Differentiation of BIRADS-4 small breast lesions via Multimodal Ultrasound Tomography

G. Zografos,P. Liakou, D. Koulocheri,I. Liovarou , M. Sofras, S. Hadjiagapis, M. Orme and V.Z. Marmarelis.

European Radiology ISSN 0938-7994



To demonstrate the use of a new 3D diagnostic imaging technology, termed Multimodal Ultrasonic Tomography (MUT), for the detection of solid breast lesions < 15 mm in maximum dimension.

Methods and materials

3D MUT imaging was performed on 71 volunteers presenting BIRADS-4 nodules, asymmetrical densities, and architectural distortions in X-ray mammograms, who subsequently underwent biopsy. MUT involved D tomographic imaging of the pendulant breast in a water bath using transmission ultrasound and constructed multimodal images corresponding to refractivity and frequency-dependent attenuation (calibrated relative to water). The multimodal images were fused into composite images and a composite index (CI) was calculated and used for diagnostic purposes. The composite images were evaluated against results of histopathology on biopsy specimens.


Histopathology revealed 22 malignant and 49 benign lesions. The pixels of 22 malignant lesions exhibited high values in both refractivity and attenuation, resulting in CI values > 1. In contrast, 99.9 % of benign lesions and normal tissue pixels exhibited lower values of at least one of the attributes measured, corresponding to CI values < 1.


MUT imaging appears to differentiate small malignant solid breast lesions as exhibiting CI values >1, while benign lesions or normal breast tissues exhibit CI values <1.

Key Points

MUT was able to detect all 22 biopsy-confirmed malignant lesions.

MUT was able to differentiate the malignant from the benign lesions.

Additional MUT detections outside the biopsy area must be evaluated prospectively.

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