Use of ultrasound elasticity imaging to monitor the response of a primary breast cancer to neoadjuvant chemotherapy in one patient in a pilot study

Abstract

IntroductionThe automated breast volume scanner (ABVS) is the fi rst of its kind and utilises a large, 17 cm × 15 cm high-frequency ultrasound probe which sweeps across the whole breast generating images that can be reformatted into multiple planes and a 3D volume. ABVS will change breast ultrasound practice by: introducing operator standardisation, reproducibility and repeatability of measurement and interpretation; changing who acquires the volume set and how breast ultrasounds are reported; and allowing accurate comparison of previous and current examinations for screening and assessing treatment change. Methods Patients presented to the symptomatic clinic for conventional 2D ultrasound assessment with a variety of conditions. An additional ABVS was performed. Results Cases were classifi ed into: benign -for example, cysts, fi broadenomas, diabetic mastopathy; and malignant. Conclusion We present a review of our initial experience and highlight its advantages over conventional ultrasound, which include: improved mapping of lesions enabling more accurate future assessment and follow-up, and improved assessment of distortion over conventional 2D ultrasound. Further research is required to explore other potential benefi ts. Introduction A study of symptomatic breast units geographically spread over Ireland collected image quality, compression and radiation dose data from 18 mammography units; so how do these optimisation parameters compare nationally and internationally? The mean glandular dose (MGD) diagnostic reference level was proposed for the all-digital breast screening service [1] but not for the symptomatic breast service. Methods The quantitative and qualitative data were analysed using SPSS. Recommendations of MGD diagnostic reference levels were made at various levels for fi lm-screen mammography (FSM) and full-fi eld digital mammography (FFDM) units to match those levels published in worldwide. O2 Symptomatic breast services inResults MGDs received by symptomatic breast patients within Ireland are higher than those received in the all-digital Irish Breast Screening service, although the diff erences for FFDM are not substantial; 55 to 65 mm breast: 1.75 mGy (screening) versus 2.4 mGy (symptomatic) at the 95th percentile. The four-view routine mammography MGDs obtained in symptomatic breast units in Ireland are, however, substantially diff erent from other screening units with mixed FSM/FFDM modalities: 4.5 mGy (UK); 4.98 mGy (USA) versus 5.96 mGy (FFDM, symptomatic) and 9.63 mGy (FSM, symptomatic). Various reasons are proposed for the diff erences. Conclusion MGD diagnostic reference levels achieved in the screening service may be lower due to the exacting requirements for radiographer training, nonsurgical alteration of patient breasts and equipment quality assurance levels. Greater training of radiographers performing mammography in the symptomatic breast services is required to standardise mammographic projections with regard to MGDs delivered. Reference O3Correlations between shear wave elastog...

Investigating longitudinal changes in the mechanical properties of MCF-7 cells exposed to paclitaxol using particle tracking microrheology

“…Elastography and shear wave ultrasound imaging have been used in clinical trials for the differentiation of benign and malignant breast tumors with considerable success (Tanter et al 2008, Evans et al 2010, Sebag et al 2010. Experiments are now underway to measure the changes in shear wave propagation as a function of treatment, while evidence that elastography can detect such changes have been reported (Bando et al 2007, Brindle 2008, English et al 2011, Hayashi et al 2012. Future work will include detailed studies of the longitudinal response of individually treated cells in a more controlled environment.…”

“…Recent studies have demonstrated that these modalities can be used for the detection of tumors based on quantitative stiffness measurements (Findings et al 2012, Berg et al 2012. A number of recent studies have led us to hypothesize that both ultrasound compression and shear wave elastography imaging could also be used for cancer treatment monitoring (Bando et al 2007, Brindle 2008, English et al 2011, Hayashi et al 2012. Similarly, magnetic resonance (MR) elastography has been shown to have potential in similar clinical applications.…”