Vasilis Z. Marmarelis PhD, Presenter: Researcher, MastoScopia SA Shareholder, MastoScopia SA

Michael Sofras, Abstract Co-Author: Researcher, MastoScopia SA

Dimitra Koulocheri MD, Abstract Co-Author: Nothing to Disclose

Paraskevi Liakou MD, Abstract Co-Author: Nothing to Disclose

Stefanos Hadjiagapis PhD, Abstract Co-Author: CEO, MastoScopia SA Stockholder, MastoScopia SA

George Zografos MD, Abstract Co-Author: Nothing to Disclose

To demonstrate the ability of the new diagnostic imaging technology of Multimodal Ultrasonic Tomography (MUT) to achieve early detection of breast cancer (down to mm-size lesions) in initial clinical trials through its unique non-invasive tissue-differentiation capability.

We performed 3D tomographic scans of pendulant breasts in water-bath for 64 volunteers with BI-RADS 4 mammograms, presenting 93 lesions (42 malignant and 51 benign), using transmission ultrasound in a fixed-coordinate system. Specially coded sequences of ultrasonic pulses were properly analyzed with novel methodologies to obtain MUT images of refractivity, frequency-dependent attenuation and dispersion. In-plane pixel size was 0.25 mm x 0.25 mm and vertical separation between adjacent coronal slices was 2-4 mm (depending on clinical requirements). The examined hypothesis was that the obtained multimodal images can be fused to achieve reliable detection and differentiation of breast lesions down to mm size. All lesions were confirmed via histopathology performed in the normal course of clinical practice. There were no operational complications in any of the MUT scans and all volunteers attested to total comfort.

All 93 lesions were clearly detected on the MUT diagnostic images and were also classified correctly into benign (51) or malignant (42) using their respective multimodal information and the novel classification method developed for MUT. The lesions ranged in size from 2 mm to 38 mm. An illustrative example of composite MUT “diagnostic images” is shown in the attached Figure, depicting a small (3 mm x 4 mm) malignant IDC lesion and a DCIS lesion with maximum dimension of 2 mm. Malignant lesions generally exhibited higher (calibrated) values of refractivity, attenuation and dispersion. However, proper combination of these attributes was necessary in order to achieve high sensitivity and specificity.

Initial clinical results demonstrated the ability of the MUT technology to detect all 93 lesions in 64 volunteers with BI-RADS 4 mammograms and confirmed the non-invasive lesion differentiation capability of MUT in all cases.

The high sensitivity and specificity of the MUT technology offers the prospect of an improved screening modality for the early diagnosis of breast cancer without ionizing radiation at modest cost.

Marmarelis, V, Sofras, M, Koulocheri, D, Liakou, P, Hadjiagapis, S, Zografos, G, Detection and Differentiation of mm-size Lesions in the Breast Using the New Technology of 3D Multimodal Ultrasonic Tomography.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11034449.html