Ultrasound Tomography.

Ultrasound tomography (USCT) is a promising imaging modality, mainly aiming at early diagnosis of breast cancer. It provides three-dimensional, reproducible images of higher quality than conventional ultrasound methods and additionally offers quantitative information on tissue properties. This chapter provides an introduction to the background and history of USCT, followed by an overview of image reconstruction algorithms and system design. It concludes with a discussion of current and future applications as well as limitations and their potential solutions.

Single-Fiber Transducer Arrays for 3-D Ultrasound Computed Tomography: From Requirements to Results.

A potential method for future breast cancer screening is 3-D ultrasound computed tomography (USCT). The utilized image reconstruction algorithms require transducer characteristics fundamentally different from conventional transducer arrays, leading to the necessity of a custom design. This design has to provide random transducer positioning, isotropic sound emission as well as a large bandwidth and wide opening angle. In this article, we present a new transducer array design to be utilized in a third generation 3-D USCT system. Each system requires 128 cylindrical arrays, mounted into the shell of a hemispherical measurement vessel. Each new array contains a 0.6 mm thick disk with 18 single PZT fibers (0.46 mm diameter) embedded in a polymer matrix. Randomized positioning of the fibers is achieved with an arrange-and-fill process. The single-fiber disks are connected on both ends with a matching and backing disk using simple stacking and adhesives. This enables fast and scalable production. We characterized the acoustic field of 54 transducers with a hydrophone. Measurements in 2-D showed isotropic acoustic fields. The mean bandwidth and opening angle are 131% and 42°, respectively (both -10 dB). The large bandwidth arises from two resonances within the utilized frequency range. Parameter studies using different models showed that the realized design is already close to the achievable optimum for the transducer technology used. Two 3-D USCT systems were equipped with the new arrays. First images show promising results, with an increase in image contrast and a significant reduction of artifacts.

Ultrasonic Synthetic-Aperture Interface Imaging.

Synthetic-aperture (SA) imaging is a popular method to visualize the reflectivity of an object from ultrasonic reflections. The method yields an image of the (volume) contrast in acoustic impedance with respect to the embedding. Typically, constant mass density is assumed in the underlying derivation. Due to the band-limited nature of the recorded data, the image is blurred in space, which is quantified by the associated point spread function. SA volume imaging is valid under the Born approximation, where it is assumed that the contrast is weak. When objects are large with respect to the wavelength, it is questionable whether SA volume imaging should be the method-of-choice. Herein, we propose an alternative solution that we refer to as SA interface imaging. This approach yields a vector image of the discontinuities of acoustic impedance at the tissue interfaces. Constant wave speed is assumed in the underlying derivation. The image is blurred in space by a tensor, which we refer to as the interface spread function. SA interface imaging is valid under the Kirchhoff approximation, where it is assumed that the wavelength is small compared to the spatial dimensions of the interfaces. We compare the performance of volume and interface imaging on synthetic data and on experimental data of a gelatin cylinder with a radius of 75 wavelengths, submerged in water. As expected, the interface image peaks at the gelatin-water interface, while the volume image exposes a peak and trough on opposing sides of the interface.

Comparing different ultrasound imaging methods for breast cancer detection.

Ultrasound is frequently used to evaluate suspicious masses in breasts. These evaluations could be improved by taking advantage of advanced imaging algorithms, which become feasible for low frequencies if accurate knowledge about the phase and amplitude of the wave field illuminating the volume of interest is available. In this study, we compare five imaging and inversion methods: time-of-flight tomography, synthetic aperture focusing technique, backpropagation, Born inversion, and contrast source inversion. All methods are tested on the same full-wave synthetic data representing a 2-D scan using a circular array enclosing a cancerous breast submerged in water. Of the tested methods, only contrast source inversion yielded an accurate reconstruction of the speed-ofsound profile of the tumor and its surroundings, because only this method takes effects such as multiple scattering, refraction, and diffraction into account.

4D co-registration of X-ray and MR-mammograms: initial clinical results and potential incremental diagnostic value.

PURPOSE: 4D co-registration of X-ray- and MR-mammograms (XM and MM) is a new method of image fusion. The present study aims to evaluate its clinical feasibility, radiological accuracy, and potential clinical value. METHODS: XM and MM of 25 patients were co-registered. Results were evaluated by a blinded reader. RESULTS: Precision of the 4D co-registration was "very good" (mean-score [ms]=7), and lesions were "easier to delineate" (ms=5). In 88.8%, "relevant additional diagnostic information" was present, accounting for a more "confident diagnosis" in 76% (ms=5). CONCLUSION: 4D co-registration is feasible, accurate, and of potential clinical value.

3D ultrasound computer tomography of the breast: a new era?

A promising candidate for imaging of breast cancer is ultrasound computer tomography (USCT). The main advantages of a USCT system are simultaneous recording of reproducible reflection, attenuation and speed of sound volumes, high image quality, and fast data acquisition. The here presented 3D USCT prototype realizes for the first time the full potential of such a device. It is ready for a clinical study. Full volumes of a breast can be acquired in four minutes. In this paper images acquired with a clinical breast phantom are presented. The resolution and imaged details of the reflectivity reconstruction are comparable to a 3 tesla MRI volume of the phantom. Image quality and resolution is isotropic in all three dimensions, confirming the successful implementation experimentally.

2D/3D image fusion of X-ray mammograms with breast MRI: visualizing dynamic contrast enhancement in mammograms.

PURPOSE: Breast cancer is the most common cancer among women. The established screening method to detect breast cancer is X-ray mammography. Additionally, MRI is used for diagnosis in clinical routine. Due to complementary diagnostic information, both modalities are often read in combination. Yet, the correlation is challenging due to different dimensionality of images and different patient positioning. In this paper, we describe a method to fuse X-ray mammograms with DCE-MRI. The present study was conducted to evaluate the feasibility of the approach. METHODS: For the combination of information from both modalities, the images have to be registered using a compression simulation based on a patient-specific biomechanical model. The registered images can be compared directly. The contrast enhancement in the DCE-MRI volume is evaluated using parametric enhancement maps. A projection image of the contrast enhancement is created. The image fusion combines it with X-ray mammograms for intuitive multimodal diagnosis. RESULTS: The image fusion was evaluated using 11 clinical datasets. For 10 of 11 datasets, a good accuracy of the image registration was achieved. The overlap of contrast-enhanced regions with marked lesions in the mammogram is 61%. Lesions are clearly differentiable from surrounding tissue by the DCE-MRI projection in 10 of 11 cases. CONCLUSION: The described preliminary results are promising, thus we expect the visualization of quantitative information from dynamic MRI together with mammograms to be beneficial for multimodal diagnosis. Because of the use of clinical standard modalities, no additional image acquisition is needed.