Concept for fast breast cancer ultrasound screening in addition to mammography – first clinical results

Abstract

In breast cancer screening, x-ray mammography is the standard imaging modality. For clarification of suspicious findings, handheld ultrasound (US) is used as an adjunct modality. It is so far not included in screening due to the lack of standardization, high costs and the risk of increased false positives within screening population. First attempts to standardize US with automated breast US are still not completely fulfilling clinical needs, e.g. workflow and reading are claimed not to be fast enough. Therefore, various groups introduced new concepts of fast US screening, providing standardized images in the same orientation as the mammography images, leading to a speed-up of reading and reporting.To acquire US images in an x-ray mammography environment, an automated breast US transducer was inserted into a modified compression paddle. After mammography or tomosynthesis, an automated breast US scan was performed. We investigated new concepts to optimize workflow speed and approaches to achieve nearly full US coverage of the breast in a clinical study.We successfully integrated automated US scanning in a clinical workflow with less than one minute for the additional scan. Compared to the workflows of automated breast US and handheld US, the proposed scanning concept provides a high time and cost saving potential. Preliminary results indicate a high breast area coverage of the US scan. The first clinical results of our method demonstrated a proof of concept for a technical solution to include US screening into the standard breast cancer screening workflow. The standard workflow is changed minimally and the additional time investment is low since no patient repositioning or system adjustments are needed between both scanning modalities.