Clinical amplitude/velocity reconstructive imaging (CARD) — a new sonographic method for detecting breast lesions

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Abstract
X-ray mammography and breast ultrasound are methods for the detection of breast lesions, especially cancers. They work in a complementary manner, but only X-ray mammography can be used for screening purposes because the recent sonographic techniques are not as cost-effective, not as fast as mammography, observer-dependent and, in some instances, not reliable enough. A new ultrasound method is described which uses an X-ray-identical examination set-up and the following two properties of breast lesions: change of echo patterns behind the lesion and increased sound velocity, especially within malignant lesions. These features can be imaged on a reference structure, a reflecting plate positioned on the side of the breast which is opposite to the transducer. Results of pre-operative examinations of 80 patients with 39 benign and 52 malignant lesions are reported. Clinical, histopathological, and especially X-ray mammography findings are compared. Five cancers were not detectable by ultrasound but had clear suspicious signs on X-ray mammography. Nine cancers were not detected by X-ray mammography but were clearly visible with the new sonographic examination. By the combination of X-ray mammographic findings and their behaviour with the new sonographic method some lesions could correctly be identified as benign. The new sonographic method works in a complementary way to X-ray mammography. By further technical development it could be automated and probably performed as easily, as fast and as reproducibly as X-ray mammography. Using this method systematically in combination with X-ray mammography the detection rate of breast cancer could possibly be increased and unnecessary biopsies of benign lesions could be prevented.