Breast vibro-acoustography: initial results show promise

INTRODUCTION: Vibro-acoustography (VA) is a recently developed imaging modality that is sensitive to the dynamic characteristics of tissue. It detects low-frequency harmonic vibrations in tissue that are induced by the radiation force of ultrasound. Here, we have investigated applications of VA for in vivo breast imaging. METHODS: A recently developed combined mammography-VA system for in vivo breast imaging was tested on female volunteers, aged 25 years or older, with suspected breast lesions on their clinical examination. After mammography, a set of VA scans was acquired by the experimental device. In a masked assessment, VA images were evaluated independently by 3 reviewers who identified mass lesions and calcifications. The diagnostic accuracy of this imaging method was determined by comparing the reviewers' responses with clinical data. RESULTS: We collected images from 57 participants: 7 were used for training and 48 for evaluation of diagnostic accuracy (images from 2 participants were excluded because of unexpected imaging artifacts). In total, 16 malignant and 32 benign lesions were examined. Specificity for diagnostic accuracy was 94% or higher for all 3 reviewers, but sensitivity varied (69% to 100%). All reviewers were able to detect 97% of masses, but sensitivity for detection of calcification was lower (≤ 72% for all reviewers). CONCLUSIONS: VA can be used to detect various breast abnormalities, including calcifications and benign and malignant masses, with relatively high specificity. VA technology may lead to a new clinical tool for breast imaging applications

Breast Arterial Calcification Is Associated with Reproductive Factors in Asymptomatic Postmenopausal Women

Abstract Objective: The etiology of breast arterial calcification (BAC) is not well understood. We examined reproductive history and cardiovascular disease (CVD) risk factor associations with the presence of detectable BAC in asymptomatic postmenopausal women. Methods: Reproductive history and CVD risk factors were obtained in 240 asymptomatic postmenopausal women from a community-based research study who had a screening mammogram within 2 years of their participation in the study. The mammograms were reviewed for the presence of detectable BAC. Age-adjusted logistic regression models were fit to assess the association between each risk factor and the presence of BAC. Multiple variable logistic regression models were used to identify the most parsimonious model for the presence of BAC. Results: The prevalence of BAC increased with increased age (p?<?0.0001). The most parsimonious logistic regression model for BAC presence included age at time of examination, increased parity (p?=?0.01), earlier age at first birth (p?=?0.002), weight, and an age-by-weight interaction term (p?=?0.004). Older women with a smaller body size had a higher probability of having BAC than women of the same age with a larger body size. Conclusions: The presence or absence of BAC at mammography may provide an assessment of a postmenopausal woman's lifetime estrogen exposure and indicate women who could be at risk for hormonally related conditions.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/85108/1/jwh_2010_1932.pd

Improved visualization of breast tissue on a dedicated breast PET system through ergonomic redesign of the imaging table

Abstract Background Breast lesions closer than 2 cm to the chest wall are difficult to position in the field of view of dedicated breast PET (db-PET) systems. This inability to detect such lesions is a significant limitation of these systems. The primary objective of this study was to determine if modifications to the design of the imaging table and detector used for a db-PET system would enable improved visualization of breast tissue close to the chest wall. All studies were performed on a commercially available db-PET system (Mammi-PET). A central square section of the imaging table, containing the standard 180-mm circular aperture, was modified such that it could be removed and replaced by thinner sections with a larger aperture. Additional changes were made to the cover plate of the detector array and the patient mattress. A total of 60 patients were studied. After administration of F-18 FDG, 30 patients were imaged with a 220-mm-diameter aperture and the standard aperture, and 30 patients with a 200-mm aperture and the standard aperture. On all scans, the length of breast tissue in the field of view was measured as the greatest extent of tissue from the nipple back to the posterior edge of the breast. Image quality and patient comfort were recorded. Results Averaged over both breasts, relative to the standard aperture, the increase in breast length was 12.5 + 7.7 mm with the 220-mm aperture, and 12.3 + 6.5 mm with the 200-mm aperture (p < 0.05 for both apertures). In ~ 5% of cases, the larger apertures resulted in some degradation in image quality due to closer proximity to cardiac/hepatic activity. In 10–20% of cases, movement of the breast tissue was observed as the detector ring was moved to scan the anterior region of the breast. The patient survey indicated no significant difference in the comfort level between the standard aperture and either of the prototype apertures. Conclusions Modifications to the image table and system resulted in a significant gain in the volume of breast tissue that could be imaged on the db-PET system and should allow better visualization of lesions close to the chest wall

Correlating Tumor Stiffness with Immunohistochemical Subtypes of Breast Cancers: Prognostic Value of Comb-Push Ultrasound Shear Elastography for Differentiating Luminal Subtypes.

