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Addition of Three-Dimensional Ultrasound Finds More Breast Cancers: Presented at RSNA
By Ed Susman
CHICAGO, IL -- December 3, 2007 -- Adding three-dimensional (3-D) ultrasound to the breast cancer diagnostic workup can increase the chances of finding a tumour, researchers said in a presentation here at the 93rd Scientific Assembly and Annual Meeting of the Radiological Society of North America (RSNA).
In one study, the use of the new technology changed management in 8% of the patients, the researchers reported.
"Three-dimensional images of the breast can enable the radiologist to identify and localise breast lesions that could be missed by conventional technologies," said Jessica Guingrich, MD, Medical Director of Breast Imaging, Susan G. Komen Breast Center, OSF Saint Francis Centers for Breast Health, Peoria, Illinois, United States.
Dr. Guingrich reported results in which the SomoVu device from U Systems, Inc. was evaluated to determine if the automated breast ultrasound system could improve identification and diagnosis of breast cancers.
The study enrolled women who were scheduled for breast cancer screening or for ultrasound diagnostic examinations for suspicious lesions found on mammography, she reported in her oral presentation November 30.
In the study protocol, women were first diagnosed using hand-held ultrasound for diagnostic imaging or for screening, as warranted. Then the women were assessed using SomoVu. They further underwent magnetic resonance imaging (MRI), if indicated for biopsy proven carcinoma. Between September 2005 and March 2007, researchers scanned 748 breasts in 429 women with SomoVu.
Study subjects had taken part in a multicenter screening program, and had been referred for ultrasound screening due to difficulty in reading their mammograms due to dense breast tissue. In this cohort, 252 of the women were referred for diagnostic workup as a result of findings suggestive of breast cancer on mammography or physical examination; 177 patients were asymptomatic and had negative mammography findings.
Overall, 45 biopsy-proven cancers were detected in the trial among 39 patients. Seventeen of the patients had biopsy-proven cancer prior to being screened with SomoVu, Dr. Guingrich said. Invasive ductal carcinoma was found in 26 cases; ductal carcinoma in situ was diagnosed in five cases.
"Three of the 39 patients had treatment plans that were modified as a direct result of 3-D ultrasound images," she said.
One malignant lesion was not visible on MRI. One mammography-occult cancer was found on the contralateral breast. One cancer was not seen on the first scan with hand-held ultrasound.
"Three-dimensional images enabled discovery and treatment of malignant breast lesions which had not been detected using a conventional protocol that included mammography, hand-held ultrasound and MRI," Dr. Guingrich said.
Dr. Guingrich is a medical adviser for U Systems, Inc.
[Presentation title: The Use of 3-D Ultrasound Images for the Identification and Diagnosis of Breast Cancer. Abstract SST01-03]
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