Breast Tomographic Ultrasound: The Spectrum from Current Dense Breast Cancer Screenings to Future Theranostic Treatments.

This review provides unique insights to the scientific scope and clinical visions of the inventors and pioneers of the SoftVue breast tomographic ultrasound (BTUS). Their >20-year collaboration produced extensive basic research and technology developments, culminating in SoftVue, which recently received the Food and Drug Administration's approval as an adjunct to breast cancer screening in women with dense breasts. SoftVue's multi-center trial confirmed the diagnostic goals of the tissue characterization and localization of quantitative acoustic tissue differences in 2D and 3D coronal image sequences.

2-D Slicewise Waveform Inversion of Sound Speed and Acoustic Attenuation for Ring Array Ultrasound Tomography Based on a Block LU Solver.

Ultrasound tomography is an emerging imaging modality that uses the transmission of ultrasound through tissue to reconstruct images of its mechanical properties. Initially, ray-based methods were used to reconstruct these images, but their inability to account for diffraction often resulted in poor resolution. Waveform inversion overcame this limitation, providing high-resolution images of the tissue.

Sound Speed Estimation for Distributed Aberration Correction in Laterally Varying Media.

Spatial variation in sound speed causes aberration in medical ultrasound imaging. Although our previous work has examined aberration correction in the presence of a spatially varying sound speed, practical implementations were limited to layered media due to the sound speed estimation process involved. Unfortunately, most models of layered media do not capture the lateral variations in sound speed that have the greatest aberrative effect on the image.

A Forward Model Incorporating Elevation-Focused Transducer Properties for 3-D Full-Waveform Inversion in Ultrasound Computed Tomography.

Ultrasound computed tomography (USCT) is an emerging medical imaging modality that holds great promise for improving human health. Full-waveform inversion (FWI)-based image reconstruction methods account for the relevant wave physics to produce high spatial resolution images of the acoustic properties of the breast tissues. A practical USCT design employs a circular ring-array comprised of elevation-focused ultrasonic transducers, and volumetric imaging is achieved by translating the ring-array orthogonally to the imaging plane.

Optimal transmit apodization for the maximization of lag-one coherence with applications to aberration delay estimation.

Phase aberration is one of the major sources of image degradation in medical ultrasound imaging. One of the earliest and simplest techniques to correct for phase aberration involves nearest-neighbor cross correlation to estimate delays between neighboring receive channels and the compensation of aberration delays in a delay-and-sum beamformer. The main challenge is that neighboring receive channels may not have sufficient signal correlation to accurately estimate the aberration delays.

A forward model incorporating elevation-focused transducer properties for 3D full-waveform inversion in ultrasound computed tomography.

Ultrasound computed tomography (USCT) is an emerging medical imaging modality that holds great promise for improving human health. Full-waveform inversion (FWI)-based image reconstruction methods account for the relevant wave physics to produce high spatial resolution images of the acoustic properties of the breast tissues. A practical USCT design employs a circular ring-array comprised of elevation-focused ultrasonic transducers, and volumentric imaging is achieved by translating the ring-array orthogonally to the imaging plane.

Separation of mainlobe and sidelobe contributions to B-mode ultrasound images based on the aperture spectrum.

Purpose: Isolating the mainlobe and sidelobe contribution to the ultrasound image can improve imaging contrast by removing off-axis clutter. Previous work achieves this separation of mainlobe and sidelobe contributions based on the covariance of received signals. However, the formation of a covariance matrix at each imaging point can be computationally burdensome and memory intensive for real-time applications.

Feasibility of ultrasound tomography-guided localized mild hyperthermia using a ring transducer: Ex vivo and in silico studies.

Background: As of 2022, breast cancer continues to be the most diagnosed cancer worldwide. This problem persists within the United States as well, as the American Cancer Society has reported that ∼12.5% of women will be diagnosed with invasive breast cancer over the course of their lifetime.

Rapid Reductions in Breast Density following Tamoxifen Therapy as Evaluated by Whole-Breast Ultrasound Tomography.

Purpose: Women whose mammographic breast density declines within 12-18 months of initiating tamoxifen for chemoprevention or adjuvant treatment show improved therapeutic responses compared with those whose density is unchanged. We tested whether measuring changes in sound speed (a surrogate of breast density) using ultrasound tomography (UST) could enable rapid identification of favorable responses to tamoxifen.

Methods: We evaluated serial density measures at baseline and at 1 to 3, 4 to 6, and 12+ months among 74 women (aged 30-70 years) following initiation of tamoxifen for clinical indications, including an elevated risk of breast cancer (20%) and diagnoses of in situ (39%) or invasive (40%) breast carcinoma, enrolled at Karmanos Cancer Institute and Henry Ford Health System (Detroit, MI, USA).

The Potential Role of the Fat-Glandular Interface (FGI) in Breast Carcinogenesis: Results from an Ultrasound Tomography (UST) Study.

This study explored the relationship between the extent of the fat-glandular interface (FGI) and the presence of malignant vs. benign lesions. Two hundred and eight patients were scanned with ultrasound tomography (UST) as part of a Health Insurance Portability and Accountability Act (HIPAA)-compliant study.

