Clinical benefits of combined diagnostic three-dimensional digital breast tomosynthesis and ultrasound imaging

Abstract

Our goal is to evaluate diagnostic digital breast tomosynthesis and ultrasound imaging clinical value in detecting and diagnosing early stage breast cancers. Determine if fusion imaging would decrease the number of biopsies and reduce further patient workup otherwise required to establish a definitive diagnosis. This paper presents the clinical results based on the study conducted at Helsinki University Central Hospital. Presentation demonstrates clinical dual modality images and results. Tomosynthesis of amorphous selenium based full field digital mammography system will be also presented. Forty asymptomatic women enrolled in the study based on prior identification of suspicious findings on screening mammograms where the possibility of breast cancer could not be excluded. Abnormal screening mammogram findings included tumor-like densities, parenchymal asymmetries and architectural distortions. Eight women were operated and 32 were not referred for surgery. Those cases, which were operated, three lesions represented ductal carcinoma in situ, two ductal carcinomas, one atypical ductal hyperplasia, one fibroadenoma and one radial scar. The 32 not operated cases revealed to be benign or superimposition of normal parenchymal breast tissue. The cases were returned to biennial screening. Ultrasound did not show clearly any lesions, but using tomosynthesis and ultrasound together we were able to analyze and locate the lesions exactly. Special tomosynthesis improves overall lesion detection and analysis. The value of tomosynthesis and ultrasound fusion imaging will be to provide additional clinical information in order to improve decision making accuracy to either confirm or exclude a suspected abnormality and in particular detect small breast cancers.