From breast exams to childbirth, ultrasound is gaining momentum

From breast exams to childbirth, ultrasound is gaining momentum

Lauren Dubinsky, Senior Reporter | July 13, 2016
From the July 2016 issue of HealthCare Business News magazine

“Handheld is very operator-dependent, so depending on the skill of the ultrasound technician, you may get a very good image or some may not be good,” he adds. “Also, there is a risk of missing tissue, which is a huge concern.” For an ABUS exam, the clinician just has to press a button, which is similar to a mammography exam. It takes away a lot of the variability of the operator in order to get consistent, quality images on a population basis.

GE’s Invenia ABUS system, which received FDA approval in 2012, is the only ABUS system approved as an adjunct screening tool for dense breasts. There are other ABUS systems on the market, but they are mostly used in the diagnostic setting. Siemens Healthcare’s ACUSON S2000 Automated Breast Volume Scanner was introduced in 2008 and several software advancements have been made for it over the last few years. It acquires a 3-D volumetric view of the breast.

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A study published in the American Journal of Roentgenology in May compared how well radiologists can detect breast cancer using full-field digital mammography alone and then using it along with 3-D ABUS. For the cancers that were originally missed with mammography, ABUS improved sensitivity from 38.5 percent to 62.4 percent. For cancers that were missed by mammography that had no prior interventions, sensitivity improved from 32.4 percent to 68.1 percent.

The researchers concluded that, “The addition of ABUS to screening mammography showed a significant increase in cancer detection with a nominal insignificant decrease in specificity. Although these findings were in a research environment, one might expect a similar impact of screening ABUS in clinical practice.”

Prior studies showed that ABUS increases sensitivity, but that it impacts specificity. This new study shows that there was a substantial increase in sensitivity and that the impact on specificity was very low and not statistically significant. “That tells us that the technology continues to be very promising and it could play a very pivotal role in the way we personalize screening, especially for dense breast women,” says Suryanarayanan.

Breast microcalcifications
Breast microcalcifications are small calcium deposits that are usually not a result of cancer, but can be a sign of precancerous cells or early breast cancer if they appear in certain patterns. They appear as white specks on mammography, but with gray-scale ultrasound imaging they can barely be seen. In 2012, Thomas Jefferson University in Philadelphia conducted a pilot study that compared Toshiba America Medical Systems, Inc.’s MicroPure imaging processing technique with gray-scale ultrasound imaging for detecting breast microcalcifications. The researchers found that MicroPure significantly improved the identification of microcalcifications compared with gray-scale imaging.

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