Multicenter Study of Whole Breast Stiffness Imaging by Ultrasound Tomography (SoftVue) for Characterization of Breast Tissues and Masses.

We evaluated whole breast stiffness imaging by SoftVue ultrasound tomography (UST), extracted from the bulk modulus, to volumetrically map differences in breast tissues and masses. A total 206 women with either palpable or mammographically/sonographically visible masses underwent UST scanning prior to biopsy as part of a prospective, HIPAA-compliant multicenter cohort study. The volumetric data sets comprised 298 masses (78 cancers, 105 fibroadenomas, 91 cysts and 24 other benign) in 239 breasts.

The Fat-glandular Interface and Breast Tumor Locations: Appearances on Ultrasound Tomography Are Supported by Quantitative Peritumoral Analyses.

Objective: To analyze the preferred tissue locations of common breast masses in relation to anatomic quadrants and the fat-glandular interface (FGI) using ultrasound tomography (UST).

Methods: Ultrasound tomography scanning was performed in 206 consecutive women with 298 mammographically and/or sonographically visible, benign and malignant breast masses following written informed consent to participate in an 8-site multicenter, Institutional Review Board-approved cohort study. Mass locations were categorized by their anatomic breast quadrant and the FGI, which was defined by UST as the high-contrast circumferential junction of fat and fibroglandular tissue on coronal sound speed imaging.

Determinants of the reliability of ultrasound tomography sound speed estimates as a surrogate for volumetric breast density.

Purpose: High breast density, as measured by mammography, is associated with increased breast cancer risk, but standard methods of assessment have limitations including 2D representation of breast tissue, distortion due to breast compression, and use of ionizing radiation. Ultrasound tomography (UST) is a novel imaging method that averts these limitations and uses sound speed measures rather than x-ray imaging to estimate breast density. The authors evaluated the reproducibility of measures of speed of sound and changes in this parameter using UST.

Breast ultrasound tomography versus MRI for clinical display of anatomy and tumor rendering: preliminary results.

Objective: The objective of our study was to determine the clinical display thresholds of an ultrasound tomography prototype relative to MRI for comparable visualization of breast anatomy and tumor rendering.

Subjects And Methods: Thirty-six women were imaged with MRI and our ultrasound tomography prototype. The ultrasound tomography scan generated reflection, sound-speed, and attenuation images.

Modification of Kirchhoff migration with variable sound speed and attenuation for acoustic imaging of media and application to tomographic imaging of the breast.

Purpose: To explore the feasibility of improving cross-sectional reflection imaging of the breast using refractive and attenuation corrections derived from ultrasound tomography data.

Methods: The authors have adapted the planar Kirchhoff migration method, commonly used in geophysics to reconstruct reflection images, for use in ultrasound tomography imaging of the breast. Furthermore, the authors extended this method to allow for refractive and attenuative corrections.

In vivo breast sound-speed imaging with ultrasound tomography.

We discuss a bent-ray ultrasound tomography algorithm with total-variation (TV) regularization. We have applied this algorithm to 61 in vivo breast datasets collected with our in-house clinical prototype for imaging sound-speed distributions in the breast. Our analysis showed that TV regularization could preserve sharper lesion edges than the classic Tikhonov regularization.

An improved automatic time-of-flight picker for medical ultrasound tomography.

Objective And Motivation: Time-of-flight (TOF) tomography used by a clinical ultrasound tomography device can efficiently and reliably produce sound-speed images of the breast for cancer diagnosis. Accurate picking of TOFs of transmitted ultrasound signals is extremely important to ensure high-resolution and high-quality ultrasound sound-speed tomograms. Since manually picking is time-consuming for large datasets, we developed an improved automatic TOF picker based on the Akaike information criterion (AIC), as described in this paper.

Detection of breast cancer with ultrasound tomography: first results with the Computed Ultrasound Risk Evaluation (CURE) prototype.

Although mammography is the gold standard for breast imaging, its limitations result in a high rate of biopsies of benign lesions and a significant false negative rate for women with dense breasts. In response to this imaging performance gap we have been developing a clinical breast imaging methodology based on the principles of ultrasound tomography. The Computed Ultrasound Risk Evaluation (CURE) system has been designed with the clinical goals of whole breast, operator-independent imaging, and differentiation of breast masses.

Novel approach to evaluating breast density utilizing ultrasound tomography.

Women with high mammographic breast density have a four- to fivefold increased risk of developing breast cancer compared to women with fatty breasts. Many preventative strategies have attempted to correlate changes in breast density with response to interventions including drugs and diet. The purpose of this work is to investigate the feasibility of assessing breast density with acoustic velocity measurements with ultrasound tomography, and to compare the results with existing measures of mammographic breast density.

Development of ultrasound tomography for breast imaging: technical assessment.

Ultrasound imaging is widely used in medicine because of its benign characteristics and real-time capabilities. Physics theory suggests that the application of tomographic techniques may allow ultrasound imaging to reach its full potential as a diagnostic tool allowing it to compete with other tomographic modalities such as x-ray computer tomography, and MRI. This paper describes the construction and use of a prototype tomographic scanner and reports on the feasibility of implementing tomographic theory in practice and the potential of ultrasound (US) tomography in diagnostic imaging.