Tomographic Ultrasound Imaging Research Articles

4D transperineal ultrasound: feedback for good obstetric anal sphincter injuries reparation.

Obstetric anal injury is the main risk factor for traumatic anal, faecal and flatus, incontinence in women in reproductive age. Its recognition and good reparation are crucial for long term outcomes. We report a case of a nulliparous woman who reported a fourth-degree perineal tear after delivery. The obstetric anal sphincter injury was repaired and a four-dimensional transperineal ultrasound was performed after reparation and then one and three months after discharge. The woman did not experience any incontinence and no points of discontinuity were observed at tomographic ultrasound imaging reconstruction. In this case, 4D-TPUS was a tool in the obstetrician's hands to evaluate the surgical success of OASIS repair, which requires some expertise. 4D-TPUS ultrasound is useful and reliable during immediate puerperium and in the subsequent follow-up, giving positive feedback on the correct positioning of the stiches and on a good healing process. Further studies are needed to demonstrate this usefulness in the operators training and for improving their surgical skills.

Update on Placenta Accreta Spectrum Diagnosis and Management Challenges

Abstract: Placenta accreta spectrum (PAS) disorders, also known as morbidly adherent placenta (MAP) include anomalous adherence of the placenta to implantation location. : PAS could be classified into 3 categories based on the penetration distance of trophoblasts via the myometrium and serosa of the uterus into placenta accreta, increta, and percreta. : A recent study in 2020 showed that using the introduced model based on 3 parameters; uterovesical vascularity, unusual lacunae (grades 2 and 3), and bladder wall interruption, has 100% accuracy in the diagnosis of PAS. : Accurate diagnosis of morbidly adherent placenta (MAP), helps in multidisciplinary team management at delivery, with better maternal and neonatal outcomes. : PAS could be suspected early in pregnancy by recognizing women with doubted Cesarean scar pregnancy (CSP) because CSP in the first trimester and PAS in the second and third trimesters might denote various stages of a similar pathology. : Gray scale US with or without adding color Doppler and made by transabdominal or trans vaginal route are commonly utilized for prenatal screening and diagnosis of PAS. : In a recent study made by Alalfy et al. in 2021 they revealed the systematic combined approach with the use of Alalfy Simple Criteria for assessment of placenta previa and PAS using 3D TUI (Tomographic Ultrasound Imaging and 3D power Doppler has a high diagnostic value in the diagnosis of PAS from the non-adherent placenta, the estimation of the myometrial thickness and the depth of placental invasion with the determination of different PAS subgroup plus defining diffuse from focal invasion (Figs. 1 and 2).

Multimode ultrasound imaging of an anal canal gastrointestinal stromal tumour (GIST).

Gastrointestinal stromal tumours (GISTs) can develop throughout the entire gastrointestinal tract, but these tumours are usually found in the stomach and small intestine. In this case, a rare GIST arising from the anal canal was investigated using high-frequency endoanal ultrasound and external three-dimensional ultrasound with tomographic ultrasound imaging. The endoanal approach revealed the inner structure of the tumour. External ultrasound was used to determine the relationship between the lesion and surrounding tissues. In the limited reports of anal canal GISTs, no other lesions have been correctly diagnosed preoperatively or displayed in detail on imaging. The multilayer structure of the anal sphincter and these lesions can be clearly displayed by a variety of ultrasound imaging methods, which are nonradiative, low-cost and easily accessible.Modern ultrasound has the potential for broad application in anal canal tumour diagnosis and surveillance.

Coronal Plane Assessment for Levator Trauma.

Levator avulsion is a major etiological factor of pelvic organ prolapse (POP) and is primarily diagnosed on tomographic axial plane imaging. Two-dimensional imagingcan also image the levator. The objective was to test reproducibility and validity of coronal plane assessment for diagnosis of levator trauma by assessing the coronal plane obtained on tomographic ultrasound imaging. A retrospective study of women who had undergone an interview, POPQ and four-dimensional translabial ultrasound at a tertiary urogynecological unit. Post-processing of archived volume data was performed for assessment; and levator muscle area and estimate of remnant muscle mass in the coronal plane. Interobserver reproducibility of the latter two measures and associations between various measures of levator trauma and POP were tested. Interobserver agreement was good for percentage estimates (ICC 0.743), but fair for area measurements (ICC 0.482). Six hundred and twenty four women were seen, 468 (75%) had significant clinical prolapse. Full levator avulsions were diagnosed in 137 (22%). Mean TTS was 2.7 (range 0-12). On coronal plane assessment average muscle area was 1.47 (SD 0.76) cm2 and 1.55 (SD 0.74) cm2 on the right and left, respectively (P = .005). It was 76% and 79% for average estimates of muscle mass (P = .021). Both measures were strongly associated with POP; however, they were not superior to TTS in predicting POP. Coronal plane assessment in volume data is reproducible and valid for evaluation of levator trauma. Muscle mass estimate may be a better measure than muscle area.

