Early detection of Cancer using Mammograms with Advanced Artificial Intelligence (AI) Algorithms for Breast lesions

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Breast Cancer Assessment With Pulse-Echo Speed of Sound Ultrasound From Intrinsic Tissue Reflections: Proof-of-Concept

PURPOSE The aim of this study was to differentiate malignant and benign solid breast lesions with a novel ultrasound (US) technique, which measures speed of sound (SoS) using standard US transducers and intrinsic tissue reflections and scattering (speckles) as internal reference. MATERIALS AND METHODS This prospective, institutional review board-approved, Health Insurance Portability and Accountability Act-compliant prospective comparison study was performed with prior written informed consent from 20 women. Ten women with histological proven breast cancer and 10 with fibroadenoma were measured. A conventional US system with a linear probe was used for SoS-US (SonixTouch; Ultrasonix, Richmond, British Columbia, Canada). Tissue speckle reflections served as a timing reference for the US signals transmitted through the breasts. Relative phase inconsistencies were detected using plane wave measurements from different angular directions, and SoS images with 0.5-mm resolution were generated using a spatial domain reconstruction algorithm. The SoS of tumors were compared with the breast density of a larger cohort of 106 healthy women. RESULTS Breast lesions show focal increments ΔSoS (meters per second) with respect to the tissue background. Peak ΔSoS values were evaluated. Breast carcinoma showed significantly higher ΔSoS than fibroadenomas ([INCREMENT]SoS > 41.64 m/s: sensitivity, 90%; specificity, 80%; area under curve, 0.910) and healthy breast tissue of different densities (area under curve, 0.938; sensitivity, 90%; specificity, 96.5%). The lesion localization in SoS-US images was consistent with B-mode imaging and repeated SoS-US measurements were reproducible. CONCLUSIONS Using SoS-US, based on conventional US and tissue speckles as timing reference, breast carcinoma showed significantly higher SoS values than fibroadenoma and healthy breast tissue of different densities. The SoS presents a promising technique for differentiating solid breast lesions

3D Ultrasound Computer Tomography for Breast Cancer Diagnosis at KIT: an Overview

3D Ultrasound Computer Tomography (USCT) emitting and receiving spherical wave fronts overcomes the limitations of 2D systems by offering a nearly isotropic 3D point spread function, a large depth of field, less loss of out-of-plane reflections, and fast 3D data acquisition. 3D devices for clinical practice require a more complex hard- and software due to the huge data rate, time-consuming image reconstruction, and large number of small transducers. The here reviewed KIT 3D USCT is a prototype for clinical studies, which realizes for the first time the full benefits of a 3D system

Limited Angle Ultrasound Tomography of the Compressed Breast

X-ray mammography is widely accepted as the clinical standard for breast cancer screening and diagnosis. However, reflection mode ultrasound has been known to outperform x-ray in screening performance in dense breasts. With newer modes of ultrasound, acoustic properties of breast tissue, such as the speed of sound and attenuation coefficient distributions, can be extracted from captured ultrasound signals and used to characterize breast tissue types and contribute to detection and diagnosis of malignancy. The same is possibly true for optical absorption via photoacoustic imaging. Recently, we have developed a dual-sided ultrasound scanner that can be integrated with existing x-ray mammographic systems and acquire images in the mammographic view and compression. Transmission imaging for speed of sound and attenuation coefficient in this geometry is termed limited angle tomography, as the beams at frequencies yielding high resolution cannot transit the long axis of the compressed breast. This approach, ideally, should facilitate the co-registration and comparisons between images from three modalities discussed here (x-ray, ultrasound and photoacoustic) and increase diagnostic detection confidence. However, potential limitations inherent in limited angle tomography have received minimal exploration up to this study, and existing imaging techniques developed for this approach are based on overly optimistic assumptions that hinder achievement of the desired image quality. This investigation of these problems should contribute valuable information to the validation and translation of the mammographically-configured, dual-sided ultrasound, or ultrasound and photoacoustic, scanner to the clinic. This dissertation first aims to extensively identify possible sources of error resulting from imaging in the limited angle tomography approach. Simulation findings mapping parametric conditions reveal that image artifacts arising in reflection mode (B-mode) can be modulated or mitigated by ultrasound gels with adequate acoustic properties. In addition, sound speed imaging was performed determining the level of significance for several key sources of error. Results suggest that imaging in transmission mode is the most sensitive to transducer misplacement in the signal propagation direction. This misplacement, however, could be minimized easily by routinely calibrating transducer positions. Next, this dissertation aims to advance speed of sound, attenuation, and photoacoustic image reconstruction algorithms for the limited angle tomography approach. This was done by utilizing both structural information of the imaged objects/tissues by means of the corresponding reflection mode images taken from the same imaging location, and a full acoustic modeling framework to account for complex acoustic interactions within the field of view. We have shown through simulations that both a priori information from reflection mode images and full acoustic modeling contribute to a noticeable improvement in the reconstructed images. Work done throughout the course of this dissertation should provide a foundation and insight necessary for improvements upon the existing dual-sided ultrasound scanner towards breast imaging in the clinic.PHDBiomedical EngineeringUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttps://deepblue.lib.umich.edu/bitstream/2027.42/143944/1/rungroj_1.pd

