COMBINED DIGITAL X-RAY AND ULTRASOUND BREAST IMAGING

3D超声将通过DX龙门上的自动扫描机构与全视场数字乳房x线摄影（DX）系统相结合。建议充分利用这两种模式的创新组合模式之间的许多协同作用，以进行乳腺癌诊断，并最终进行检测。在系统中实施和测试的基本和高级模式是那些应该提供相对独立的乳腺组织信息的模式，并且我们在密歇根大学和/或通用电气的众多乳腺成像小组中拥有广泛的相关研究经验。先进的模式包括断层合成，它与投影成像不同，通过超声方法评估特定组织的x射线相互作用特性。非线性弹性和超声（UL）三维彩色血流成像提供了不可用的力学和生理信息

3D ultrasound will be combined with a full-field digital mammography (DX) system via an automatic scanning mechanism on the DX gantry. It is proposed to take full advantage of the many synergisms among an innovative combination of modes of these two modalities for breast cancer diagnosis, and, eventually, detection. The basic and advanced modes implemented and tested in the system are those which should provide relatively independent information about the breast tissues and with which we have extensive, related research experience in the numerous breast imaging groups at the University of Michigan and/or General Electric. Advanced modes include tomosynthesis which, unlike projection imaging, gives x-ray interaction properties of the specific tissues evaluated by the ultrasound methods. Nonlinear elasticity and 3D color flow imaging by ultrasound (UL) provide mechanical and physiological information unavailable from conventional, noncontrast x-ray and ultrasound imaging. Compound and single-view US imaging are complimentary, with the former providing better distal tumor borders and other features helpful to visual and computer-aided diagnosis. In a single positioning, with possible variation in compression, the breast will be imaged by: 1) the basic modes -- projection digital x-ray and full field 3D gray scale ultrasound: 2) the advanced modes -- 3D x-ray tomosynthesis and advanced ultrasound of the mass region (nonlinear elasticity, 3D color flow, and compound imaging). In the main clinical evaluations on 160 women with masses going to biopsy and 40 with simple cysts, the basic and advanced imaging modes will be compared on the same patients and good combinations of modes revealed. The first hypothesis is that the basic combined technique is diagnostically equivalent to the current best practice of high quality mammography plus hand-held ultrasound performed by MQSA-certified radiologists. Linear combinations of the basic and advanced modes will be evaluated for relative diagnostic accuracy. Clinical evaluation of the potential of the combined system for screening of selected populations must follow demonstration of diagnostic equivalence. Developments will be done to objectively illustrate some of the approaches and potential of visual and computer aided diagnosis (CAD) and detection with these multiple modes. In addition to the coregistration inherent in the combined system, image based registration will be applied to correct for modestly differing views, compressions and tissue motions between modalities, modes, UL transducer sweeps, and studies at different times.