Diagnostic value of TVS, 3.0TMRI, and tomographic ultrasound imaging in EP.

Diagnostic value of TVS, 3.0TMRI, and tomographic ultrasound imaging in EP.

Levator ani muscle avulsion and subsequent vaginal delivery: 8-year longitudinal follow-up.

To assess the evolution of levator ani muscle (LAM) avulsion from 1 year to 8 years after first delivery in women with and those without subsequent vaginal delivery. In addition, to assess whether women with full or partial avulsion 8 years after first delivery have larger LAM hiatal area and more symptoms of pelvic organ prolapse compared to women with normal LAM insertion. In this single-center longitudinal study, 195 women who were primiparous at the start of the study were included and underwent transperineal ultrasound examination 1 year and 8 years after first delivery. Muscle insertion was assessed by tomographic ultrasound imaging in the axial plane. Full LAM avulsion was defined as abnormal muscle insertion in all three central slices. Partial LAM avulsion was defined as abnormal muscle insertion in one or two central slices. Eight years after the first delivery, LAM hiatal area was assessed at rest, during maximum pelvic floor muscle contraction and on maximum Valsalva maneuver. To assess symptoms of pelvic organ prolapse, the vaginal symptoms module of the International Consultation on Incontinence Questionnaire was used. At 1-year follow-up, 25 (12.8%) women showed signs of LAM avulsion, of whom 20 fulfilled the sonographic criteria of full avulsion and five of partial avulsion. Eight years after the first delivery, 35 (17.9%) women were diagnosed with avulsion, of whom 25 were diagnosed with full avulsion and 10 with partial avulsion. No woman with partial or full avulsion at 1 year had improved avulsion status at the 8-year follow-up. Of the 150 women who had subsequent vaginal delivery, 21 (14.0%) women were diagnosed with partial or full LAM avulsion 1 year after first delivery, and 31 (20.7%) women were diagnosed with partial or full avulsion 8 years after first delivery. Of the 45 women without subsequent vaginal delivery, one woman with partial avulsion 1 year after first delivery was diagnosed with full avulsion at the 8-year follow-up. All women with full avulsion at 1-year follow-up were diagnosed with full avulsion at the 8-year follow-up regardless of whether they had subsequent vaginal delivery. At 8-year follow-up, women with full avulsion had statistically significantly larger LAM hiatal area compared to women with normal muscle insertion. Mean ± SD vaginal symptom scores ranged between 5.5 ± 5.7 and 6.0 ± 4.0 and vaginal symptom quality of life scores ranged between 0.9 ± 1.4 and 1.5 ± 2.2 and did not differ significantly between women with normal muscle insertion and women with partial or full avulsion at 8-year follow-up. More LAM avulsions were present 8 years compared with 1 year after first delivery in women with subsequent vaginal delivery. Except for one primipara, all women without subsequent vaginal delivery had unchanged LAM avulsion status between 1 year and 8 years after their first delivery. Larger LAM hiatal area was found in women with full avulsion compared to those with normal muscle insertion at 8-year follow-up. Vaginal symptoms scores were low and did not differ between women with normal muscle insertion and those with partial or full avulsion at 8-year follow-up. © 2024 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

Comparison of diagnostic values between 2D three-section ultrasound and 3D tomographic ultrasound imaging for fetal cleft palate at 11–13+6 weeks

