Ultrafast plane wave imaging of breast lesions

Abstract

Ultrafast plane wave imaging has great potential for 3-D functional ultrasound imaging but also comes with decreased lateral resolution, contrast, and penetration depth with respect to conventional imaging (CI). By utilizing coherent plane-wave compound imaging (CPWCI) and different beam forming techniques (Delay and Sum (DAS), Stolt’s-fk, and Lu’s-fk), we have demonstrated to improve resolution, penetration, and contrast-to-noise ratio. In this work we evaluate this technique in patients. A Siemens Sequoia system equipped with an 18L6HD, 14L5, and 10L4 was used to acquire CI and CPWCI data in 77 patients suspected of breast cancer visiting our clinic. CI data was acquired at three angles (-11, 0, and 11 degrees) and beamformed in the Sequoia and incoherently compounded while CPWCI data was acquired for 33 angles (-16:1:16 degrees) and subsequently processed off-line. In total, 9 malignant lesions, 35 benign lesions, and 32 normal other structures were found. For all three transducers, improved penetration was observed with CPWCI compared to CI. Additionally, contrast to noise ratio was also improved by CPWCI, especially at larger imaging depths. Qualitatively, an improved resolution appeared to be present, probably also caused by the improved contrast. Currently, a reader study in which radiologists have to score CI and CPWCI images sight by side while blinded to the acquisition mode is being prepared to test the efficacy of CPWCI in clinical practice. In conclusion, CPWCI bears great promise for improved breast cancer detection.