Ultrasound elastography as an adjuvant to conventional ultrasound in the preoperative assessment of axillary lymph nodes in suspected breast cancer: a pilot study.

AIMS: To compare the performance of ultrasound elastography with conventional ultrasound in the assessment of axillary lymph nodes in suspected breast cancer and whether ultrasound elastography as an adjunct to conventional ultrasound can increase the sensitivity of conventional ultrasound used alone. MATERIALS AND METHODS: Fifty symptomatic women with a sonographic suspicion for breast cancer underwent ultrasound elastography of the ipsilateral axilla concurrent with conventional ultrasound being performed as part of triple assessment. Elastograms were visually scored, strain measurements calculated and node area and perimeter measurements taken. Theoretical biopsy cut points were selected. The sensitivity, specificity, positive predictive value (PPV), and negative predictive values (NPV) were calculated and receiver operating characteristic (ROC) analysis was performed and compared for elastograms and conventional ultrasound images with surgical histology as the reference standard. RESULTS: The mean age of the women was 57 years. Twenty-nine out of 50 of the nodes were histologically negative on surgical histology and 21 were positive. The sensitivity, specificity, PPV, and NPV for conventional ultrasound were 76, 78, 70, and 81%, respectively; 90, 86, 83, and 93%, respectively, for visual ultrasound elastography; and for strain scoring, 100, 48, 58 and 100%, respectively. There was no significant difference between any of the node measurements CONCLUSIONS: Initial experience with ultrasound elastography of axillary lymph nodes, showed that it is more sensitive than conventional ultrasound in detecting abnormal nodes in the axilla in cases of suspected breast cancer. The specificity remained acceptable and ultrasound elastography used as an adjunct to conventional ultrasound has the potential to improve the performance of conventional ultrasound alone.

Three-dimensional ultrasound imaging.

This review is about the development of three-dimensional (3D) ultrasonic medical imaging, how it works, and where its future lies. It assumes knowledge of two-dimensional (2D) ultrasound, which is covered elsewhere in this issue. The three main ways in which 3D ultrasound may be acquired are described: the mechanically swept 3D probe, the 2D transducer array that can acquire intrinsically 3D data, and the freehand 3D ultrasound. This provides an appreciation of the constraints implicit in each of these approaches together with their strengths and weaknesses. Then some of the techniques that are used for processing the 3D data and the way this can lead to information of clinical value are discussed. A table is provided to show the range of clinical applications reported in the literature. Finally, the discussion relating to the technology and its clinical applications to explain why 3D ultrasound has been relatively slow to be adopted in routine clinics is drawn together and the issues that will govern its development in the future explored.

Sensorless reconstruction of freehand 3D ultrasound data.

Freehand 3D ultrasound can be acquired without a position sensor by finding the separations of pairs of frames using information in the images themselves. Previous work has not considered how to reconstruct entirely freehand data, which can exhibit irregularly spaced frames, non-monotonic out-of-plane probe motion and significant inplane motion. This paper presents reconstruction methods that overcome these limitations and are able to robustly reconstruct freehand data. The methods are assessed on freehand data sets and compared to reconstructions obtained using a position sensor.

Retaining axial-lateral orthogonality in steered ultrasound data to improve image quality in reconstructed lateral displacement data

Ultrasound elastography tracks tissue displacements under small levels of compression to obtain images of strain, a mechanical property useful in the detection and characterization of pathology. Due to the nature of ultrasound beamforming, only tissue displacements in the direction of beam propagation, referred to as 'axial', are measured to high quality, although an ability to measure other components of tissue displacement is desired to more fully characterize the mechanical behavior of tissue. Previous studies have used multiple one-dimensional (1D) angled axial displacements tracked from steered ultrasound beams to reconstruct improved quality trans-axial displacements within the scan plane ('lateral'). We show that two-dimensional (2D) displacement tracking is not possible with unmodified electronically-steered ultrasound data, and present a method of reshaping frames of steered ultrasound data to retain axial-lateral orthogonality, which permits 2D displacement tracking. Simulated and experimental ultrasound data are used to compare changes in image quality of lateral displacements reconstructed using 1D and 2D tracked steered axial and steered lateral data. Reconstructed lateral displacement image quality generally improves with the use of 2D displacement tracking at each steering angle, relative to axial tracking alone, particularly at high levels of compression. Due to the influence of tracking noise, unsteered lateral displacements exhibit greater accuracy than axial-based reconstructions at high levels of applied strain. © 2011 SPIE.

Operation of a high frequency piezoelectric ultrasound array with an application specific integrated circuit

Integration of a piezoelectric high frequency ultrasound (HFUS) array with a microfabricated application specific integrated circuit (ASIC) performing a range of functions has several advantages for ultrasound imaging. The number of signal cables between the array/electronics and the data acquisition / imaging system can be reduced, cutting costs and increasing functionality. Electrical impedance matching is also simplified and the same approach can reduce overall system dimensions for applications such as endoscopic ultrasound. The work reported in this paper demonstrates early ASIC operation with a piezocomposite HFUS array operating at approximately 30 MHz. The array was tested in three different modes. Clear signals were seen in catch-mode, with an external transducer as a source of ultrasound, and in pitch-mode with the external transducer as a receiver. Pitch-catch mode was also tested successfully, using sequential excitation on three array elements, and viable signals were detected. However, these were relatively small and affected by interference from mixed-signal sources in the ASIC. Nevertheless, the functionality and compatibility of the two main components of an integrated HFUS - ASIC device have been demonstrated and the means of further optimization are evident.

Efficient Implementation of Spatially-Varying 3-D Ultrasound Deconvolution

Abstract—There are sometimes occasions when ultrasound beamforming is performed with only a subset of the total data that will eventually be available. The most obvious example is a mechanically-swept (wobbler) probe in which the three-dimensional data block is formed from a set of individual B-scans. In these circumstances, non-blind deconvolution can be used to improve the resolution of the data. Unfortunately, most of these situations involve large blocks of three-dimensional data. Furthermore, the ultrasound blur function varies spatially with distance from the transducer. These two facts make the deconvolution process time-consuming to implement. This paper is about ways to address this problem and produce spatially-varying deconvolution of large blocks of three-dimensional data in a matter of seconds. We present two approaches, one based on hardware and the other based on software. We compare the time they each take to achieve similar results and discuss the computational resources and form of blur model that each requires.