ObjectiveTo assess diagnostic values of 2D three-section ultrasound including central sagittal section of the face, axial section of the superior alveolar process, and coronal section of the posterior triangle of the nose and 3D tomographic ultrasound imaging (TUI) in fetal cleft palate at 11–13+6 weeks. Methods21 cleft palate fetuses who were delivered or induced in our hospital from January 2018 to May 2021 were enrolled. All fetuses with cleft palate underwent nuchal translucency (NT) measurement and screening at 11–13+6 weeks. Relevant findings of cleft palate detected by 2D and 3D TUI during NT screening were retrospectively analyzed. The cleft palate detection rate was compared between two groups. ResultsThe detection rates of 3D TUI and 2D three-section ultrasound for cleft palate were 0.857 (18/21) and 0.810 (17/21), with no statistical significance (P > 0.05). The detection rates on triangular coronal section of the posterior nose were by 2-D three-section ultrasound was 81.0%, significantly higher than 52.3% (11/21) and 66.6% (14/21) on the central sagittal section and axial section of the superior alveolar process (both P < 0.05). ConclusionBoth 2D three-section ultrasound and 3D TUI yield high diagnostic value for cleft palate at 11–13+6 weeks. The detection rate of cleft palate on the coronal section of the posterior triangle of the nose by 2D three-section ultrasound is higher compared with those on the remaining two planes.

AI-Enhanced Analysis Reveals Impact of Maternal Diabetes on Subcutaneous Fat Mass in Fetuses without Growth Alterations.

Pregnant women with diabetes often present impaired fetal growth, which is less common if maternal diabetes is well-controlled. However, developing strategies to estimate fetal body composition beyond fetal growth that could better predict metabolic complications later in life is essential. This study aimed to evaluate subcutaneous fat tissue (femur and humerus) in fetuses with normal growth among pregnant women with well-controlled diabetes using a reproducible 3D-ultrasound tool and offline TUI (Tomographic Ultrasound Imaging) analysis. Additionally, three artificial intelligence classifier models were trained and validated to assess the clinical utility of the fetal subcutaneous fat measurement. A significantly larger subcutaneous fat area was found in three-femur and two-humerus selected segments of fetuses from women with diabetes compared to the healthy pregnant control group. The full classifier model that includes subcutaneous fat measure, gestational age, fetal weight, fetal abdominal circumference, maternal body mass index, and fetal weight percentile as variables, showed the best performance, with a detection rate of 70%, considering a false positive rate of 10%, and a positive predictive value of 82%. These findings provide valuable insights into the impact of maternal diabetes on fetal subcutaneous fat tissue as a variable independent of fetal growth.

Real-time 3-D reconstruction from multiple simultaneous ultrasound scans for enhanced imaging

Ultrasound imaging offers numerous benefits compared to other modalities, including portability, affordability, and real-time volumetric imaging capabilities. However, its limited field of view hinders image interpretation, significantly limiting its potential clinical applications. This study focuses on creating tomographic ultrasound imaging by automatically registering partially overlapping 3-D ultrasound volumes (coarsely localized in space). This approach can be used to gather a comprehensive field of view of the anatomical area imaged and to enhance the acquired image information. Potential applications involve both tomographic/wide-view imaging using conventional ultrasound probes and future technologies, where multiple ultrasound probes will be able to scan simultaneously the anatomy of interest. This work describes the development of advanced artificial intelligence and image analysis methods to create real-time 3-D anatomical reconstructions of a designated area of interest. Simultaneously (or quasi simultaneously) acquired ultrasound volumes with partial overlap can be spatially aligned using rigid registration, because they present geometrically similar information. We used novel supervised and unsupervised transformers and compared the results with more traditional methods such as mutual information and cross-correlation. This application contributes to creating new imaging processing techniques for ultrasound imaging and making this complex modality more user-friendly and clinically usable.

Vaginal wall thickness as potential biomarker of vaginal health. A proposal for standardized ultrasound measurement using three-dimensional transvaginal ultrasound.

Vaginal wall thickness could be used as a biomarker of vaginal health. We propose a standardized method using three-dimensional (3D) ultrasound for measuring vaginal wall thickness. Fill the vagina with gel. Insert the endovaginal transducer into the vagina up to the middle third. In the sagittal plane, visualizing the cervix and vaginal fornices, capture a 3D volume of the upper third of the vagina. Using tomographic ultrasound imaging function in the sagittal plane and the posterior vaginal fornix as the reference obtain at least three axial planes of the vagina, separated by 1 cm. Measure the vaginal wall thickness at a distance of 2 cm from the posterior vaginal fornix at 12, 3, 6, and 9 o'clock. The reproducibility of measurements was high. Measurements of vaginal wall thickness can be reliably performed.

