Description and first clinical use of a new system for combined mammography and automated clinical amplitude/velocity reconstructive imaging breast sonography.

Rationale And Objectives: The authors tested a new automated system for clinical amplitude/velocity reconstructive imaging (CARI) breast sonography and compared the results with those of a manual laboratory model of this imaging modality, conventional sonography, and mammography.

Methods: Fifty-one patients with breast lesions were examined by mammography, conventional breast sonography, a laboratory version of a mammography-like breast compression device for breast sonography, and an automated system that allows sonography while in compression and reconstructs an image of the whole breast. The automated device allows reconstruction of one image per breast from an automatically acquired sonographic data set and simultaneous performance of mammography. The results of mammography and all modes of sonography were compared with histopathology in 36 surgically treated lesions of which 20 were benign and 16 malignant. In addition, 17 lesions confirmed to be benign by different imaging modalities were examined with the three different sonographic devices.

Results: All 16 histopathologically proven malignant lesions were identified correctly by compression sonography (laboratory and automated device) compared with 14 by conventional sonography. Of the 20 benign lesions, 16 were interpreted correctly by conventional sonography, 19 with the laboratory version, and 18 with the automated device, whereas mammography identified 12 benign lesions correctly and missed 1 malignant lesion. Only 16 of 17 lesions diagnosed to be benign by outpatient imaging could be examined with all three modes of study sonography and were found to be benign with all three modes in all cases.

Conclusions: Compared with the laboratory version, the automated device facilitates acquisition and evaluation of compression breast sonography and is similar in lesion detection and differentiation. It should be tested in a larger number of patients.