ObjectivesUltrasound tomography (UST) is an emerging whole-breast 3-dimensional imaging technique that obtains quantitative tomograms of speed of sound of the entire breast. The imaged parameter is the speed of sound which is used as a surrogate measure of density at each voxel and holds promise as a method to evaluate breast density without ionizing radiation. This study evaluated the technique of UST and compared whole-breast volume averaged speed of sound (VASS) with MR percent water content from noncontrast magnetic resonance imaging (MRI).Materials and MethodsForty-three healthy female volunteers (median age, 40 years; range, 29–59 years) underwent bilateral breast UST and MRI using a 2-point Dixon technique. Reproducibility of VASS was evaluated using Bland-Altman analysis. Volume averaged speed of sound and MR percent water were evaluated and compared using Pearson correlation coefficient.ResultsThe mean ± standard deviation VASS measurement was 1463 ± 29 m s−1 (range, 1434–1542 m s−1). There was high similarity between right (1464 ± 30 m s−1) and left (1462 ± 28 m s−1) breasts (P = 0.113) (intraclass correlation coefficient, 0.98). Mean MR percent water content was 35.7% ± 14.7% (range, 13.2%–75.3%), with small but significant differences between right and left breasts (36.3% ± 14.9% and 35.1% ± 14.7%, respectively; P = 0.004). There was a very strong correlation between VASS and MR percent water density (r2 = 0.96, P < 0.0001).ConclusionsUltrasound tomography holds promise as a reliable and reproducible 3-dimensional technique to provide a surrogate measure of breast density and correlates strongly with MR percent water content.

Purpose: To evaluate the accuracy of an external immobilisation system in patients receiving radiotherapy for prostate cancer.Methods: Portal Imaging data were audited in 20 patients treated using an in-house immobilisation system and 20 patients treated using an indexed commercial immobilisation system (CombifixÔ). Individual and group random and systematic errors were calculated to determine the accuracy of set-up using skin marks alone and with a no-action-level protocol. Results:The initial results showed a larger systematic error in the CombifixÔ in the anterior-posterior direction (2.7 mm) compared with the in-house system (1.5 mm). The possible source of this was identified as the difficulty in accurately aligning the laser to a curved couch top prior to setting the isocentre height. A change in the process of setting the isocentre was introduced, and comparable baseline set-up accuracy was achieved. This was with a systematic error of 2.0 mm and a random error 1.5 mm of patient position set-up error with skin marks alone, and using the CombifixÔ. The systematic errors were further reduced to <1 mm with an off-line no-action-level protocol. Conclusion:Using the CombifixÔ system a high level of set-up accuracy was reproduced in routine daily practice.

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