Keywords:
Cancer, Diagnostic procedure, Image manipulation / Reconstruction, Oncology, Breast
Authors:
A. Iriarte1, G. de vargas2, C. Bore1, P. Bannister1, L. Tsui1, D. Gibbins3; 1Bristol/UK, 2Madrid/ES, 3Bristol /UK
DOI:
10.1594/ecr2018/C-1623
Methods and materials
Clinical:
Patients attending symptomatic clinics at three sites were identified by clinicians as having a palpable lump.
Following informed consent,
eligible patients underwent a MARIA® scan.
The bilateral reconstructed 3D images were used in this study.
The density classification process was accessed by comparison with BIRAD density scores estimated from mammograms.
Equipment:
MARIA® is a CE-marked radio-frequency (RF) medical imaging system [1][2] comprising a patient bed,
a Scanning and Data Processing (SDP) unit which is located under the bed and a touch-screen console featuring a software user interface that controls both acquisition and review - see Fig.1.
The SDP unit contains a hemispherical array of 60 RF antenna [6] which encircle the breast.
The breast lies pendant in the array through a hole in the bed and one of a set of conformal ceramic inserts,
placed into the array are provided to fit a range of breast sizes without the need for compression (Fig.
1).
By serially energising each antenna,
scattering parameters are collected from the signals received at all remaining antennas.
As signals propagate across the breast,
their magnitudes and phases are modified according to the dielectric properties of the tissue traversed.
Description of the procedure:
Patients were scanned before any surgical or biopsy intervention.
Data collected were BIRADS score,
age,
menopausal status,
and breast size.
The subject was required to lie prone with the breast inserted into the ceramic cup.
A coupling fluid [7],
similar to hand moisturiser,
is applied between the breast and insert to maintain good RF contact.
The scan consisted of checks for goodness of fit of the breast (lack of air gap) and then at least two scans of about 30 seconds each.
The total scan time with patient present was typically less than 5 minutes.
Evaluation method:
A flow diagram of the evaluation process can be seen in Fig.
2.
A 3D image of the patient is created from the scattering parameters (Fig.
3) using a modified version of the classical delay-and-sum (DAS) beamforming algorithm [8]. A median filter is applied to reduce image noise and a histogram of pixel intensity is produced (Fig.
4).
The area under histogram for the highest 35% of pixel magnitudes is calculated and used as a metric in a linear classification procedure.
Breasts are classified as being either "lucent" or "dense".
The position of the threshold is obtained from a training set of cases with known density characteristics,
for example,
BIRAD scores estimated from mammograms.