de Jong, L.

de Korte, C.L.

Fütterer, J.J.

Mann, R.M.

Siepel, F.J.

Stramigioli, S.

van Zelst, J.

Welleweerd, M.K.

English

University of Twente Research Information

Breast lesion markers for 3D ultrasound examinations of thebreast.Poster No.: C-2956Congress: ECR 2018Type: Scientific ExhibitAuthors: L. de Jong1, M. K. Welleweerd2, J. van Zelst1, F. J. Siepel2,S. Stramigioli2, J. J. Futterer1, R. M. Mann1, C. L. de Korte1;1Nijmegen/NL, 2Enschede/NLKeywords: Image registration, Screening, Observer performance, Ultrasound,BreastDOI: 10.1594/ecr2018/C-2956Any information contained in this pdf file is automatically generated from digital materialsubmitted to EPOS by third parties in the form of scientific presentations. Referencesto any names, marks, products, or services of third parties or hypertext links to third-party sites or information are provided solely as a convenience to you and do not inany way constitute or imply ECR's endorsement, sponsorship or recommendation of thethird party, information, product or service. ECR is not responsible for the content ofthese pages and does not make any representations regarding the content or accuracyof material in this file.As per copyright regulations, any unauthorised use of the material or parts thereof aswell as commercial reproduction or multiple distribution by any traditional or electronicallybased reproduction/publication method ist strictly prohibited.You agree to defend, indemnify, and hold ECR harmless from and against any and allclaims, damages, costs, and expenses, including attorneys' fees, arising from or relatedto your use of these pages.Please note: Links to movies, ppt slideshows and any other multimedia files are notavailable in the pdf version of presentations.www.myESR.orgPage 1 of 10Aims and objectivesOne of the advantages of 3D ultrasound is the possibility to have the whole breastscanned by technicians with batch or remote reporting by a dedicated breast radiologist[1,2]. However, feedback on concurrent focal abnormalities (e.g. palpable lesions) islost. We therefore aimed to develop skin markers for 3D ultrasound that can be usedfor marking focal abnormalities without disturbing the interpretation of the 3D ultrasounddataset.Page 2 of 10Methods and materialsMarker production:Markers were molded using a mold that was designed and 3D printed in a rubber-likematerial, allowing for removal of the resulting markers. Spherical, conical, circular, anddisk-shaped variants were molded in different sizes (Figure 1). The material used forthe marker is EcoFlex-Gel® (Macungie, Pennsylvania USA), which is a commerciallyavailable Room Temperature Curing (RTC) silicon. This silicon proved suitable for USimaging and can also be used as phantom material [3]. After mixing the two componentsthe silicon mixture is poured into the mold and is left to cure for two hours in a vacuumchamber for air removal. When the silicon is fully cured the markers can be removedfrom the mold for application.Image acquisition:3D ultrasound examinations were performed with the patient in supine position using aSiemens Acuson S2000 automated breast volume scanner (ABVS) system (Siemens,Erlangen) (Figure 2). In 5 patients undergoing 3D ultrasound examinations for clinicalreasons the same 3D volume was imaged twice, once with and once without a marker inplace. Ultrasound acquisition parameters were the same as used in clinical practice andvaried between patients based on cup size. Acquisition settings between the scans withand without a marker in place were identical in each patient.Image assessment:Markers were assessed by an experienced breast radiologist for ultrasoundcompatibility using qualitative parameters; detectability, shadowing-, enhancement-,and displacement artifact. Interpretability of the images with and without markers wascompared.Usability assessment:For application in clinical practice parameters on usability were evaluated. Applicationand removal of the marker, adhesion to the skin during scanning and material safety weretaken into account for evaluation.Page 3 of 10Images for this section:Fig. 1: Mold design used for pouring different sizes and shapes of markers.© Department of Robotics and Mechatronics, University of Twente - Enschede/NLPage 4 of 10Fig. 2: Siemens Acuson S2000 with ABVS arm used for acquisition of 3D ultrasoundimaging.© Radiology and nuclear medicine, Radboudumc, Radboudumc - Nijmegen/NLPage 5 of 10ResultsProduction and application:Production complexity of the silicon markers is low. Curing time allowed for effectivedegassing of the silicon. The markers are safe and easily applied to the skin. Adhesion issufficient to prevent dislocation during the 3D ultrasound acquisition, multiple sequentialacquisitions did not dislocate the marker.Ultrasound compatibility:Markers are clearly visible at skin level, presenting as small black circles in the coronalplane (Figure 3). In the transversal and reconstructed sagittal plane marker presenceis more subtle (Figure 4 and 5). There is only minimal shadowing at the edges of themarker. This did not affect image interpretability.Page 6 of 10Images for this section:Fig. 3: Reconstructed coronal plane of scans with (left) and without (right) marker.© Radiology and nuclear medicine, Radboudumc, Radboudumc - Nijmegen/NLFig. 4: Reconstruction of sagittal plane of scans with (left) and without (right) marker.Page 7 of 10© Radiology and nuclear medicine, Radboudumc, Radboudumc - Nijmegen/NLFig. 5: Transversal plane of scan with (upper) and without (right) marker.© Radiology and nuclear medicine, Radboudumc, Radboudumc - Nijmegen/NLPage 8 of 10ConclusionInexpensive, easy producible RTC silicon markers can be used for lesion marking in 3Dultrasound without affecting image interpretability.Page 9 of 10References[1] Van Zelst, J. C., Platel, B., Karssemeijer, N., & Mann, R. M. (2015). Multiplanarreconstructions of 3D automated breast ultrasound improve lesion differentiation byradiologists. Academic radiology, 22(12), 1489-1496.[2] Giuliano, V., & Giuliano, C. (2013). Improved breast cancer detection in asymptomaticwomen using 3D-automated breast ultrasound in mammographically dense breasts.Clinical imaging, 37(3), 480-486.[3] Ceha, D., Petersb, T. M., & Chenb, E. C. (2015). Acoustic characterization of polyvinylchloride and self-healing silicone as phantom materials. Liver, 1595, 0-5.Page 10 of 10

Breast lesion markers for 3D ultrasound examinations of the breast

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Breast lesion markers for 3D ultrasound examinations of the breast

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