The automated breast volume scanner (ABVS, Figure 1) was introduced for women with dense breast in which mammography has reduced sensitivity [1]. A limitation is the reduced specificity of the ABVS resulting in high recall rates, additional ultrasound exams and unnecessary biopsies [2]. Elastography might improve specificity as malignant lesions (e.g. invasive ductal carcinoma (IDC)) are often stiffer resulting in decreased strain compared to benign lesions [3]. The aim was to develop 3-D elastography for the ABVS and to validate this method in-vivo.

This study was approved by the local institutional ethical committee (CMO Radboudumc, project number CMO 2016-2692). (A)symptomatic patients were recruited between July 2017 and October 2018 and gave written informed consent in accordance with the Declaration of Helsinki. The inclusion criteria were adult women (18 years and older) who were scheduled for a mammogram or ultrasound breast exam at Radboudumc (Nijmegen, the Netherlands) for breast cancer screening or after being referred by their healthcare professional. Volumetric ultrasound radio-frequency datasets were acquired by the ABVS (Acuson...

31 women participated in which 2 IDC, 2 ductal carcinoma in situ (DCIS), 1 malignant phyllodes tumor (PT), 3 fibro-adenoma (FA), 8 cysts and 5 other benign lesions (OtherB) were present. The median strain ratios in the annotated regions were 2.8 and 3.5 (IDC); 0.9 and 2.1 (DCIS), 1.3 (PT), and 0.8 ± 0.5 (FA), and 1.3 ± 0.6 (OtherB) in median ± IQR determined over all patients (Figure 3). IDC showed increased strain ratios compared to benign lesions (FA, OB and cysts). DCIS is...

A novel operator-independent 3-D breast ultrasound elastography method was developed and implemented on a clinical ultrasound breast volume scanner to obtain and visualise in vivo elastography images in three dimensions. The preliminary results indicated that the IDC had the highest strain ratio with respect to benign lesions and normal tissue, although the study population was limited and the observed lesions were relatively small (<10 mm width).

Gijs A.G.M. Hendriks, MSc Medical UltraSound Imaging Center, Department of Radiology and Nuclear Medicine, Radboud university medical center, Nijmegen, the Netherlands Geert Grooteplein 10 PO Box 9101 6500 HB Nijmegen, the Netherlands Phone: + 31243651503 e-mail : [email protected]

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