Sonographic Evaluation of Mammographically Asymmetric Breast Tissue

Abstracts Importance of the Conclusions: Authors could construct 3D images of breast tumors. 3D Elastography is able to differentiate breast tumors whether it is benign or malignant. TL.09.004 Quantitative Ultrasound Elastography of Sclerotic Fat Necrosis After Autologous Fat Grafting for Augmentation Mammoplasty S. H. Hung Taipei City Hospital, Taipei, Taiwan, R.O.C Brief Description of the Purpose of the Study: Fat necrosis is a benign inflammatory process resulting from autologous fat grafting and may have several appearances at imaging. Ultrasound findings of sclerotic fat necrosis (SFN) can present as speculated mass and mimic those of malignant lesions. Virtual touch tissue quantification (VTQ) of acoustic radiation force impulse (ARFI) imaging is a quantitative technique used to measure tissue stiffness. The present study was conducted to assess the usefulness of VTQ in the differentiation of SFN from malignant masses. Methods: 14 pathologically proven cases of SFN after fat grafting and 32 malignant breast masses were examined using both conventional ultrasound and VTQ. The tissue stiffness for VTQ was expressed as shear wave velocity (SWV) (m/s), and receiver operating characteristic curve (ROC) analyses were performed to assess the diagnostic performance. Main Results: The average SWVs of the SFN cases and the malignant masses were 2.117 m/s (range: 0.61-9.00 m/s) and 4.615 m/s (range: 2.32-9.00 m/s), respectively (p , 0.001). ROC analyses indicated that the area under the curve was 0.871 (p , 0.001). Importance of the Conclusions: VTQ of ARFI imaging provides quantitative elasticity measurements of the tissue stiffness of fat necrosis. As such, VTQ could be a valuable complementary method for differentiating between SFN and malignant breast lesions. TL.09.008 Automatic BI-RADS Diagnosis of Breast Lesions by CAD (Computer-Aid Diagnosis) Wen-Hung Kuo, Shu-Chuan Chuang, Shou-Huan Yang, Ku Yung-Lung, Argon Chen, King-Jen Chang Breast Center, National Taiwan University Hospital, Taipei, Taiwan Brief Description of the Purpose of the Study: This research is to develop a robust, well-performing automatic CAD system which can provide objective suggestion for breast ultrasound BI-RADS categorization. Methods: Sonographic tumor features of 264 tissue-proved BI-RADS 3 to 5 breast lesions were collected. There are initially 30 quantitative attributes extracted automatically from one representative view by computer . 9 attributes, including 6 B-mode attributes and 3 elastography-related attributes are taken into practical model building. We randomly take 175 cases for model training and leave 89 cases as the independent test data. In both, benignancy and malignancy ratio is about 2 to 1. Using -Parameterized Three-Phased Ensemble Model-, we transform the original binary predicting result into probabilistic form so that the model can be applied to BI-RADS categorization which is based on malignancy probability. Main Results: The computer-made proportions of malignancy in each predicted BI-RADS category for 3-4A-4B-4C-5 are 0, 0.0938, 0.4118, 0.8333, 1 respectively. The clinician clinician’s performance are 0, 0.0909, 0.4166, 0.8333, 1. The overall performance of CAD auto-categorization is compatible the result made by experienced clinician. Importance of the Conclusions: This revolutionized automatic computer-aid diagnosis approach for breast ultrasound will give advise to first-line inexperienced physician for referral and provide corresponding second opinion for experiences doctor.

S43

TL.09.011 Sonographic Evaluation of Mammographically Asymmetric Breast Tissue Y. H. Chou, C. M. Tiu, S. Y. Chiou, H. J. Chiou, Y. C. Lai, H. K. Wang Taipei Veterans General Hospital, Taipei, Taiwan Brief Description of the Purpose of the Study: To evaluate the significance of asymmetric breast tissue on mammograms (MG) using ultrasonography (US). Methods: Of the 4,331 MGs obtained in one year, 124 patients (2.9%) were demonstrated to have asymmetric breast density. All of the patients underwent US examination on the basis of mammographic findings, and any patient having US-suspected focal pathology will undergo excisional biopsy, coarse needle biopsy, or vacuum-assisted mammotomy. All asymmetric areas with architectural distortion and clustered microcalcifications were excluded. Main Results: Among the 124 patients, US demonstrated either normal or focal dense glandular or fibroglandular tissue in 85, and in the other 39 patients there were focal abnormality on US. The final diagnosis included: fibrocystic diseases (FCC) (21), presenting as small cysts with / without focal fibrosis or sclerosing adenosis; epithelial hyperplasia (5), one of these four patient was associated with focal atypia; mixed benign pathologies (8), with both FCC and epithelial hyperplasia; and malignancies (5), with infiltrative ductal carcinoma in two, ductal carcinoma in situ (DCIS) in two, and infiltrative lobular carcinoma in one. Importance of the Conclusions: Asymmetric breast tissue on MG can be of certain clinical significance, and further evaluation should be conducted using the state-of-the-art high resolution US. TL.09.012 Sonographic and Mammographic Changes of Breasts in Women Receiving Estrogen Replacement Therapy C. M. Tiu, Y. H. Chou, Y. H. Lee, Y. C. Lai, H. K. Wang, H. J. Chiou Taipei Veterans General Hospital, Taipei, Taiwan Brief Description of the Purpose of the Study: To evaluate the morphological changes of breasts on sonography (US) and mammography (MG) in women following estrogen replacement therapy (ERT). Methods: 126 women received ERT due to ophorectomy. 100 postmenopausal women were enrolled as control group. The breast patterns were classified. All 126 women received MG follow up, and 82 women had also US study. Main Results: 17 women (13%) showed increased density on MG, significantly higher than those in control group (c2521.566, p , 0.0001). Among women having US exam, 16 (20%) showed increased breast volume and newly developed abnormal findings (with mostly fibrocystic changes), also significantly higher than the control group (c2519.571, p , 0.0001) patients with relatively fatty breast showed higher incidence of pattern changes. Importance of the Conclusions: Patients receiving ERT showed significant density changes on MG and morphological changes on US.

10 - Ultrasound in Fetal Medicine/Obstetrics PA.10.001 Transsphenoidal Basal Encephalocele: Case Diagnosed in Routine Echographic Exam F. P. Nobrega, N. Zerwes, A. E. G. M. T. Ferreira, F. F. Mauad, G. C. Grotti, F. S. Ramalho, K. S. Melo Escola De Ultra-Sonografia E Reciclagem Medica Ribeir~ao Preto