Comparison of conventional, compounding, computer enhancement, and compounding with computer enhancement in ultrasound imaging of the breast.

OBJECTIVE

Real-time spatial compounding and computer enhancement (CE) in ultrasound have become commercially available for better visualization of breast masses. This study evaluated image quality and diagnostic information using these techniques as compared with conventional ultrasound in breast imaging.

MATERIALS AND METHODS

One hundred consecutive lesions in 81 patients with clinically detectable breast lesions were imaged using conventional, compounding, CE, and compounding with CE. The images were blinded to technique and patient information and were then randomized. Three blinded reviewers analyzed the images and rated them for margin definition, near-field detail, definition of lesion, shadowing, and posterior enhancement on a scale of 1 (worse) to 5 (best) independently. The blinded reviewers then ranked the 4 images of the same lesion from best to worse.

RESULTS

The lesions included benign (81) and malignant (19) lesions. All reviewers selected compounding with CE 100% of the time as the best image, when the images of the same lesion were presented in a set. Compounding alone was selected second, CE was selected as third, and conventional imaging was selected as having the worst image quality in all cases. Individual image quality was compounding with CE, 4.86; compounding, 4.10; CE, 3.80; and conventional, 3.09; on the 5-point scale.

CONCLUSION

Compounding with CE significantly improves the image quality over conventional breast ultrasound. Compounding and CE enhance image quality when used individually, but the combination of the 2 techniques is superior.