Breast elastography has been thought for years to be the next frontier in breast cancer noninvasive diagnostics. It is in essence a manual self-exam, except that “palpation” is done by ultrasound. Since breast cancer tissue is stiffer than a normal breast, an ultrasound elastography of suspected mass has been shown to be a highly sensitive technique (see references below).
That brings us to the current development. Siemens believes it has come up with software to generate elastograms on its Acuson Antares ultrasound system, that ” may provide a clinically relevant differentiation of benign and malignant tissue.”
A new method in ultrasound known as “eSie Touch Elasticity Imaging” will be shown by Siemens Medical Solutions at the ECR 2007 (European Congress of Radiology) in Vienna, Austria. Physicians hope that this new method, which is an adjunct to regular breast ultrasound examinations, may provide a clinically relevant differentiation of benign and malignant tissue. The method is currently being tested in several studies with promising results and could potentially reduce the number of unnecessary breast biopsies. The software for this diagnostic advance is offered with the 5.0 release of the Acuson Antares ultrasound system, premium edition.
Clinicians use this innovative application to generate an “elastogram” which provides additional information about mechanical properties, e.g. the stiffness of breast lesions. The Siemens method offers a significant improvement in the acquisition of the data – in most cases, the heart beat and the breathing of the patient will provide a sufficient movement to generate the elastogram.
In a recently published study, 80 patients with a total of 123 suspicious lesions were examined. Using elasticity measurements from the eSie Touch Elasticity Imaging application, 18 lesions were classified as malignant, which was confirmed in17 cases by a needle-guided biopsy. Of the 105 lesions predicted as benign, all were biopsy-proven benign. “Elasticity imaging has a high specificity,” confirms the head of the study, Richard G. Barr, professor for radiology at the Northeastern Ohio University College of Medicine and Radiology at the Southwoods X-Ray and MRI in Youngstown, Ohio/USA. Barr hopes that the use of elasticity imaging will help to reduce the number of breast biopsies for many patients. The results of the Barr study are presently being validated in comprehensive studies in Europe and elsewhere in the United States.
Elasticity imaging illustrates the relative stiffness of tissue compared to its surroundings. As tissue undergoes pathologic changes, its relative stiffness will change. The stiffness of the tissue as well as its size compared to the B-mode image provides further insight into potential pathology. “The idea of using the mechanical characteristics of soft tissue to diagnose disease is almost as old as medicine itself. Hippocrates shared this knowledge more than 2,000 years ago,” says Klaus Hambuchen, head of the Ultrasound Division of Siemens Medical Solutions. “To be able to visualize tissue elasticity with ultrasound is an enormous advance in the diagnosis of breast cancer”.
While ultrasound examinations do not eliminate biopsies in general, there is hope that this new method may greatly reduce the number of unnecessary breast biopsies. A biopsy is not only an uncomfortable, invasive procedure, it also often requires a long waiting time for the results. Estimates by experts show that approximately 75 percent of all biopsies are negative. As a result, elasticity imaging offers a huge potential to improve patient care and lower costs at the same time.
eSie Touch Elasticity Imaging will be available on the Acuson Antares 5.0 ultrasound system, premium edition, shipping in March 2007. The technology is part of the comprehensive software package for breast diagnosis.