Use of High-Resolution Ultrasound in Characterizing the Surface Topography of a Breast Implant

Abstract

Background and Objectives: With the emergence of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), it has become necessary to identify the implant shell type patients have received. Therefore, an immediate, reliable method for identifying a breast implant shell type is essential. Evidence-based research and applying a real-world technique that identifies the surface topographic information of the inserted breast implants, without surgery, has become of paramount importance for breast implant physicians. Methods and Materials: A review of the medical records of 1901 patients who received 3802 breast implants and subsequently received an ultrasound-assisted examination was performed. All patients received not only a breast cancer examination but also a high-resolution ultrasonography (HRUS) assisted examination of the device at a single center between 31 August 2017 and 31 December 2022. Results: Most patients had breast implants within 10 years (77.7%) of the examination. Of the 3802 implants screened, 2034 (53.5%) were identified with macro-textured shell topography in ultrasonography. A macrotextured shell type implant was used in 53.5% of cases and a smooth type in 42.7% of cases. Seventy-three (1.9%) breast implant shell types could not be identified due to ruptures. However, 250 breast implant shell types could be identified despite rupture cases (6.5%). Conclusions: HRUS was found to be a useful and reliable image modality for identifying various surface shell types of breast implants. The shell type information would be helpful to patients who lack information about their breast implants and are concerned about BIA-ALCL.

Developing a deep learning model to predict the breast implant texture types with ultrasonography image: feasibility study

“…Although there is a lack of standardized breast implant surface classification, ultrasonographic shell surface topographic images can divide the breast implant texture types into texture type and smoothness in high-resolution ultrasound [14]. Texture type shows roughness compared with smooth type in high-resolution ultrasonography (Supplementary data 3) [14]. Identifying the texture type of an inserted implant using ultrasonography instead of surgery is clinically important because the physician must consider the BIA-ALCL risk induced from the textured breast implant.…”

“…Identifying the texture type of an inserted implant using ultrasonography instead of surgery is clinically important because the physician must consider the BIA-ALCL risk induced from the textured breast implant. As an extension of previous research on the feasibility of high-resolution ultrasonography for identifying the breast implant shell surface topography, this study was conducted to develop a deep-learning model to predict the breast implant texture types with ultrasonographic images [14]. In ultrasonography, smooth types include micro-texture and nanotexture types because micro-texture and nanotexture types show almost the same shell surface.…”

“…In our problem, shell surface topography was divided into texture and smooth. The smooth type included micro-texture and nanotexture as conventional clinical classification [14]. Micro-texture and nanotexture types show almost the same shell surface topography with smooth type in high-resolution ultrasonography and light microscopy [14].…”

“…The smooth type included micro-texture and nanotexture as conventional clinical classification [14]. Micro-texture and nanotexture types show almost the same shell surface topography with smooth type in high-resolution ultrasonography and light microscopy [14]. As some retrospective data were not stored as a DICOM (Digital Imaging and Communications in Medicine), we instead used only the centered PCAS-rendered image (Table 1) by discarding the top 12%, bottom 10%, and left and right 7% of pixels.…”

“…Mammograms and MRI, which are used to monitor breast implant-related complications, cannot identify the implant shell surface topography. Only ultrasonography can identify the inserted implant shell surface topography [13,14].…”