Abstract
A new approach has been used for ultrasound detection of small benign and malignant breast masses, namely, control of scattering in such a manner that a small mass can be easily recognized because of the effect of the scattering on the contrast between the mass and the surrounding normal tissue. Maintenance of good resolution as scattering is varied is an essential aspect of this approach. Image contrast is dependent on a number of instrumentation parameters but, in a fundamental sense, it is related to differences in the amount of scattering between a solid breast mass and the surrounding normal tissue. In the subject studies, modification of image contrast is accomplished by varying either the center frequency output of the transducer or the band-pass of the receiver. These approaches take advantage of differences in the frequency dependence of scattering coefficients of solid breast masses and normal tissue. A unique technique for varying center frequency without switching transducers was developed, namely, use of a wide bandwidth, co-polymer PVDF transducer, in combination with certain instrumentation conditions which allow the center frequency output of a single ultrasound transducer to vary over a relatively wide frequency range. Using this technique, an automatic B-mode ultrasound imaging breast instrument which allows emission of 3.5, 4.5, 6.5 and llMHz ultrasound frequencies from the same co-polymer transducer was used to examine patients with solid breast masses. Both a wide band-pass receiver, similar to that commonly used in clinical ultrasound systems and a tunable receiver (which allows variation of the band-pass from wide to narrow) was used with this automated system. Using the standard receiver system, it was found that there are advantages to having a range of transducer frequencies immediately available for breast examination. These include: (1) improved detection of masses located in highly attenuating regions of breast (by decreasing frequency); (2) availability of diagnostically relevant information at some one frequency which may not be apparent at other frequencies. Using the multiple frequency system and the standard receiver, it was found that the most appropriate examination frequencies for detection and diagnosis of fibroadenomas are higher frequencies (8 to 11MHz). This is particularly true in the case of fibroadenomas in fatty breasts. By using higher frequencies (10MHz and above) along with band-pass filtering of the tunable receiver, it was possible to produce a significant difference in scattering between a mass and the surrounding normal tissue, while maintaining or improving resolution. Images obtained under these circumstances show intense backscattering from normal breast tissues and significantly less scattering from breast masses, whether benign or malignant. This technique may have significant potential for detection of small breast masses since it allows such masses to be sharply outlined in high contrast to their surroundings. Preliminary data also indicates that this technique may provide image characterization of benign and malignant breast masses.
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