Slip imaging: reducing ambiguity in breast lesion assessment.

Ultrasound elasticity imaging (elastography) is gaining popularity as an adjunct to B-mode ultrasound for breast cancer diagnosis. Cancerous masses are usually stiffer than normal tissue, hence, using elasticity imaging should lead to better differentiation between benign and malignant masses than using B-mode alone. Clinicians assess the mobility of masses on palpation; cancers usually being less mobile. We introduce a method to estimate mobility, called slip imaging and combine it with conventional B-mode and elasticity data. In the reported evaluation on 70 women recalled to a breast assessment clinic, images were scored by three breast radiologists independently. Diagnostic accuracy increased from 75.7% with B-mode alone, to 78.1% when including elasticity imaging, to 80.0% when further including slip imaging. Specificity increased (74.6%:75.4%:82.5% respectively), with an apparent trade-off in sensitivity (77.1%:81.3%:77.1%). We conclude that Slip imaging is potentially a useful adjunct to B-mode and elasticity imaging and should undergo further research and development.

Radiologic characteristics and management of screen-detected metastatic carcinoid tumor of the breast: a case report.

Carcinoid tumors are known to metastasize to the breast, but their appearance can mimic a primary breast carcinoma, making biopsy essential in order to give the correct preoperative diagnosis. It has been suggested that core biopsy might precipitate a carcinoid crisis and should be avoided. We describe a case of screen-detected carcinoid tumor metastasis in the breast safely diagnosed by core biopsy and present the imaging findings, including magnetic resonance imaging and elastography. This case illustrates the importance of preoperative histologic diagnosis in enabling the appropriate surgical or medical management of these patients. Review of the literature also supports the policy that biopsy of nonhormonally active tumors may be safely performed.

Assisted-freehand ultrasound elasticity imaging.

Good-quality elasticity imaging requires highly controlled compressions of the breast, which are often challenging to obtain with freehand, even by an experienced radiologist. This paper presents assisted-freehand ultrasound (AFUSON): a fusion of freehand and automated ultrasound systems designed to assisted elasticity imaging acquisition while remaining as flexible as freehand. In the form of a hand-held device, this semi-automatic solution delivers both increased acquisition precision and control. Compared with freehand acquisitions, it reduces out-of-plane motion decorrelation by one-half and lateral motion by one-third, increases within-scan repeatability by 50%, and does so across operators.