Automated Deformable Mapping Methods to Relate Corresponding Lesions in 3D X-ray and 3D Ultrasound Breast Images

Mammography is the current standard imaging method for detecting breast cancer by using x-rays to produce 2D images of the breast. However, with mammography alone there is difficulty determining whether a lesion is benign or malignant and reduced sensitivity to detecting lesions in dense breasts. Ultrasound imaging used in conjunction with mammography has shown valuable contributions for lesion characterization by differentiating between solid and cystic lesions. Conventional breast ultrasound has high false positive rates; however, it has shown improved abilities to detect lesions in dense breasts. Breast ultrasound is typically performed freehand to produce anterior-to-posterior 2D images in a different geometry (supine) than mammography (upright). This difference in geometries is likely responsible for the finding that at least 10% of the time lesions found in the ultrasound images do not correspond with lesions found in mammograms. To solve this problem additional imaging techniques must be investigated to aid a radiologist in identifying corresponding lesions in the two modalities to ensure early detection of a potential cancer. This dissertation describes and validates automated deformable mapping methods to register and relate corresponding lesions between multi-modality images acquired using 3D mammography (Digital Breast Tomosynthesis (DBT) and dedicated breast Computed Tomography (bCT)) and 3D ultrasound (Automated Breast Ultrasound (ABUS)). The methodology involves the use of finite element modeling and analysis to simulate the differences in compression and breast orientation to better align lesions acquired from images from these modalities. Preliminary studies were performed using several multimodality compressible breast phantoms to determine breast lesion registrations between: i) cranio-caudal (CC) and mediolateral oblique (MLO) DBT views and ABUS, ii) simulated bCT and DBT (CC and MLO views), and iii) simulated bCT and ABUS. Distances between the centers of masses, dCOM, of corresponding lesions were used to assess the deformable mapping method. These phantom studies showed the potential to apply this technique for real breast lesions with mean dCOM registration values as low as 4.9 ± 2.4 mm for DBT (CC view) mapped to ABUS, 9.3 ± 2.8 mm for DBT (MLO view) mapped to ABUS, 4.8 ± 2.4 mm for bCT mapped to ABUS, 5.0 ± 2.2 mm for bCT mapped to DBT (CC view), and 4.7 ± 2.5 mm for bCT mapped to DBT (MLO view). All of the phantom studies showed that using external fiducial markers helped improve the registration capability of the deformable mapping algorithm. An IRB-approved proof-of-concept study was performed with patient volunteers to validate the deformable registration method on 5 patient datasets with a total of up to 7 lesions for DBT (CC and MLO views) to ABUS registration. Resulting dCOM’s using the deformable method showed statistically significant improvements over rigid registration techniques with a mean dCOM of 11.6 ± 5.3 mm for DBT (CC view) mapped to ABUS and a mean dCOM of 12.3 ± 4.8 mm for DBT (MLO view) mapped to ABUS. The present work demonstrates the potential for using deformable registration techniques to relate corresponding lesions in 3D x-ray and 3D ultrasound images. This methodology should improve a radiologists’ characterization of breast lesions which can reduce patient callbacks, misdiagnoses, additional patient dose and unnecessary biopsies. Additionally, this technique can save a radiologist time in navigating 3D image volumes and the one-to-one lesion correspondence between modalities can aid in the early detection of breast malignancies.PHDNuclear Engineering & Radiological SciencesUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttps://deepblue.lib.umich.edu/bitstream/2027.42/150042/1/canngree_1.pd

Proceedings of the International Workshop on Medical Ultrasound Tomography: 1.- 3. Nov. 2017, Speyer, Germany

Ultrasound Tomography is an emerging technology for medical imaging that is quickly approaching its clinical utility. Research groups around the globe are engaged in research spanning from theory to practical applications. The International Workshop on Medical Ultrasound Tomography (1.-3. November 2017, Speyer, Germany) brought together scientists to exchange their knowledge and discuss new ideas and results in order to boost the research in Ultrasound Tomography