Research progress in pelvic floor ultrasound for assessing the morphology and function of levator ani muscle in women.

Pelvic floor ultrasound can clearly visualize the position and morphology of pelvic floor organs, observe the pelvic organ prolapse in real-time, and quantify and analyze the degree of the levator ani muscle injury, which is the most common imaging method to assess the morphology and function of the levator ani muscle to date. The different ultrasound imaging techniques provide a variety of indicators, each with its own advantages and limitations.Furthermore, two-dimensional ultrasound is the basis of imaging, but it fails to detect cross-sectional images of the pelvic floor; three-dimensional ultrasound can acquire the axial plane of the levator hiatus; tomographic ultrasound imaging allows real-time observation of the levator ani muscle injury; shear wave elastography can provide a quantitative assessment of the contractility and elastic characteristics of the levator ani muscle in real-time. It is of great significance to summarize the basic principles of various ultrasound imaging techniques, summarize the ultrasound image characteristics of levator ani muscle and its hiatus in different populations and different states, and explore the cut-off values and diagnostic criteria-related ultrasound parameters for improving the diagnostic efficiency of pelvic floor ultrasound for levator ani muscle injury, leading to reducing missed diagnosis and misdiagnosis of lesions.

Abstract P3007: Rosuvastatin-eluting Gold-nanoparticle-loaded Perivascular Wrap For Enhanced Arteriovenous Fistula Maturation In A Murine Model

Background: Arteriovenous fistulas (AVFs) are a vital form of arteriovenous access for patients requiring hemodialysis, but they are linked to overall morbidity and mortality when they fail to mature. The most common cause of AVF non-maturation is neointimal hyperplasia (NIH). To minimize the effects of NIH, a perivascular wrap composed of polycaprolactone (PCL), rosuvastatin (ROSU), and gold nanoparticles (AuNPs) was created. Objectives: This study assessed the impact of ROSU-eluting, radiopaque resorbable perivascular wraps on pathologic NIH in a chronic kidney disease (CKD) rodent model of AVF. Methods: Electrospun PCL wraps containing AuNPs and/or ROSU were monitored for in vitro AuNP release, ROSU elution, and cell viability. The wraps were implanted around an AVF in a CKD rodent model for in vivo ultrasound (US) and micro-computed tomography (mCT) imaging. AVF specimens were collected for histological analyses. Results: Cell viability was preserved in the presence of both AuNP- and ROSU-containing wraps. In vitro release of ROSU and AuNPs correlated with in vivo findings of decreasing radiopacity on mCT over time. AuNP-loaded wraps had increased radiopacity compared with PCL-alone wraps and control AVFs without wraps. The addition of ROSU decreased US and histologic measurements of NIH. Conclusions: The reduced NIH seen with ROSU-loaded perivascular wraps suggests a synergistic effect between mechanical support and anti-hyperplasia medication. Furthermore, AuNP loading increased wrap radiopacity. Together, our results show that AuNP- and ROSU-loaded PCL wraps induce AVF maturation and suppress NIH while facilitating optimal implanted device visualization.

Ultrasound examination of the pelvic floor during active labor: A longitudinal cohort study.

There is limited evidence about changes in the pelvic floor during active labor. We aimed to investigate changes in hiatal dimensions during the active first stage of labor and associations with fetal descent and head position. We conducted a longitudinal, prospective cohort study at the National University Hospital of Iceland, from 2016 to 2018. Nulliparous women with spontaneous onset of labor, a single fetus in cephalic presentation, and gestational age ≥37 weeks were eligible. Fetal position was assessed with transabdominal ultrasound and fetal descent was measured with transperineal ultrasound. Three-dimensional volumes were acquired from transperineal scanning at the start of the active phase of labor and in late first stage or early second stage. The largest transverse hiatal diameter was measured in the plane of minimal hiatal dimensions. The levator urethral gap was measured as the distance between the center of the urethra and the levator insertion using tomographic ultrasound imaging. Measurements of the levator urethral gap were made in the plane of minimal hiatal dimensions and 2.5 and 5 mm cranial to this. The final study population comprised 78 women. The mean transverse hiatal diameter increased 12.4% between the two examinations, from 39.4 ± 4.1 mm (±standard deviation) at the first examination to 44.3 ± 5.8 mm at the last examination (p < 0.01). We found a moderate correlation between the transverse hiatal diameter and fetal station at the last examination (r = 0.44, r2 = 0.19; p < 0.01; regression equation y = 2.71 + 0.014x), and a weak correlation between the change in transverse hiatal diameter and change in fetal station (r = 0.29; r2 = 0.08; p = 0.01; regression equation y = 0.24 + 0.012x). Levator urethral gap increased significantly in all three planes on both the left and right sides. Head position was not associated with hiatal measurements after adjusting for fetal station. We found a significant, but only modest, increase of the hiatal dimensions during the first stage of labor. The risk of levator ani trauma will therefore be low during this stage. The change in transverse hiatal diameter was associated with fetal descent but not with head position.

