TY - GEN
T1 - Combining Quantitative 3D Subharmonic Imaging and Clinical Assessments for Accurate Characterization of Breast Masses
AU - Forsberg, Flemming
AU - Merton, Daniel A.
AU - Wallace, Kirk
AU - Eisenbrey, John R.
AU - Sridharan, Anush
AU - Piccoli, Catherine W.
AU - Sevrukov, Alexander
AU - Wilkes, Annina
AU - Ojeda-Fournier, Haydee
AU - Mattrey, Robert F.
AU - MacHado, Priscilla
AU - Stanczak, Maria
N1 - Funding Information:
Supported by National Institutes of Health grant R01 CA140338, U.S. Army Medical Research Material Command grant W81XWH-11-1-0630 and Lantheus Medical Imaging (supplied Definity).
Publisher Copyright:
© 2019 IEEE.
PY - 2019/10
Y1 - 2019/10
N2 - This multi-center study evaluated the ability of contrast-enhanced, nonlinear 3D ultrasound imaging to characterize indeterminate breast lesions using quantitative parametric maps and clinical assessments. In total 236 women with biopsy-proven breast lesions were enrolled in this study. Following B-mode and power Doppler imaging (PDI), an ultrasound contrast agent (Definity®, Lantheus Medical Imaging, N Billerica, MA, USA) was administrated. Contrast-enhanced 3D harmonic imaging (HI; transmitting/receiving at 5.0/10.0 MHz) as well as 3D subharmonic imaging (SHI; transmitting/receiving at 5.8/2.9 MHz) were performed using a modified Logiq 9 scanner (GE Healthcare, Waukesha, WI, USA) with a 4D10L probe. Five radiologists blinded to the reference independently scored the imaging modes using a 7-point BIRADS scale. Parametric volumes were constructed from time-intensity curves for vascular heterogeneity, perfusion (PER as the slope of the curve) and area under the curve (AUC) based on individual voxel values in the lesion. ROC analysis were applied to assess diagnostic accuracy with biopsy results as the reference. Out of the 236 cases, 219 were successfully scanned and biopsies resulted in 164 (75%) benign and 55 (25%) malignant lesions. 3D HI showed flow in 8 lesions (5 benign and 3 malignant), whereas 3D SHI visualized flow in 83 lesions (58 benign and 25 malignant). Hence, extracting quantitative parameters was restricted to the SHI volumes that demonstrated sufficient flow for processing. Diagnostic accuracy for the quantitative SHI parameters ranged from 0.52 to 0.75. Diagnostic accuracies from the clinical assessments ranged from 0.55-0.94 for baseline ultrasound, 0.52-0.93 for PDI, 0.59-0.85 for HI and 0.55-0.91 for SHI. The best logistical regression model achieved an accuracy of 0.91. In conclusion, combining quantitative SHI perfusion estimates and conventional B-mode imaging may increase the accuracy for characterizing indeterminate breast masses.
AB - This multi-center study evaluated the ability of contrast-enhanced, nonlinear 3D ultrasound imaging to characterize indeterminate breast lesions using quantitative parametric maps and clinical assessments. In total 236 women with biopsy-proven breast lesions were enrolled in this study. Following B-mode and power Doppler imaging (PDI), an ultrasound contrast agent (Definity®, Lantheus Medical Imaging, N Billerica, MA, USA) was administrated. Contrast-enhanced 3D harmonic imaging (HI; transmitting/receiving at 5.0/10.0 MHz) as well as 3D subharmonic imaging (SHI; transmitting/receiving at 5.8/2.9 MHz) were performed using a modified Logiq 9 scanner (GE Healthcare, Waukesha, WI, USA) with a 4D10L probe. Five radiologists blinded to the reference independently scored the imaging modes using a 7-point BIRADS scale. Parametric volumes were constructed from time-intensity curves for vascular heterogeneity, perfusion (PER as the slope of the curve) and area under the curve (AUC) based on individual voxel values in the lesion. ROC analysis were applied to assess diagnostic accuracy with biopsy results as the reference. Out of the 236 cases, 219 were successfully scanned and biopsies resulted in 164 (75%) benign and 55 (25%) malignant lesions. 3D HI showed flow in 8 lesions (5 benign and 3 malignant), whereas 3D SHI visualized flow in 83 lesions (58 benign and 25 malignant). Hence, extracting quantitative parameters was restricted to the SHI volumes that demonstrated sufficient flow for processing. Diagnostic accuracy for the quantitative SHI parameters ranged from 0.52 to 0.75. Diagnostic accuracies from the clinical assessments ranged from 0.55-0.94 for baseline ultrasound, 0.52-0.93 for PDI, 0.59-0.85 for HI and 0.55-0.91 for SHI. The best logistical regression model achieved an accuracy of 0.91. In conclusion, combining quantitative SHI perfusion estimates and conventional B-mode imaging may increase the accuracy for characterizing indeterminate breast masses.
KW - breast cancer
KW - microbubbles
KW - subharmonic imaging
KW - ultrasound
KW - ultrasound contrast agents
UR - http://www.scopus.com/inward/record.url?scp=85077623615&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85077623615&partnerID=8YFLogxK
U2 - 10.1109/ULTSYM.2019.8926196
DO - 10.1109/ULTSYM.2019.8926196
M3 - Conference contribution
AN - SCOPUS:85077623615
T3 - IEEE International Ultrasonics Symposium, IUS
SP - 1177
EP - 1180
BT - 2019 IEEE International Ultrasonics Symposium, IUS 2019
PB - IEEE Computer Society
T2 - 2019 IEEE International Ultrasonics Symposium, IUS 2019
Y2 - 6 October 2019 through 9 October 2019
ER -