Robert Albert Schmidt MD, Presenter: Stockholder, R2 Technology, Inc, Los Altos, CA Research grant, Koninklijke Philips Electronics NV, Bothell, WA Research grant, Fuji Photo Film Co, Ltd, Stamford, CT Speakers Bureau, Fuji Photo Film Co, Ltd, Stamford, CT Consultant, Konica Minolta Group Advisory Board, Konica Minolta Group

Rob Entrekin MS, Abstract Co-Author: Employee, Koninklijke Philips Electronics NV Research funded, Koninklijke Philips Electronics NV

Bruce A. Porter MD, Abstract Co-Author: Nothing to Disclose

Alexandra V. Edwards, Abstract Co-Author: Nothing to Disclose

Gillian Maclaine Newstead MD, Abstract Co-Author: Speakers Bureau, Fuji Photo Film Co, Ltd Advisory Board, Konica Minolta Group

Charlene A. Sennett MD, Abstract Co-Author: Nothing to Disclose

Hiroyuki Abe MD, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

Ultrasound is important in evaluation for breast cancer. While hand-held ultrasound (HHUS) is the standard, it is time-consuming, operator dependent and has a limited field of view. We did a preliminary evaluation of a whole breast ultrasound device (WhoBUS).

20 patients with 24 known lesions visible on HHUS were eligible for analysis (9 confirmed malignant, 15 benign). Mean age was 51 (range 25-82). 8 benign lesions had pathologic confirmation; 7 were judged benign by mammogram, HHUS or MRI. HHUS was performed by an experienced radiologist using an ATL HDI5000 with 50mm L12/5 probe (Philips; Bothell, Washington). The Philips WhoBUS utilizes a modified mammographic compression gantry, with the L12/5 probe driven automatically over preset field sizes and connected to an HDI5000 unit and a computer/display device. 15 additional patients not yet analyzed will also be available for presentation.

Mean HHUS size of the malignancies was 19mm (4-36), and 11mm (5-19) for the benign lesions. 100% of the malignant lesions were seen on WhoBUS. Mean size correlation with both histologic and HHUS sizes was good. Two cancers seen on WhoBUS were not detected on original HHUS scans, only on “second-look” US after MRI found them. 7 of the 15 benign lesions were seen (47%). Benign lesions were smaller (11mm vs 19mm), but there was no difference in mean size between benign lesions detected and not detected. Difficulties encountered were slippage of the breast due to coupling gel, patient motion, limitations in imaging the nipple region and chest wall tissues, limited penetration of the high frequency transducer and restriction of scan directions to caudo-cranial, LM and ML.

WhoBUS detected malignancies in this small series well, but found less than half the benign lesions, which were significantly smaller. Some lesions were subtle even on targeted HHUS, and would represent a challenge for any global US scanning technique. Two cancers missed on HHUS were seen on WhoBUS.

Whole breast ultrasound shows promise of becoming a useful clinical tool, but improvements in device design and much larger series are needed to validate its ability to routinely find small cancers.

Schmidt, R, Entrekin, R, Porter, B, Edwards, A, Newstead, G, Sennett, C, Abe, H, et al, , Preliminary Experience with WhoBUS, an Automated Whole Breast Ultrasound Scanner: Comparison with Conventional Hand-held Ultrasound.  Radiological Society of North America 2006 Scientific Assembly and Annual Meeting, November 26 - December 1, 2006 ,Chicago IL. http://archive.rsna.org/2006/4439026.html