Hybrid Ultrasound Tomography Scanner-a Novel Instrument Designed to Examine Breast as a Breast Cancer Screening Method
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2019, Vol 14, Issue 4
Abstract
Alternative radiological methods have been searched to improve early breast cancer detection. A prototype of a hybrid ultrasound tomography scanner was constructed as a novel non-invasive breast cancer screening method. The results of measurements with the new instrument were compared to conventional breast ultrasound, mammography, and magnetic resonance data from these same patients. The estimated hybrid ultrasound tomography scanner sensitivity was 74%, and specificity was 68%. Although these results do not match classical radiological methods yet, this preliminary report confirms the ability of the hybrid ultrasound tomography scanner to detect and visualize different types of breast lesions including breast cancer, providing a rationale for further research. Breast cancer is the most frequent malignancy in women worldwide. The key factor for its complete cure is early dection of the lesion. In any clinical setting, effective screening methods should be: common, well available, cost-effective, easy to apply, noninvasive, and - foremost - reliable. It is also of importance that the method in question be of high sensitivity and possibly high specificity. In case of the breast tissue, the last two criteria are difficult to attain at a time because the breasts of individual women demonstrate different tissue compositions and densities, hindering thus the final interpretation of the examination. Radiological methods applied so far for the early detection of breast cancer in the general population include ultrasound examination, mammography, and magnetic resonance imaging. Each of these methods has some advantages and shortcomings. Whereas ultrasound is entirely safe for the patient and offers a rather good insight into the breast of mainly glandular composition, mammography is a routine method for the detection of lesions in breasts of predominant adipose composition, however, at the expense of patient exposition to ionizing radiation. Magnetic resonance imaging demonstrates the best sensitivity and specificity of the three, yet high costs of the examination and the necessity to give the patient a contrast medium limit its broader application for in-depth diagnosis. Therefore, new and complementary methods are constantly being invented and tested for the early detection of breast cancer in hope that these inventions will turn suitable for screening and will thus save more human lives. The aim of the present communication is to report the first set of data obtained with a novel instrument designed to examine the breasts, hybrid ultrasound tomography scanner by DRAMINSKI Ultrasound Scanners Company, (Olsztyn, Poland), as a new means of cancer screening. Materials and Methods Description of Ultrasound Tomography Scanner The ultrasound tomography is noninvasive and painless, as there is neither mechanical compression of the breast, nor ionizing radiation applied. During the measurement, patients are placed on the scanner bed in the prone position with the breast submerged in the container filled with water (Figure 1). The breast is scanned in coronal sections in 1 mm distances, using the ultrasonic circular array shifted vertically [1]. The ring array contains 1024 miniature piezoceramic ultrasonic transducers arranged evenly on the inner side of the ring surrounding the breast. Elementary transducers have active surface dimensions of 0.5 x 18 mm and work at a frequency of about 2 MHz [2]. Depending on the length of the breast, about 100 to 200 coronal sections are measured, from its base to the nipple. The Figure 2 shows the block scheme of the hybrid ultrasound tomography scanner (Figures 1 and 2). In ultrasound tomography 3 complementary ultrasound images, representing a distribution of transmission, reflection and scattering ultrasound parameters are reconstructed. The fusion of these images allows a qualitative and quantitative characterization of breast tissue in the entire breast volume [3] (Figure 3). Patients and Breast Evaluation In this study 132 women aged 18-82 years underwent breast examination with the hybrid ultrasound tomography scanner. Each detected lesion of the breast was evaluated on the basis of the red pixel number indicating malignancy in relation to the yellow pixel number indicating benignity. Pixels were counted separately in each coronal, transversal and sagittal section of the lesion in the fusion image (Figure 3), and then averaged. These results were expressed as the “percentage of malignancy” (%) and taken for the statistical analysis. Breast density was determined according to American College of Radiology [4]. Conventional B-mode ultrasound breast imaging, mammography and magnetic resonance breast imaging results expressed in BIRADS scale were used for comparison.
Authors and Affiliations
Milewski Tomasz, Michalak Maciej, Wiktorowicz Andrzej, Opieliński Krzysztof, Pruchnicki Piotr, Bułkowski Mariusz, Gielecki Jerzy, Jóźwik Marcin
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