Ultrasonographic elastography of the breast using acoustic radiation force impulse technology: preliminary study

Tozaki, Mitsuhiro; Isobe, Sachiko; Miki, Yoshio; Ogawa, Yukari; Homma, Kanako; Saito, Masahiro; Joo, Chanwoong; Fukuma, Eisuke

doi:10.1007/s11604-011-0561-2

Cited by 34 publications

(17 citation statements)

References 17 publications

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“…Both the displacement magnitude and the speed of the shear wave propagation away from the pushing location are related to the viscoelastic tissue properties; thus, these modalities provide an additional contrast mechanism that is adjunctive to the information provided by B-mode imaging. 8 Initial studies from early adopters have reported promising findings for a wide variety of clinical applications, including, for example, noninvasively staging liver fibrosis (Virtual Touch [Siemens], 117 SWE [SuperSonic Imagine, 118 ElastPQ [Philips]), and breast lesion characterization (SWE, 119 Virtual Touch 120 ).…”

Section: Potential Clinical Benefit Of Cip In Nonfetal Tissues Not mentioning

confidence: 99%

Conditionally Increased Acoustic Pressures in Nonfetal Diagnostic Ultrasound Examinations Without Contrast Agents: A Preliminary Assessment

Nightingale

Church

Harris

et al. 2015

J of Ultrasound Medicine

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The mechanical index (MI) has been used by the US Food and Drug Administration (FDA) since 1992 for regulatory decisions regarding the acoustic output of diagnostic ultrasound equipment. Its formula is based on predictions of acoustic cavitation under specific conditions. Since its implementation over 2 decades ago, new imaging modes have been developed that employ unique beam sequences exploiting higher-order acoustic phenomena, and, concurrently, studies of the bioeffects of ultrasound under a range of imaging scenarios have been conducted. In 2012, the American Institute of Ultrasound in Medicine Technical Standards Committee convened a working group of its Output Standards Subcommittee to examine and report on the potential risks and benefits of the use of conditionally increased acoustic pressures (CIP) under specific diagnostic imaging scenarios. The term “conditionally” is included to indicate that CIP would be considered on a per-patient basis for the duration required to obtain the necessary diagnostic information. This document is a result of that effort. In summary, a fundamental assumption in the MI calculation is the presence of a preexisting gas body. For tissues not known to contain preexisting gas bodies, based on theoretical predications and experimentally reported cavitation thresholds, we find this assumption to be invalid. We thus conclude that exceeding the recommended maximum MI level given in the FDA guidance could be warranted without concern for increased risk of cavitation in these tissues. However, there is limited literature assessing the potential clinical benefit of exceeding the MI guidelines in these tissues. The report proposes a 3-tiered approach for CIP that follows the model for employing elevated output in magnetic resonance imaging and concludes with summary recommendations to facilitate Institutional Review Board (IRB)-monitored clinical studies investigating CIP in specific tissues.

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Section: Potential Clinical Benefit Of Cip In Nonfetal Tissues Not mentioning

confidence: 99%

Conditionally Increased Acoustic Pressures in Nonfetal Diagnostic Ultrasound Examinations Without Contrast Agents: A Preliminary Assessment

Nightingale

Church

Harris

et al. 2015

J of Ultrasound Medicine

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“…Lesions which are not confirmed are classified as Pattern 2. Lesions classified as Patterns 1 and 2 are considered benign, whereas lesions classified as Pattern 3 are considered suspicious [45]. At present these criteria have not been tested on large patient populations.…”

Section: Elastographic Criteriamentioning

confidence: 99%

“…Tozaki et al [45] studied 40 lesions (18 benign and 22 malignant; confirmed by histological analysis) to investigate the usefulness of qualitative elastography using ARFI in the differential diagnosis of solid breast lesions. Classification was based on a 3-level visual pattern: all lesions classified as Patterns 1 and 2 were benign and 73% of the lesions classified as Pattern 3 were malignant.…”