PURPOSE:The purpose of our study is to correlate quantitatively measured tumor stiffness with immunohistochemical (IHC) subtypes of breast cancer. Additionally, the influence of prognostic histologic features (cancer grade, size, lymph node status, and histological type and grade) to the tumor elasticity and IHC profile relationship will be investigated. METHODS:Under an institutional review board (IRB) approved protocol, B-mode ultrasound (US) and comb-push ultrasound shear elastography (CUSE) were performed on 157 female patients with suspicious breast lesions. Out of 157 patients 83 breast cancer patients confirmed by pathology were included in this study. The association between CUSE mean stiffness values and the aforementioned prognostic features of the breast cancer tumors were investigated. RESULTS:Our results demonstrate that the most statistically significant difference (p = 0.0074) with mean elasticity is tumor size. When considering large tumors (size ≥ 8mm), thus minimizing the statistical significance of tumor size, a significant difference (p 20%) subtypes. CONCLUSION:Tumor size is an independent factor influencing mean elasticity. The Ki-67 proliferation index and histological grade were dependent factors influencing mean elasticity for the differentiation between luminal subtypes. Future studies on a larger group of patients may broaden the clinical significance of these findings

Comb-push ultrasound shear elastography of breast masses: initial results show promise.

To evaluate the performance of Comb-push Ultrasound Shear Elastography (CUSE) for classification of breast masses.CUSE is an ultrasound-based quantitative two-dimensional shear wave elasticity imaging technique, which utilizes multiple laterally distributed acoustic radiation force (ARF) beams to simultaneously excite the tissue and induce shear waves. Female patients who were categorized as having suspicious breast masses underwent CUSE evaluations prior to biopsy. An elasticity estimate within the breast mass was obtained from the CUSE shear wave speed map. Elasticity estimates of various types of benign and malignant masses were compared with biopsy results.Fifty-four female patients with suspicious breast masses from our ongoing study are presented. Our cohort included 31 malignant and 23 benign breast masses. Our results indicate that the mean shear wave speed was significantly higher in malignant masses (6 ± 1.58 m/s) in comparison to benign masses (3.65 ± 1.36 m/s). Therefore, the stiffness of the mass quantified by the Young's modulus is significantly higher in malignant masses. According to the receiver operating characteristic curve (ROC), the optimal cut-off value of 83 kPa yields 87.10% sensitivity, 82.61% specificity, and 0.88 for the area under the curve (AUC).CUSE has the potential for clinical utility as a quantitative diagnostic imaging tool adjunct to B-mode ultrasound for differentiation of malignant and benign breast masses

Automated and real-time segmentation of suspicious breast masses using convolutional neural network

<div><p>In this work, a computer-aided tool for detection was developed to segment breast masses from clinical ultrasound (US) scans. The underlying Multi U-net algorithm is based on convolutional neural networks. Under the Mayo Clinic Institutional Review Board protocol, a prospective study of the automatic segmentation of suspicious breast masses was performed. The cohort consisted of 258 female patients who were clinically identified with suspicious breast masses and underwent clinical US scan and breast biopsy. The computer-aided detection tool effectively segmented the breast masses, achieving a mean Dice coefficient of 0.82, a true positive fraction (TPF) of 0.84, and a false positive fraction (FPF) of 0.01. By avoiding positioning of an initial seed, the algorithm is able to segment images in real time (13–55 ms per image), and can have potential clinical applications. The algorithm is at par with a conventional seeded algorithm, which had a mean Dice coefficient of 0.84 and performs significantly better (P< 0.0001) than the original U-net algorithm.</p></div

A Mid-Layer Model for Human Reliability Analysis: Understanding the Cognitive Causes of Human Failure Events

The Office of Nuclear Regulatory Research (RES) is sponsoring work in response to a Staff Requirements Memorandum (SRM) directing an effort to establish a single human reliability analysis (HRA) method for the agency or guidance for the use of multiple methods. As part of this effort an attempt to develop a comprehensive HRA qualitative approach is being pursued. This paper presents a draft of the method’s middle layer, a part of the qualitative analysis phase that links failure mechanisms to performance shaping factors. Starting with a Crew Response Tree (CRT) that has identified human failure events, analysts identify potential failure mechanisms using the mid-layer model. The mid-layer model presented in this paper traces the identification of the failure mechanisms using the Information-Diagnosis/Decision-Action (IDA) model and cognitive models from the psychological literature. Each failure mechanism is grouped according to a phase of IDA. Under each phase of IDA, the cognitive models help identify the relevant performance shaping factors for the failure mechanism. The use of IDA and cognitive models can be traced through fault trees, which provide a detailed complement to the CRT

B-mode ultrasound (US) and shear wave speed map of of selected patient studies.

<p>B-mode ultrasound (US) and shear wave speed map of of selected patient studies.</p