Real-Time Ultrasound Detection of Breast Microcalcifications Using Multifocus Twinkling Artifact Imaging

Kang, Jinbum; Han, Kanghee; Song, Ilseob; Kim, Kang-Sik; Jang, Won Seuk; Kim, Min Jung; Yoo, Yangmo

doi:10.1109/tmi.2021.3136901

Cited by 9 publications

(6 citation statements)

References 44 publications

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“…For real-time US-MDTA imaging, three focus beams with optimized acoustic parameters (e.g., the number of focusing, focal depth and f-number) were employed to maintain the proper frame rate during mechanical scanning. The MDTA imaging with the optimized transmit conditions highly increased the sensitivity of TA signals after clutter filtering, and all higher TA signals than background noise level were visualized and considered as microcalcifications, as described in our previous reports 21 .…”

Section: Methodsmentioning

confidence: 87%

Feasibility study using multifocal Doppler twinkling artifacts to detect suspicious microcalcifications in ex vivo specimens of breast cancer on US

Park

Kang

Han

et al. 2022

Sci Rep

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Multifocal Doppler twinkling artifact (MDTA) imaging has shown high detection rates of microcalcifications in phantom studies. We aimed to evaluate its performance in detecting suspicious microcalcifications in comparison with mammography by using ex vivo breast cancer specimens. We prospectively included ten women with breast cancer that presented with calcifications on mammography. Both digital specimen mammography and MDTA imaging were performed for ex vivo breast cancer specimens on the day of surgery. Five breast radiologists marked cells that included suspicious microcalcifications (referred to as ‘positive cell’) on specimen mammographic images using a grid of 5-mm cells. Cells that were marked by at least three readers were considered as ‘consensus-positive’. Matched color Doppler twinkling artifact (CDTA) signals were compared between reconstructed US-MDTA projection images and mammographic images. The median detection rate for each case was 74.7% for positive cells and 96.7% for consensus-positive cells. Of the 10 cases, 90% showed a detection rate of ≥ 80%, with 50% of cases showing a 100% detection rate for consensus-positive cells. The proposed MDTA imaging method showed high performance for detecting suspicious microcalcifications in ex vivo breast cancer specimens, and may be a feasible approach for detecting suspicious breast microcalcifications with US.

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Section: Methodsmentioning

confidence: 87%

Feasibility study using multifocal Doppler twinkling artifacts to detect suspicious microcalcifications in ex vivo specimens of breast cancer on US

Park

Kang

Han

et al. 2022

Sci Rep

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“…Breast microcalci cations are calcium deposits that are considered as robust markers of breast cancer when identi ed on mammography. Microcalci cations are frequently associated with premalignant DCIS and IDC ( [34]) and microcalci cation detection in real time is important in the guidance of many breast biopsies [35]. For many years, breast calci cations have always been used as an indicator for the diagnosis of early breast cancer, but its underlying mechanism has not yet been fully understood.…”

Section: Discussionmentioning

confidence: 99%

Secretion of BMP-2 by TAMs up-regulates the expression of RUNX2 and TWIST1 to promote the microcalcifications and tumor metastasis in breast cancer

