When it comes to breast cancer screening for women with dense breasts, automated breast ultrasound (ABUS) is the right choice to supplement with mammography, according to industry experts.
At the presentation of the 2021 annual meeting of the European Radiation Congress (ECR), Athina Vourtsis, MD, Ph.D., director of the Diagnostic Mammography Center in Athens, Greece, as well as founding president of the Breast Imaging Association Hellenic. case for using ABUS when you need additional screening for women with increased breast density.
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While screening mammography is still regarded as the gold standard for breast cancer detection, she noted that 50 percent of existing breast cancers are not related to the mammography microsurgery best construction. That opens the door for the masking effect, leading to a potential increase in interstitial cancers.
In addition, 43 percent of women between the ages of 40 and 74 have dense breasts. Not only are they four to six times more likely to develop breast cancer, but they have an 18-fold higher risk for breast cancer. transitional cancer as well. As a result, Vourtsis said, the implementation of an effective remedial screening tool is critical.
Manual ultrasound (HHUS) can work well, she said, but there are challenges involved. Capturing high-quality images can require hard training, and still depends on operator experience. The visual acuity is also small, and HHUS has a higher false positive rate.
This is where ABUS comes in, she said. It can be used in diagnostic settings, such as a second eye after MRI, in preoperative settings, or it can be used for correlation between molecular subtypes of breast cancer.
Benefits of ABUS
Among several advantages, Vourtsis said, ABUS is independent of operator, offers a larger view, can complete batch and dual readings, and can incorporate computer-aided detection (CAD) .
The extracted images are better, moreover, she explained, as the tool can convert 2D datasets into multi-plane 3D reconstructed images that give a deeper view of re- breast experts. According to the existing study, she said, this multi-plan reconstruction offers 96 percent to 100 percent specificity and 80 percent to 89 percent sensitivity for breast cancer detection, which as well as an improved space under the loop. In addition, evidence shows that it can reduce between 3 percent and 18 percent of non-lethal biopsied lesions to BI-RADS 2.
Successful implementation
There are three aspects to ABUS ‘s successful implementation, Vourtsis said, with the technologist, patient and radiologist all playing important roles.
Technologist: It is up to the technician to position the patient appropriately and apply a sufficient lotion to the entire breast before imaging. Appropriate depth and tension, as well as proper transducer positioning are essential to get the best images. Following these steps will lead to the best image capture that can do a better job of detecting smaller breast cancers that are behind the nipple, near the breast wall, or on the edge of the nipple. chest. It can also reduce the false positive rate and improve the positive predictive value of the biopsies performed.
Patient: Instruct all patients to hold their breath as usual, but to avoid talking or coughing during the imaging process. They should also stay non-stop and not try to change position between each image build.
Radiologist: To reduce the false positive rate, providers need to capture detailed information from the patient’s history. Be sure to read all measurements and planes, she recommended, and in the radiation report, use a structured BI-RADS statement and record all results. You should also read both ABUS images and mammography for the most complete assessment.
Artifacts
Radiologists also need proper training and education to be able to identify the arteries that can occur with ABUS, Vourtsis stress.
There are four main types of artifact you will encounter:
- Technical: Caused by improper positioning, lack of contact, or skin folding.
- Software: Nipple or silhouette artifact product.
- Physiologic: Caused by cardiac activity or movement.
- Related Lesion: The result of a sprain, augmentation, or a shadow.
There are ways to avoid these things, however, she said:
- Use extra planes to study peripheral anomalies and artifacts.
- Use second sight to cast a shadow as a one-view device only.
- Use the rotating software to define a shadow.
Even with all these advantages and capabilities, Vourtsis said, work is still ongoing to continue developing ABUS. Research is currently underway to see how the implementation of CAD could reduce the recall rate associated with the screening method and at the same time improve the detection of casualties. suspicious.
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