Second-Generation 3D Automated Breast Ultrasonography (Prone ABUS) for Dense Breast Cancer Screening Integrated to Mammography: Effectiveness, Performance and Detection Rates

Gatta, Gianluca; Cappabianca, Salvatore; Forgia, Daniele La; Massafra, Raffaella; Fanizzi, Annarita; Cuccurullo, Vincenzo; Brunese, Luca; Tagliafico, Alberto; Grassi, Roberto

doi:10.3390/jpm11090875

Cited by 14 publications

(21 citation statements)

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“…ABUS includes computer-aided detection as auxiliary software, which can reduce the reading time without compromising the screening accuracy [ 35 , 36 ]. A study conducted in 2021 compared screening with MMG alone and with ABUS in 1165 women with dense breasts and reported that ABUS combined with MMG increased the sensitivity by 31.8% [ 37 ]. Future challenges include further examination of cost-effectiveness and, as with portable US (i.e., handheld US), reducing the risk of false positives [ 38 ].…”

Section: Discussionmentioning

confidence: 99%

Optimal Breast Density Characterization Using a Three-Dimensional Automated Breast Densitometry System

et al. 2021

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Dense breasts are a risk factor for breast cancer. Assessment of breast density is important and radiologist-dependent. We objectively measured mammographic density using the three-dimensional automatic mammographic density measurement device Volpara™ and examined the criteria for combined use of ultrasonography (US). Of 1227 patients who underwent primary breast cancer surgery between January 2019 and April 2021 at our hospital, 441 were included. A case series study was conducted based on patient age, diagnostic accuracy, effects of mammography (MMG) combined with US, size of invasion, and calcifications. The mean density of both breasts according to the Volpara Density Grade (VDG) was 0–3.4% in 2 patients, 3.5–7.4% in 55 patients, 7.5–15.4% in 173 patients, and ≥15.5% in 211 patients. Breast density tended to be higher in younger patients. Diagnostic accuracy of MMG tended to decrease with increasing breast density. US detection rates were not associated with VDG on MMG and were favorable at all densities. The risk of a non-detected result was high in patients without malignant suspicious calcifications. Supplementary use of US for patients without suspicious calcifications on MMG and high breast density, particularly ≥25.5%, could improve the breast cancer detection rate.

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Section: Discussionmentioning

confidence: 99%

Optimal Breast Density Characterization Using a Three-Dimensional Automated Breast Densitometry System

et al. 2021

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“…Sensitivity increased significantly using both methods compared to applying solely a mammogram (63.6% vs. 100%) and specificity slightly decreased (99% vs. 98.4%) [18]. According to Gatta et al combing both methods are more accurate in the detection of breast cancer [19]. According to the results, 4 breast cancers were detected by the mammogram, whereas 8 were detected by applying a combination of both the…”

Section: Comparison Of Mammography and Abusmentioning

confidence: 98%

“…The specificity of the mammography was 94% and the combination of these two methods was 87%. The combination of these two methods provides a sensitivity level that is comparable to the MRI [19].…”

Section: Ap Projection Lateral Projection Medial Projectionmentioning

confidence: 99%

Automated Breast Ultrasound

Žaja

Matijaš

2022

Radiol. vjesn. (Online)

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Due to the growing number of breast cancer patients, an early diagnosis is important in order to reduce the mortality rate of those affected. Methods such as mammography, DBT, MRI, HHUS or ABUS are used in the detection of breast cancer. The aim of this article is to review the literature showing the basic principle of ABUS and to point out its advantages and disadvantages in relation to conventional methods of breast imaging. ABUS is a relatively new ultrasound method that performs well on patients with dense breast tissue. It reduces operator dependence and provides valuable diagnostic information with multiplanar reconstructions. Using evidence from reliable researches, studies have demonstrated that ABUS has a higher diagnostic accuracy compared to mammography, which remains the primary modality for early diagnosis of breast cancer. Applying ABUS as an adjunct to mammography during the screening test has proven effective and further confirmed the importance of their application in clinical practice. The disadvantage of the combination of ABUS and mammography was that in a large number of studies the specificity was lower compared to mammography itself. Compared to DBT, ABUS has demonstrated to have a higher diagnostic performance, with the exception that it lacks the ability to effectively detect calcifications. Although MRI seem to outperform ABUS, ABUS devices offer a cost-effective and easy to use imaging system, making it the best alternative. The HHUS technique, on the other hand, was perceived by many studies as less painful, with a shorter operative time compared to ABUS. However, the sensitivity and specificity of this screening method continues to remain inferior to ABUS. The use of artificial intelligence is becoming widely used today. As a result, the CAD software has been developed to be applied in conjunction with ABUS in order to improve the detection rate of breast cancer as well as its accuracy. The use of CAD significantly reduced image reading time and improved the overall diagnostic accuracy of ABUS. According to all the presented data, the use of ABUS medical devices in clinical practice continues to grow in importance and with the further development of technology and medicine, its full integration into healthcare systems around the world is expected.

