Impact of real-time virtual sonography, a coordinated sonography and MRI system that uses an image fusion technique, on the sonographic evaluation of MRI-detected lesions of the breast in second-look sonography

Abstract

The aim of this study was to verify the utility of second-look sonography using real-time virtual sonography (RVS)-a coordinated sonography with an MRI system that uses an image fusion technique with magnetic navigation-on the sonographic evaluation of MRI-detected lesions of the breast. Of the 196 consecutive patients who were examined with breast MRI in our hospital from 2006 to 2009, those patients who underwent second-look sonography to identify MRI-detected lesions were enrolled in this study. MRI was performed using a 1.5-T imager with the patient in a supine position. To assess the efficacy benefits of RVS, the correlations between lesion detection rates, MRI features, distribution, and histopathological classification on second-look sonography using conventional B-mode or RVS were analyzed. Of the 196 patients, 55 (28 %) demonstrated 67 lesions initially detected by MRI, followed by second-look sonography. Of the 67 MRI-detected lesions, 18 (30 %) were identified with second-look sonography using conventional B-mode alone, whereas 60 (90 %) lesions were detected with second-look sonography using RVS (p < 0.001). The detection rates of 16 focal lesions, 46 mass lesions, 16 lesions sized <5 mm, 45 lesions sized 5-10 mm, 26 lesions situated within the mammary gland, 41 lesions situated around mammary fascia, 24 malignant lesions, and 43 benign lesions were, respectively, 25, 26, 25, 24, 42, 17, 33, and 23 % by conventional B-mode, and were significantly higher, respectively, at 94, 89, 94, 89, 88, 90, 92, and 88 % by RVS. Of the seven lesions with no sonographic correlates, five could be biopsied by marking MRI information onto the body surface using RVS. Overall, 65 of 67 (97 %) MRI-detected lesions were confirmed by histopathological results. Our results suggest that the additional use of RVS on second-look sonography significantly increases the sonographic detection rate of MRI-detected lesions without operator dependence.

Ultrasonography imaging of the anterolateral ligament using real-time virtual sonography

“…To our knowledge, this is the first report to investigate the detailed imaging of the ALL with US. RVS has previously been used in the identification and biopsy of breast cancers and abdominal tumors [15,16,17,18,19]. These studies suggest that the RVS system can accurately identify these tumors.…”

“…These studies suggest that the RVS system can accurately identify these tumors. Nakano et al reported that of 63 breast lesions, 42 (67%) lesions were identified by conventional US, whereas all lesions were identified by RVS [18]. Kitada et al reported that RVS-guided radiofrequency ablation therapy for hepatocellular carcinomas could be useful for treating hepatocellular carcinomas that are difficult to detect with US [16].…”

Impact of an abbreviated protocol for breast MRI in diagnostic accuracy

“…agreement, single rater/measurement (i.e., ICC [2,1]) was performed (15). For intrareader reliability, a two-way mixed-effects model (absolute agreement, single measurement) was computed.…”

Real-time virtual sonography examination and biopsy for suspicious breast lesions identified on MRI alone

“…The second-look US detection rate of MRI-detected lesions must be influenced by operator dependence. Recently, real-time virtual sonography (RVS) without the influence of operator experience and skill has been shown to significantly increase the second-look US detection rate of breast lesions initially detected at MRI [8][9][10]. The RVS system can coordinate US and MRI images using a magnetic positiontracking system and both US and MRI cutaway images of the same site are simultaneously displayed on one monitor in a side-by-side format in real time ( Fig.…”

“…The RVS system can coordinate US and MRI images using a magnetic positiontracking system and both US and MRI cutaway images of the same site are simultaneously displayed on one monitor in a side-by-side format in real time ( Fig. 1) [8][9][10][11]. If it were possible to increase the successful breast MRI-US correlation with RVS, it would be easier, cheaper and more comfortable for the patient to undergo a USguided biopsy for suspicious lesions identified on breast MRI alone.…”