Wang

Dong

Zheng

et al. 2023

Preprint

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INTRODUCTION: Microcalcifications is an important indicator of breast cancer yet the mechanism of its formation remains to be elucidated. Tumor-associated macrophages (TAMs) can secrete bone morphogenetic protein 2 (BMP-2), which is associated with presence of microcalcifications. BMP-2 is also known to up-regulate RUNX2, a regulator of the differentiation of osteoblasts, which could be the potential mechanism underlying microcalcification formation. METHODS:Immunohistochemical staining of CD163 (marker of the M2-like macrophages), BMP-2, RUNX2 and TWIST1 were performed on tissue microarray (TMA) sections of 272 primary invasive breast cancer. Following induction, M2‐like TAMs were co-cultured with breast cancer cells with or without adding BMP receptor Ⅰ inhibitor (LDN). The level of BMP-2 in culture solution was measured by ELISA. The expression of RUNX2, TWIST1 and their downstream factors were measured by western blot. The deposition of microcalcifications was analyzed by Alizarin Red S staining. Orthotopic metastasis in mice models were established to further determine the role of TAMs in microcalcifications and Epithelial Mesenchymal Transition (EMT). PET-CT was used to detect the metastasis in mice. RESULTS:Immunohistochemical analysis showed that the expression of RUNX2 and TWIST1 was significantly correlated with microcalcifications. Expression of RUNX2 was also correlated with infiltration of TAMs and the expression of BMP-2. Results from co-culturing of TAMs with breast cancer cells showed that the secretion of BMP-2 from TAMs could induce microcalcifications and EMT by upregulating the expression of RUNX2 and TWIST1 respectively, while these effects could be reversed by LDN. Similar results were observed in the mouse model of orthotopic metastasis. CONCLUSIONS:These findings support the hypothesis that the secretion of BMP-2 by TAMs could up-regulate the expression of RUNX2 and TWIST1 to promote microcalcifications and induce EMT in breast cancer.

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“…The ability to adapt and perform well when identifying minor irregularities and evaluating the features of lesions is a valuable asset that aids in making precise diagnoses. This real-time feature enables the use of ultrasound guidance during biopsies, which improves the accuracy of tissue sample and reduces the necessity for more invasive treatments [ 16 , 43 , 44 ].…”

Section: Advantages Of Breast Ultrasound In Breast Cancer Screeningmentioning

confidence: 99%

“…This constraint is especially noteworthy when considering its function in identifying specific categories of imperceptible, initial-phase breast tumors. Recent research highlights the significance of employing a multimodal strategy, which involves the integration of many imaging methods, in order to achieve a correct breast cancer screening [ 42 , 43 , 44 ].…”

Section: Disadvantages/limitations Of Breast Ultrasound In Breast Can...mentioning

confidence: 99%

Evaluating the Role of Breast Ultrasound in Early Detection of Breast Cancer in Low- and Middle-Income Countries: A Comprehensive Narrative Review

Iacob,

Stoicescu

et al. 2024

Bioengineering

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Breast cancer, affecting both genders, but mostly females, exhibits shifting demographic patterns, with an increasing incidence in younger age groups. Early identification through mammography, clinical examinations, and breast self-exams enhances treatment efficacy, but challenges persist in low- and medium-income countries due to limited imaging resources. This review assesses the feasibility of employing breast ultrasound as the primary breast cancer screening method, particularly in resource-constrained regions. Following the PRISMA guidelines, this study examines 52 publications from the last five years. Breast ultrasound, distinct from mammography, offers advantages like radiation-free imaging, suitability for repeated screenings, and preference for younger populations. Real-time imaging and dense breast tissue evaluation enhance sensitivity, accessibility, and cost-effectiveness. However, limitations include reduced specificity, operator dependence, and challenges in detecting microcalcifications. Automatic breast ultrasound (ABUS) addresses some issues but faces constraints like potential inaccuracies and limited microcalcification detection. The analysis underscores the need for a comprehensive approach to breast cancer screening, emphasizing international collaboration and addressing limitations, especially in resource-constrained settings. Despite advancements, notably with ABUS, the primary goal is to contribute insights for optimizing breast cancer screening globally, improving outcomes, and mitigating the impact of this debilitating disease.

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Real-Time Ultrasound Detection of Breast Microcalcifications Using Multifocus Twinkling Artifact Imaging

Cited by 9 publications

References 44 publications

Feasibility study using multifocal Doppler twinkling artifacts to detect suspicious microcalcifications in ex vivo specimens of breast cancer on US

Feasibility study using multifocal Doppler twinkling artifacts to detect suspicious microcalcifications in ex vivo specimens of breast cancer on US

Secretion of BMP-2 by TAMs up-regulates the expression of RUNX2 and TWIST1 to promote the microcalcifications and tumor metastasis in breast cancer

Evaluating the Role of Breast Ultrasound in Early Detection of Breast Cancer in Low- and Middle-Income Countries: A Comprehensive Narrative Review

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