Open-UST: An Open-Source Ultrasound Tomography Transducer Array System.

Fast imaging methods are needed to promote clinical adoption of ultrasound tomography (UST), and more widely available UST hardware could support the experimental validation of new measurement configurations. In this work, an open-source 256-element transducer ring array was developed (morganjroberts.github. io/open-UST) and manufactured using rapid prototyping, for only £2k. Novel manufacturing techniques were used, resulting in a 1.17° mean beam axis skew angle, a [Formula: see text] mean element position error, and a [Formula: see text] deviation in matching layer thickness. The nominal acoustic performance was measured using hydrophone scans and watershot data, and the 61.2 dB signal-to-noise ratio (SNR), 55.4° opening angle, 10.2 mm beamwidth, and 54% transmit-receive bandwidth (-12 dB) were found to be similar to existing systems and compatible with state-of-the-art full-waveform-inversion image reconstruction methods. The interelement variation in acoustic performance was typically < 10% without using normalization, meaning that the elements can be modeled identically during image reconstruction, removing the need for individual source definitions based on hydrophone measurements. Finally, data from a phantom experiment were successfully reconstructed. These results demonstrate that the open-UST system is accessible for users and is suitable for UST imaging research.

Safe and effective profile of the VSTENT bioresorbable polymer sirolimus-eluting stent in the treatment of patients with de novo coronary artery lesions: a prospective, cohort, multicenter study.

The drug-eluting stent was a significant stride forward in the development of enhanced therapeutic therapy for coronary intervention, with three generations of increased advancement. VSTENT is a newly developed stent manufactured in Vietnam that aims to provide coronary artery patients with a safe, effective, and cost-efficient option. The purpose of this trial was to determine the efficacy and safety of a new bioresorbable polymer sirolimus-eluting stent called VSTENT. This is a prospective, cohort, multicenter research in 5 centers of Vietnam. A prespecified subgroup received intravascular ultrasound (IVUS) or optical coherence tomography (OCT) imaging. We determined procedure success and complications during index hospitalization. We monitored all participants for a year. Six-month and 12-month rates of major cardiovascular events were reported. All patients had coronary angiography after 6 months to detect late lumen loss (LLL). Prespecified patients also had IVUS or OCT performed. The rate of device success was 100% (95% CI: 98.3-100%; P<0.001). Major cardiovascular events were 4.7% (95% CI: 1.9-9.4%; P<0.001). The LLL over quantitative coronary angiography (QCA) was 0.08±0.19 mm (95% CI: 0.05-0.10; P<0.001) in the in-stent segment and 0.07±0.31 mm (95% CI: 0.03-0.11; P=0.002) in 5 mm within the two ends of the stent segment. The LLL recorded by IVUS and OCT at 6 months was 0.12±0.35 mm (95% CI: 0.01-0.22; P=0.028) and 0.15±0.24 mm (95% CI: 0.02-0.28; P=0.024), respectively. This study's device success rates were perfect. IVUS and OCT findings on LLL were favorable at 6-month follow-up. One-year follow-up showed low in-stent restenosis (ISR) and target lesion revascularization (TLR) rates, reflecting few significant cardiovascular events. VSTENT's safety and efficacy make it a promising percutaneous intervention option in developing nations.

