Learning objectives
Different diagnostic imaging technologies,
consolidated and emerging,
can nowadays be applied to breast district: Mammography [1],
Breast Tomosynthesis [2],
Ductography [3],
Magnetic Resonance Imaging (MRI) dedicated to breast [4],
Automated Breast Ultrasound Systems (ABUS) with the patient in supine [5] or prone position [6] and Molecular Breast Imaging (MBI) [7].
Free-hand Ultrasound (US) plays an important role in breast diagnostics as a real-time examination,
not ionizing and non-invasive,
cost effective,
ideal also for repetitive follow-up and able to give information about anatomy (B-Mode modality),
hemodynamics...
Background
A.
Subject Predisposition
For ex-vivo Virtual Biopsy and fusion imaging tests,
two hand-made phantoms,
one prepared with a chicken-breast and an olive with pit,
and another one prepared with four olives with pit,
were used.
The chicken-breast wanted to be a human breast tissue simulator,
while the olives with pit wanted to be solid breast mass simulators.
On the ex vivo phantoms,
both Virtual Biopsy and fusion imaging with 3DPan and 2D acquisitions were performed.
For in vivo real-time biopsy US Virtual Navigator guidance,
20...
Findings and procedure details
Virtual Biopsy guided core biopsy was performed both in ex vivo (chicken-breast with olives with pit as mimicking lesions) and in vivo on 20 patients already scheduled for core biopsy.
On 15 patients the Virtual Biopsy was performed directly with 2D scans,
on 5 patients the Virtual Biopsy was used with the fusion between the real-time 2D scan and the already acquired 3DPan volumes of the same patients.
On the ex vivo phantoms,
both Virtual Biopsy and fusion imaging with 3DPan and 2D acquisitions were...
Conclusion
In this preliminary study,
the Virtual Biopsy tool facilitated core biopsy needle insertion both in ex vivo and in vivo tests,
especially for less experienced operators in US guided core biopsy procedures.
With its graphical representation of the needle tip insertion point and the planning of the path within the area to be sampled,
it represented a valuable tool for improved practical confidence.
The confidence is even increased by the possibility to monitor in real time the tissue stiffness with elastosonography and the hemodynamics of...
Personal information
Elisabetta Giannotti
Dipartimento di Scienze Biomediche,
Sperimentali e Cliniche,
Sezione di Radiodiagnostica Università degli Studi di Firenze,
Firenze,
Italy
[email protected]
Sara D’Onofrio
Esaote S.p.A.,
Firenze,
Italy
[email protected]
References
[1] K.
Kerlikowske et al.,
“Positive Predictive Value of Screening Mammography by Age and Family History of Breast Cancer”,
JAMA 1993;270(20):2444-2450
[2] D.
Gur et al.,
“Digital Breast Tomosynthesis: Observer Performance Study”,
AJR 2009; 193:586–591
[3] G.
Cardenosa et al.,
“Ductography of the breast: technique and findings”,
AJR,
1994; 162:1081-1087
[4] S.C.
Rankin,
“MRI of the breast”,
The British Journal of Radiology,
73 (2000),
806-818
[5] Kevin M.
Kelly et al.,
“Breast cancer detection using automated whole breast ultrasound and mammography in radiographically dense breasts”,...