Cummins Thomas, Yoon Changhan, Choi Hojong, Eliahoo Payam, Kim Hyung Ham, Yamashita Mary W, Hovanessian-Larsen Linda J, Lang Julie E, Sener Stephen F, Vallone John, Martin Sue E, Kirk Shung K
University of Southern California , Department of Biomedical Engineering, 1042 Downey Way, Los Angeles, California 90089, United States.
Kumoh National Institute of Technology , Department of Medical IT Convergence Engineering, Daehak-ro 61, Gumi, Gyeongbuk 39177, Republic of Korea.
J Med Imaging (Bellingham). 2015 Oct;2(4):047001. doi: 10.1117/1.JMI.2.4.047001. Epub 2015 Dec 10.
Image-guided core needle biopsy is the current gold standard for breast cancer diagnosis. Microcalcifications, an important radiographic finding on mammography suggestive of early breast cancer such as ductal carcinoma in situ, are usually biopsied under stereotactic guidance. This procedure, however, is uncomfortable for patients and requires the use of ionizing radiation. It would be preferable to biopsy microcalcifications under ultrasound guidance since it is a faster procedure, more comfortable for the patient, and requires no radiation. However, microcalcifications cannot reliably be detected with the current standard ultrasound imaging systems. This study is motivated by the clinical need for real-time high-resolution ultrasound imaging of microcalcifications, so that biopsies can be accurately performed under ultrasound guidance. We have investigated how high-frequency ultrasound imaging can enable visualization of microstructures in ex vivo breast tissue biopsy samples. We generated B-mode images of breast tissue and applied the Nakagami filtering technique to help refine image output so that microcalcifications could be better assessed during ultrasound-guided core biopsies. We describe the preliminary clinical results of high-frequency ultrasound imaging of ex vivo breast biopsy tissue with microcalcifications and without Nakagami filtering and the correlation of these images with the pathology examination by hematoxylin and eosin stain and whole slide digital scanning.
影像引导下的粗针活检是目前乳腺癌诊断的金标准。微钙化是乳腺钼靶检查中提示早期乳腺癌（如导管原位癌）的一项重要影像学表现，通常在立体定向引导下进行活检。然而，该操作让患者感到不适，且需要使用电离辐射。在超声引导下对微钙化进行活检会更好，因为它操作更快，患者更舒适，且无需辐射。然而，目前的标准超声成像系统无法可靠地检测到微钙化。本研究的动机源于临床上对微钙化进行实时高分辨率超声成像的需求，以便能在超声引导下准确进行活检。我们研究了高频超声成像如何能够实现对离体乳腺组织活检样本中微观结构的可视化。我们生成了乳腺组织的B模式图像，并应用 Nakagami 滤波技术来帮助优化图像输出，以便在超声引导下的粗针活检过程中能更好地评估微钙化。我们描述了对含有微钙化且未进行 Nakagami 滤波的离体乳腺活检组织进行高频超声成像的初步临床结果，以及这些图像与苏木精和伊红染色及全玻片数字扫描病理检查结果的相关性。