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“…[36][37][38][39][40][41] Recent studies show that prone-based systems are promising for screening women with dense breasts with a diagnostic performance comparable to supine ABUS systems. 38 Furthermore, methods beyond conventional US, such as US-computed tomography (USCT), have been previously developed and shown useful for whole-breast 3D imaging. [42][43][44][45][46][47] Although ABUS-and 3DUS-based approaches use anatomical information to differentiate between fibroglandular (dense) tissues, benign and cancerous tissues, USCT provides quantitative measurements and simultaneous acquisition of 3D reflection, acoustic attenuation, and speed-of -sound images.…”

Section: Introductionmentioning

confidence: 99%

“…Alternative prone ABUS systems have been developed, including but not limited to, the commercially available SonixEmbrace™ (Ultrasonix Medical Corporation, British Columbia, Canada), SVARATM™ (TechniScan Inc., Utah, USA), and SOFIA™ (Hitachi Ltd, Tokyo, Japan) systems 36–41 . Recent studies show that prone‐based systems are promising for screening women with dense breasts with a diagnostic performance comparable to supine ABUS systems 38 . Furthermore, methods beyond conventional US, such as US‐computed tomography (USCT), have been previously developed and shown useful for whole‐breast 3D imaging 42–47 .…”

Section: Introductionmentioning

confidence: 99%

Spatially tracked whole‐breast three‐dimensional ultrasound system toward point‐of‐care breast cancer screening in high‐risk women with dense breasts

et al. 2022

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Background Mammographic screening has reduced mortality in women through the early detection of breast cancer. However, the sensitivity for breast cancer detection is significantly reduced in women with dense breasts, in addition to being an independent risk factor. Ultrasound (US) has been proven effective in detecting small, early‐stage, and invasive cancers in women with dense breasts. Purpose To develop an alternative, versatile, and cost‐effective spatially tracked three‐dimensional (3D) US system for whole‐breast imaging. This paper describes the design, development, and validation of the spatially tracked 3DUS system, including its components for spatial tracking, multi‐image registration and fusion, feasibility for whole‐breast 3DUS imaging and multi‐planar visualization in tissue‐mimicking phantoms, and a proof‐of‐concept healthy volunteer study. Methods The spatially tracked 3DUS system contains (a) a six‐axis manipulator and counterbalanced stabilizer, (b) an in‐house quick‐release 3DUS scanner, adaptable to any commercially available US system, and removable, allowing for handheld 3DUS acquisition and two‐dimensional US imaging, and (c) custom software for 3D tracking, 3DUS reconstruction, visualization, and spatial‐based multi‐image registration and fusion of 3DUS images for whole‐breast imaging. Spatial tracking of the 3D position and orientation of the system and its joints (J1–6) were evaluated in a clinically accessible workspace for bedside point‐of‐care (POC) imaging. Multi‐image registration and fusion of acquired 3DUS images were assessed with a quadrants‐based protocol in tissue‐mimicking phantoms and the target registration error (TRE) was quantified. Whole‐breast 3DUS imaging and multi‐planar visualization were evaluated with a tissue‐mimicking breast phantom. Feasibility for spatially tracked whole‐breast 3DUS imaging was assessed in a proof‐of‐concept healthy male and female volunteer study. Results Mean tracking errors were 0.87 ± 0.52, 0.70 ± 0.46, 0.53 ± 0.48, 0.34 ± 0.32, 0.43 ± 0.28, and 0.78 ± 0.54 mm for joints J1–6, respectively. Lookup table (LUT) corrections minimized the error in joints J1, J2, and J5. Compound motions exercising all joints simultaneously resulted in a mean tracking error of 1.08 ± 0.88 mm (N = 20) within the overall workspace for bedside 3DUS imaging. Multi‐image registration and fusion of two acquired 3DUS images resulted in a mean TRE of 1.28 ± 0.10 mm. Whole‐breast 3DUS imaging and multi‐planar visualization in axial, sagittal, and coronal views were demonstrated with the tissue‐mimicking breast phantom. The feasibility of the whole‐breast 3DUS approach was demonstrated in healthy male and female volunteers. In the male volunteer, the high‐resolution whole‐breast 3DUS acquisition protocol was optimized without the added complexities of curvature and tissue deformations. With small post‐acquisition corrections for motion, whole‐breast 3DUS imaging was performed on the healthy female volunteer showing relevant anatomical structures and details. Conc...

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Second-Generation 3D Automated Breast Ultrasonography (Prone ABUS) for Dense Breast Cancer Screening Integrated to Mammography: Effectiveness, Performance and Detection Rates

Cited by 14 publications

References 50 publications

Optimal Breast Density Characterization Using a Three-Dimensional Automated Breast Densitometry System

Optimal Breast Density Characterization Using a Three-Dimensional Automated Breast Densitometry System

Automated Breast Ultrasound

Spatially tracked whole‐breast three‐dimensional ultrasound system toward point‐of‐care breast cancer screening in high‐risk women with dense breasts

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