Section: Acoustic Radiation Force Impulse (Arfi)mentioning

confidence: 99%

Breast elastography: A literature review

Goddi¹,

Bonardi

Alessi

2012

Journal of Ultrasound

141

129

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KEYWORDS Sonoelastography; Breast elastography; Breast lesions.Abstract Breast elastography is a new sonographic imaging technique which provides information on breast lesions in addition to conventional ultrasonography (US) and mammography. Elastography provides a noninvasive evaluation of the stiffness of a lesion. Today, two technical solutions are available for clinical use: strain elastography and shear wave elastography. Initial evaluations of these techniques in clinical trials suggest that they may substantially improve the possibility of differentiating benign from malignant breast lesions thereby limiting recourse to biopsy and considerably reducing the number of benign breast biopsy diagnoses. This article reviews the basics of this technique, how to perform the examination, image interpretation and the results of major clinical studies. Although elastography is easy to perform, training and technical knowledge are required in order to obtain images permitting a correct interpretation. This paper will highlight the technique and point out common pitfalls.Sommario L'elastosonografia mammaria è una nuova tecnica di imaging a ultrasuoni che fornisce informazioni aggiuntive sulle lesioni della mammella rispetto all'ecografia e alla mammografia. Consente una valutazione non invasiva della rigidità tessutale di una lesione. Sono attualmente disponibili due soluzioni tecniche per uso clinico: l'elastografia con strain e l'elastografia shear wave. I primi studi clinici di valutazione di queste tecniche suggeriscono che esse possano migliorare la caratterizzazione delle lesioni mammarie differenziando quelle benigne dalle maligne e riducendo in modo sostanziale il numero di biopsie per lesioni benigne. Questo articolo rivisita le basi tecniche, i criteri interpretativi delle immagini, i principali studi clinici e le possibili cause di errore. Per quanto l'elastosonografia sia di facile esecuzione, richiede tuttavia un training e delle conoscenze tecniche adeguate per ottenere immagini correttamente interpretabili. ª

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“…Various studies have showed that conventional US may be helpful for predicting axillary LNM by evaluating the suspicious US features such as intralesional calcification, internal flow, and nodal size 8, 9 . On the other hand, many studies have showed that breast cancers are stiffer than normal and benign tissues 10–12 , which can be evaluated by US elastography. As new US-based elastography techniques, acoustic radiation force impulse (ARFI) imaging of virtual touch tissue imaging (VTI; Siemens Medical Solutions, Mountain View, CA, USA) and shear wave imaging of virtual touch tissue imaging & quantification (VTIQ; Siemens Medical Solutions, Mountain View, CA, USA) have recently been used to diagnose breast cancers by measurement of the tissue stiffness 10, 11 .…”

Section: Introductionmentioning

confidence: 99%

A Risk Model based on Ultrasound, Ultrasound Elastography, and Histologic Parameters for Predicting Axillary Lymph Node Metastasis in Breast Invasive Ductal Carcinoma

et al. 2017

Sci Rep

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To develop a risk model for predicting axillary lymph node metastasis (LNM) in patients with breast invasive ductal carcinoma (IDCs) using ultrasound (US), US elastography of virtual touch tissue imaging (VTI) and virtual touch tissue imaging & quantification (VTIQ), and histologic parameters. This study included 162 breast IDCs in 162 patients. Univariate and multivariate analyses were used to identify the risk factors and a risk model was created. The results found that 64 (39.5%) of 162 patients had axillary LNMs. The risk score (RS) for axillary LNM was defined as following: RS = 1.3 × (if lesion size ≥20 mm) + 2.6 × (if taller than wide shape) + 2.2 × (if VTI score ≥5) + 3.9 × (if histological grade III) + 1.9 × (if positive C-erbB-2). The rating system was divided into 6 stages (i.e. Stage I, Stage II, Stage III, Stage IV, Stage V, and Stage VI) and the associated risk rates in terms of axillary LNM were 0% (0/19), 6.1% (2/33), 7.7% (3/39), 65.5% (19/29), 92.3% (24/26), and 100% (16/16), respectively. The risk model for axillary LNM established in the study may facilitate subsequent treatment planning and management in patients with breast IDCs.

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Ultrasonographic elastography of the breast using acoustic radiation force impulse technology: preliminary study

Abstract: ARFI imaging is a potentially promising ultrasonographic technique for the differential diagnosis of breast lesions, particularly complicated cysts without a cystic component on B-mode images.

Cited by 34 publications

References 17 publications

Conditionally Increased Acoustic Pressures in Nonfetal Diagnostic Ultrasound Examinations Without Contrast Agents: A Preliminary Assessment

Conditionally Increased Acoustic Pressures in Nonfetal Diagnostic Ultrasound Examinations Without Contrast Agents: A Preliminary Assessment

Breast elastography: A literature review

A Risk Model based on Ultrasound, Ultrasound Elastography, and Histologic Parameters for Predicting Axillary Lymph Node Metastasis in Breast Invasive Ductal Carcinoma

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