Evaluation of Extrathyroidal Extension of Papillary Thyroid Microcarcinoma With Three-Dimensional Tomographic Ultrasound Imaging

Objective To evaluate extrathyroidal extension (ETE) in papillary thyroid microcarcinoma (PTMC) with three-dimensional tomographic ultrasound imaging (3D-TUI). Methods A total of 97 thyroid nodules of 79 patients with PTMC treated in PUMC Hospital from February 2016 to January 2018 were included in this study.Two ultrasound experts performed independent blinded assessment of the relationship between thyroid nodules and thyroid capsule by two-dimensional ultrasound (2D-US) and 3D-TUI.The results of 2D-US and 3D-TUI in evaluating ETE were compared with intraoperative findings and postoperative histological and pathological results. Results Among the 97 nodules,54 (55.7%) nodules had ETE.The diagnostic sensitivity (68.5% vs.37.0%;χ2=10.737,P=0.002),accuracy (74.5% vs.56.7%;χ2=6.686,P=0.015),and area under the receiver operating characteristic curve[0.761 (95%CI=0.677-0.845) vs.0.592 (95%CI=0.504-0.680);Z=3.500,P<0.001] of 3D-TUI were higher than those of 2D-US.However,3D-TUI and 2D-US showed no significant difference in the specificity (84.1% vs.81.4%;χ2=0.081,P=0.776),negative predictive value (67.9% vs.50.7%;χ2=3.645,P=0.066),or positive predictive value (84.1% vs.71.4%;χ2=1.663,P=0.240). Conclusion Compared with 2D-US,3D-TUI demonstrates increased diagnostic efficiency for ETE of PTMC.

Ultrasound Tomography for Lung Imaging: An Experimental Phantom Study

The ability to create real-time images of pulmonary function is highly desirable in many clinical situations. For example, information on air delivery is vital for patients in the intensive care unit (ICU) who are going through mechanical ventilation due to respiratory failure. The functional information obtained from imaging can be used to provide early warnings of developing pulmonary pathologies in real time, reducing complications and improving patient outcomes. Electrical impedance tomography (EIT) is an imaging system that has gone through clinical studies and provides such information. EIT has several drawbacks and the most important one is its limited spatial resolution and very low resolution in depth, which cannot be avoided by adding more electrodes. Therefore, it is possible to introduce ultrasound tomography (UST) as an imaging technique with the potential to provide real-time nonionizing pulmonary monitoring in lung imaging. In contrast, the UST can show significant resolution enhancement when more transducers are used. The central region of thorax can be detected with UST due to its enhanced resolution in the central area. In this work, we developed a realistic geometry thorax phantom and are focusing on the performances of 3-D UST for lung imaging applications. Results are validated using experimental thoracic phantoms representing the possible use of UST for lung imaging. The UST imaging is achieved by detecting and reconstructing the changes of sound velocity distribution resulting from pulmonary functions and conditions.

Ectopic pregnancy with implanted gestational sac in the cesarean scar

Introduction: Implantation of a pregnancy in the cesarean scar is considered a rarest presentation of ectopic pregnancy with high morbidity and mortality. The use of imaging tests is capable of early diagnosing such cases and assisting in the management of pregnancy. The present article reports two cases of ectopic pregnancy in the cesarean scar, illustrating the main aspects in ultrasound tomography (UST) and magnetic resonance imaging (MRI) exams. In addition, a bibliographic search was carried out in a database that presented data about this clinical condition. Case Series: Case 1: A 44-year-old patient, without comorbidities, G2P1cA0, with a pregnancy of 9w4d, admitted with bleeding for 03 days. Ultrasound tomography showed a single gestational sac with an embryo of anomalous morphology, with no heartbeat and in isthmic topography, in an exophytic position, over the topography of a scar from a previous cesarean section. The initial diagnosis was placental accreta. After MRI of the pelvis, an ectopic pregnancy with a gestational sac implanted in the cesarean section scar (type II—exogenous), with signs of trophoblast/placental accreta. Case 2: A 30-year-old patient, without comorbidities, G2P1c, with a 7w3d pregnancy, with abdominal pain. Ultrasound tomography showed a single gestational sac with a gestational sac implanted in the cesarean section scar, transmural type I (endogenous), which was later confirmed by pelvic MRI. Conclusion: It is necessary to highlight the importance of early diagnosis of ectopic pregnancy with implantation in a cesarean scar, given the possibility of making an appropriate therapeutic decision depending on the clinical context, aiming to reduce the possible complications of the condition.

