo mode (CUTE)

“…For instance, in liver applications, CUTE-SoS images can help identify focal liver lesions such as liver adenomas and hepatocellular carcinoma. In principle, CUTE can image any organ accessible to pulse-echo US, and its clinical applications may also extend to breast cancer diagnosis [34,35,36] or the assessment of musculoskeletal disorders [37,20], where SoS has already proven to be clinically relevant. Furthermore, CUTE-SoS images can also be used to correct aberrations in conventional B-mode images and improve their quality [38].…”