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AAPM/RSNA Physics Tutorial for Residents: Topics in US

Beyond the Basics: Elasticity Imaging with US¹

¹ From the Department of Medical Physics, University of Wisconsin, 1530 Medical Sciences Center, 1300 University Ave, Madison, WI 53706-1532. From the AAPM/RSNA Physics Tutorial at the 2002 RSNA scientific assembly. Received July 11, 2003; revision requested July 30 and received August 7; accepted August 14. Supported by grant DAMD17-00-1-0596 from the U.S. Army Medical Research and Materiel Command; supported in part by a research agreement with Siemens Medical Solutions, Ultrasound Group (Issaquah, Wash). Address correspondence to the author (e-mail: tjhall@wisc.edu).

A new mode of imaging with ultrasonography (US) is under development in several laboratories around the world. This technique allows estimation of some measure of the viscoelastic properties of tissue. The information displayed in the images is a surrogate for that obtained with manual palpation. Fundamental concepts in elasticity imaging include stress, strain, and the elastic modulus; strain imaging has received the most attention from researchers. A system for elasticity imaging is under development that produces images of mechanical strain in real time by means of a freehand scanning technique. This system is integrated into a clinical US system without any external equipment and involves software changes only. Data obtained with this system demonstrate that the relative stiffness of many fibroadenomas changes as they and the surrounding tissue are deformed. At elasticity imaging of in vivo breast lesions, invasive ductal carcinomas appear, on average, more than twice as large on the elasticity image than on the B-mode image, but fibroadenomas and cysts are nearly equal in size on the two image types. The usefulness of this technology and the new information it provides suggest that it might soon be available on commercial US systems.

© RSNA, 2003

Index Terms: Breast neoplasms, diagnosis, 00.30 • Physics • Ultrasound (US), elastography, 00.12989 • Ultrasound (US), tissue characterization, 00.12989

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