Does Real-time Compound Imaging Improve Evaluation of reast Cancer Compared to Conventional Sonography? o Kyoung Seo, M.D., Yu Whan Oh, M.D., Kyu Ran Cho, M.D., Young Hen Lee, M.D., Hyung Joon Noh, M.D., Ji Yung Lee, M.D., June Young Lee, Ph.D. 1, o Kyung Je, M.D., Eun Jeong Choi, M.D., Nam Joon Lee, M.D., Jung Hyuk Kim, M.D., Jeoung Won ae, M.D. 2 and Seok Jin Kim, M.D. 3 Departments of Diagnostic Radiology, 1 Preventive Medicine, Surgery, and 3 Internal Medicine, Korea University College of Medicine, Seoul, Korea Purpose: Real-time compound imaging obtains multiple coplanar tomographic ultrasound images and combines them into a single compound image, reducing acoustic artifacts and noise. The purpose of this study is to determine if real-time compound imaging improves evaluation of breast cancer compared to conventional sonography. Methods: From May 2000 to July 2001, we scanned the same axial plane with conventional sonography and real-time compound imaging in 520 patients with solid breast nodules. Twenty-eight cancers in 25 patients which were confirmed pathologically were included in this study. Twenty-five of 28 cases were invasive ductal carcinoma and the remaining three were ductal carcinoma in situ. Each image pair consisted of a conventional ultrasound and a real-time compound image with a stationary probe, to maintain an identical projection. The evaluating points were 1) contrast between cancer and normal breast tissue, 2) depiction of margin, 3) clarity of internal echotexture, 4) clarity of posterior echo pattern, and 5) clarity of internal microcalcifi- cation. Two radiologists graded for quality of images on a 5-point scale and in a blinded fashion and Wilcoxon rank test was used for comparison between conventional and real-time compound images. Results: For reviewer 1/reviewer 2, compound image showed grade improvements in 1) contrast (1.4±0.5/1.4±0.7), 2) margin (1.4±0.5/1.8±0.4), 3) internal echotexture (1.0± 0.5/1.4±0.7), 4) posterior echo pattern (-0.9±0.7/-0.8 ±0.7), and 5) internal microcalcification (1.8±0.5/1.8±0.5). In all evaluating points, there was statistically significant difference between conventional and compound images (P 0.05). Conclusion: Real-time compound imaging improves contrast, depiction of margin, and clarity of internal echotexture and internal microcalcification of the breast cancer. ut compound image is not effective to evaluate posterior echo pattern of the breast cancer. (Journal of Korean reast Cancer Society 2002;5:102-107) Key Words: reast, US; reast neoplasms; reast neoplasms, Diagnosis; Ultrasound (US), Technology; Ultrasound (US), Comparative studies :,
서보경 외 유방암 관찰 시 실시간 복합영상기법이 고식적 초음파보다 우수한가? 105 ꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏ 소엽화와 침상이 같이 있는 2예(7%) 등이었다. 내부에코는 저에코 17예(61%), 동일에코 7예(25%), 고에코 4예(14%)이 었고, 20예(71%)에서 내부에코의 비균질성을 보였다. 후방 에코는 그림자현상 19예(68%), 증강 4예(14%)이었고, 5예 (18%)에서는 후방에코의 변화가 없었다. 종양내 미세석회 화는 28예 중 9예에서 보였다. 두 명의 관찰자가 판단한 고식적 초음파 비교하여 실시 간 복합영상에서의 등급 상승은 1) 유방암과 정상 유방조 직과의 대조도(1.4±0.5/1.4±0.7), 2) 경계의 명료성(1.4± 0.5/ 1.8±0.4), 3) 내부에코의 명료성(1.0±0.5/1.4±0.7), 4) 후방에코의 명료성(-0.9±0.7/-0.8±0.7), 5) 종괴내 미세 석회화의 명료성(1.8±0.5/1.8±0.5)이었다. 즉, 유방암의 CI RTCI Fig. 4. 34-year-old female with invasive ductal carcinoma. Sonograms show an irregular shaped, heterogeneous hypoechoic nodule with internal microcalcifications (arrows). Real-time compound imaging () is superior technique to conventional sonography () in clarity of internal microcalcifications. CI RTCI Fig. 5. 48-year-old female with invasive ductal carcinoma. Sonograms show an irregular shaped, heterogeneous hypoechoic nodule with posterior shadowing (arrows). In clarity of posterior echo pattern, conventional sonography () is superior technique to real-time compound imaging ().
CI RTCI