Multiparametric ultrasound examination for response assessment in breast cancer patients undergoing neoadjuvant therapy.

To investigate the performance of multiparametric ultrasound for the evaluation of treatment response in breast cancer patients undergoing neoadjuvant chemotherapy (NAC). The IRB approved this prospective study. Breast cancer patients who were scheduled to undergo NAC were invited to participate in this study. Changes in tumour echogenicity, stiffness, maximum diameter, vascularity and integrated backscatter coefficient (IBC) were assessed prior to treatment and 7 days after four consecutive NAC cycles. Residual malignant cell (RMC) measurement at surgery was considered as standard of reference. RMC < 30% was considered a good response and > 70% a poor response. The correlation coefficients of these parameters were compared with RMC from post-operative histology. Linear Discriminant Analysis (LDA), cross-validation and Receiver Operating Characteristic curve (ROC) analysis were performed. Thirty patients (mean age 56.4 year) with 42 lesions were included. There was a significant correlation between RMC and echogenicity and tumour diameter after the 3rd course of NAC and average stiffness after the 2nd course. The correlation coefficient for IBC and echogenicity calculated after the first four doses of NAC were 0.27, 0.35, 0.41 and 0.30, respectively. Multivariate analysis of the echogenicity and stiffness after the third NAC revealed a sensitivity of 82%, specificity of 90%, PPV = 75%, NPV = 93%, accuracy = 88% and AUC of 0.88 for non-responding tumours (RMC > 70%). High tumour stiffness and persistent hypoechogenicity after the third NAC course allowed to accurately predict a group of non-responding tumours. A correlation between echogenicity and IBC was demonstrated as well.

Modified multi-element synthetic transmit aperture method for ultrasound imaging: A tissue phantom study.

The paper presents the modified multi-element synthetic transmit aperture (MSTA) method for ultrasound imaging. It is based on coherent summation of RF echo signals with apodization weights taking into account the finite size of the transmit subaperture and of the receive element. The work presents extension of the previous study where the modified synthetic transmit aperture (STA) method was considered and verified [1]. In the case of MSTA algorithm the apodization weights were calculated for each imaging point and all combinations of the transmit subaperture and receive element using their angular directivity functions (ADFs). The ADFs were obtained from the exact solution of the corresponding mixed boundary-value problem for periodic baffle system modeling the transducer array. Performance of the developed method was tested using Field II simulated synthetic aperture data of point reflectors for 4MHz 128-element transducer array with 0.3mm pitch and 0.02mm kerf to estimate the visualization depth and lateral resolution. Also experimentally determined data of the tissue-mimicking phantom (Dansk Fantom Service, model 571) obtained using 128 elements, 4MHz, linear transducer array (model L14-5/38) and Ultrasonix SonixTOUCH Research platform were used for qualitative assessment of imaging contrast improvement. Comparison of the results obtained by the modified and conventional MSTA algorithms indicated 15dB improvement of the noise reduction in the vicinity of transducer's surface (1mm depth), and concurrent increase in the visualization depth (86% augment of the scattered amplitude at the depth of 90mm). However, this increase was achieved at the expense of minor degradation of the lateral resolution of approximately 8% at the depth of 50mm and 5% at the depth of 90mm.

Comparison of sound fields generated by different coded excitations--experimental results.

This work reports the results of measurements of spatial distributions of ultrasound fields obtained from five energizing schemes. Three different codes, namely, chirp signal and two sinusoidal sequences were investigated. The sequences were phase modulated with 13 bits Barker code and 16 bits Golay complementary codes. Moreover, two reference signals generated as two and sixteen cycle sine tone bursts were examined. Planar, 50% (fractional) bandwidth, 15 mm diameter source transducer operating at 2 MHz center frequency was used in all measurements. The experimental data were collected using computerized scanning system and recorded using wideband, PVDF membrane hydrophone (Sonora 804). The measured echoes were compressed, so the complete pressure field in the investigated location before and after compression could be compared. In addition to a priori anticipated increase in the signal to noise ratio (SNR) for the decoded pressure fields, the results indicated differences in the pressure amplitude levels, directivity patterns, and the axial distance at which the maximum pressure amplitude was recorded. It was found that the directivity patterns of non-compressed fields exhibited shapes similar to the patterns characteristic for sinusoidal excitation having relatively long time duration. In contrast, the patterns corresponding to compressed fields resembled those produced by brief, wideband pulses. This was particularly visible in the case of binary sequences. The location of the maximum pressure amplitude measured in the 2 MHz field shifted towards the source by 15 mm and 25 mm for Barker code and Golay code, respectively. The results of this work may be applicable in the development of new coded excitation schemes. They could also be helpful in optimizing the design of imaging transducers employed in ultrasound systems designed for coded excitation. Finally, they could shed additional light on the relationship between the spatial field distribution and achievable image quality and in this way facilitate optimization of the images obtained using coded systems.