Automated full-field volumetric ultrasound

Automated
breast ultrasound (ABUS) as a screening tool: initial experience. Female patient 26 years old with histopathological diagnosis of an invasive ductal carcinoma type II. a, b Axial and coronal reformatted ABUS images shows a well-defined hypoechoic mass showing irregular outline in the left breast at its upper inner quadrant. The lesion measured 13.6 × 17.8 mm. c Axial reformatted ABUS image showing another well-defined smaller hypoechoic lesion in the upper outer quadrant (arrow) of the left breast, which was not seen by conventional HHUS. The smaller lesion measured 3 × 4 mm. d Corresponding HHUS of the larger left breast mass lesion, the lesion is well-defined, hypoechoic, having lobulated outlines and measuring 13.2 × 12.9 mm. The lesion was graded as BIRADS IV
ejrnm.springeropen.com • CC-by-4.0
Automated
breast ultrasound (ABUS) as a screening tool: initial experience. Female patient 24 years old with histopathological diagnosis of an invasive ductal carcinoma type II. a Coronal reformatted ABUS images of the right breast showing a well-defined hypoechoic lesion in its upper inner quadrant. b Coronal reformatted ABUS images of the left breast showing a smaller well defined hypoechoic lesion in its upper inner quadrant. c Axial ABUS image of the lesion in the right breast showing a well-defined hypoechoiec lesion showing irregularity of its border with posterior acoustic shadowing the lesion was graded as a BI-RADS IV lesion. d Axial ABUS image of the lesion in the left breast showing a small rounded hypoechoiec lesion with well-defined border and regular outlines. This lesion was missed on HHUS
ejrnm.springeropen.com • CC-by-4.0
Automated
breast ultrasound (ABUS) as a screening tool: initial experience. Female patient 31 years old with histopathological diagnosis of fibroadenoma. a Mammogram (cranio-caudal and mediolateral oblique views of both breasts) showing dense breast (ACR D) with no obvious lesions or calcifications. b Coronal reformatted ABUS image showing a small hypoechoic lesion in the upper outer quadrant of the right breast. c Axial reformatted ABUS image showing the small well-defined hypoechoic lesion which had a fine lobulated outline. The lesion was graded BI-RADS III
ejrnm.springeropen.com • CC-by-4.0
Does
automated breast ultrasound (ABUS) add to breast tomosynthesis (DBT) in assessment of lesions in dense breasts?. Case two: 45-year-old female with enlarging left breast. A Tomo CC slice showing a well-defined lucent mass with a thick capsule (arrow). B, C ABUS images in transverse and multiplanar views showing the mass to be isoechoic with internal echogenicities and a surrounding echogenic capsule. Surgical excision revealed angiolipoma
ejrnm.springeropen.com • CC-by-4.0
Does
automated breast ultrasound (ABUS) add to breast tomosynthesis (DBT) in assessment of lesions in dense breasts?. Case three: 39-year-old with left breast lump. Recent history of right breast abscess drainage. Youngest child 18 months old. A-D 3D Tomo slices of both breasts in MLO and CC views showing bilateral retro areolar densities with partially obscured margins. E, F Multiplanar ABUS images showing cystic nature of the masses with intraductal echogenic secretions. Chronic galactocele
ejrnm.springeropen.com • CC-by-4.0
Does
automated breast ultrasound (ABUS) add to breast tomosynthesis (DBT) in assessment of lesions in dense breasts?. Case four: 55-year-old female with left breast lump A Tomo MLO slice showing a dense spiculate mass with obscured margins (circle). B, C ABUS images in multiplanar views showing the mass to be multifocal hypoechoic with ill-defined margins. US-guided core biopsy revealed multifocal IDC with DCIS
ejrnm.springeropen.com • CC-by-4.0
Radiopaedia • CC-by-nc-sa 3.0 • de

An automatic full-field volumetric breast ultrasound scanner (AFFBUS) is a developing technology which was initiated to overcome the drawback of dense breast and to get a three-dimensional view of the breast.

Components

  • scan station
  • view station
Scan station

Automatic ultrasound imaging acquisition of the breasts is done by acquiring volumetric data. In one method currently in use,  a rigid pivoted stationary frame is manually pushed so that the transducer with gel applied on it comes in contact with the breast and an optimal scan is acquired.

View station

The acquired data is analyzed and converted into thin tomographic slices. There is a facility to use a virtual probe by which multiple other scan planes can be acquired and a lesion, if visualized, can be better demonstrated with its adjacent structures. The viewing can be done in cine mode or by regular grey scale images. Post processing may be done and finally, the interpretation is done based on the data acquired in the various planes.

Artifacts

In addition to the expected artifacts, automated breast ultrasounds have specific artifacts not seen in handheld ultrasounds of the breast . As with all ultrasound while some artifacts lower the ease of interpretation of the examination, some may be useful, such a 'skip' artifact. A skip artifact happens when the transducer makes a tiny jump because of the interaction of a transducer programmed to run at a constant speed, and an area of change in tissue density .

Advantages

  • good demonstration of breast anatomy
  • reproducible images due to improved lesion localization 
  • provides information for CAD of breast lesion
  • better overview of breast anatomy
  • negative reading competence improved

Disadvantages

Due to high pick up and demonstration of lesions, the rate of inadvertent aspirations and biopsy is high.