Abstract P3-04-13: Patient experience with automated SoftVue 3D whole breast tomographic ultrasound

Abstract Authors: Mary Yamashita, MD; Rachel Brem, MD; Lauren Baker, Ph.D; MD; Taylor Mahoney, PhD; Patrick Walker, PharmD, MPH; Rachel Treat, MA; Linda Hovanessian Larsen, MD. Title: Patient experience with automated SoftVue 3D whole breast tomographic ultrasound. Purpose: SoftVue (SV) is an automated, 3D whole breast ultrasound tomographic imaging device which is FDA PMA approved as adjunct to mammography for women with dense breasts. Screening with handheld US is labor intensive and with ABUS is associated with significant patient discomfort. A benefit of SV is that image acquisition is not operator dependent and does not require compression. Because acceptance by patients is crucial to implementation of US screening, we evaluated patients’ experience with SV, specifically, asymptomatic women with BI-RADS c or d density undergoing FFDM. Materials and Methods: As part of a prospective, 10-site study, 7,439 asymptomatic women with BI-RADS density category c or d were screened on the same day with FFDM and SV. Each patient’s experience was assessed for perceived pain, discomfort and anxiety, discretion and modesty, overall satisfaction, and whether they would recommend it to others. The responses were measured on a Likert scale with 5 choices from strongly agree to strongly disagree, then studied by Chi-Squared analysis. Results: The mean age was 53.9 ± 9.7 yo, mostly white women (87.7%). The median BMI was 24.4. Majority had no personal history of breast cancer (97.2%), but 24.8% had a previous biopsy and almost half (46.3%) had a family history of breast cancer. Almost all patients (99.6%) completed the survey. SV was perceived as significantly more comfortable than FFDM (83.7% vs 52.2%, p&amp;lt; 0.001), was painless (94.9% vs 53.1%, p&amp;lt; 0.001), and was associated with less anxiety during the procedure (95.1% vs 79.9, p&amp;lt; 0.001). Lastly, 99.3% felt the experience was private and discreet, and 95% would recommend the SV exam to other women. Conclusion: Pain, fear, anxiety, and modesty concerns are some of the barriers preventing widespread implementation of screening breast US. This data suggests that SV, an FDA PMA approved adjunctive screening exam for women with dense breast tissue, is painless, offers a private and discreet scan that limits anxiety, and is well accepted by patients. Clinical relevance statement: SV is a novel automated US tomographic screening technology that is comfortable, well-accepted, FDA PMA approved, and will likely result in improved implementation of screening breast ultrasound in women with dense breasts. Citation Format: Mary Yamashita, Rachel F. Brem, Lauren Baker, Taylor F. Mahoney, Patrick Walker, Rachel M. Treat, Linda Hovanessian Larsen. Patient experience with automated SoftVue 3D whole breast tomographic ultrasound [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P3-04-13.

Whole-Body Imaging Using Low Frequency Transmission Ultrasound

To indicate that 3D low-frequency ultrasound tomography with 3D data acquisition (volography) is a safe, low-cost, high-resolution, whole-body meso-scale medical imaging modality that gives high-resolution quantitatively accurate clinically relevant images. We compare the speed of sound accuracy in various organs in situ. We validate our 3D ultrasound tomography images using MRI and gross section anatomy as ground truth in 10-day old piglets. Data acquisition is accomplished with the QT Scanner at ∼1 MHz center frequency, and array transceivers for reflection data @3.6 MHz. Images are generated with unique model-based 3D ultrasound tomography algorithms. In reflection, we use 3D refraction-corrected ray tracing to allow 360° compounding with sub-mm resolution. Four 10-12 day old pigs were anesthetized and whole-body images were acquired via low-frequency transmitted ultrasound and 3T MRI. Tissue values were within an average of 1.07% (0.5%) of the literature values. We also show the detailed correlation of our images with MRI images in axial, coronal, and sagittal views. Volography images of a piglet show high resolution and quantitative accuracy, showing more contrast &resolution than 3T MRI, including the kidney showing medulla, cortex and fibrous cover, and small intestines with ileal lumen detail visible. We establish that 3D ultrasound tomography (volography), yields high-resolution quantitatively accurate images whole-body images in presence of bone and air which are potentially clinically useful but have not appeared in the literature.