Quantitative Mechanical Imaging for Improving Breast Ultrasound Diagnosis

描述(申请人提供)：这是一项开发新的超声技术以成像和量化活体乳房组织的非线性弹性特性的建议，目的是显著提高乳房超声的特异性。拟议的研究将把压力传感器阵列整合到二维(2D)超声换能器阵列中。该组合装置将用于测量乳房超声弹性成像过程中的接触压力。测量乳房内的总压力分布和相应的3D应变场将有助于三个主要成像技术的进步。首先，它允许校准相对机械应变图像，以比较已知施加应力水平下的图像对比度。其次，它提供了校准信息，以便能够在3D中定量重建(线性)剪切弹性模数。第三，通过测量接触瞬间施加的应力，可以对弹性非线性进行公正的评估。这三个目标中的任何一个都代表着对当前技术的重大改进，并可能提高乳腺肿块的鉴别诊断。初步数据显示了这种装置的潜在收益。首先，当采用由2D阵列实现的3D跟踪时，应变图像质量可得到显著改善。其次，不同组织类型的弹性非线性似乎是独一无二的，对于区分僵硬的恶性肿块和僵硬的良性肿块具有潜在的意义。最近的结果表明，对乳腺组织的弹性非线性参数进行成像是可能的。第三，对体外乳腺组织样本的测量发现，在所考虑的所有组织中，导管原位癌(DCIS)具有最高的弹性非线性。因此，虽然这项提议旨在提高乳腺超声的特异性，但拟议的技术开启了有趣的可能性，直接成像DCIS在乳腺中的3D分布，这将对乳腺癌的筛查、早期发现和治疗预后产生深远的影响。这项研究涉及传感器开发、广泛的实验室测试和临床数据收集，以优化组合成像/压力传感器设备在临床环境中的性能。这项提议将创建下一代实时弹性成像系统的原型，以改进乳房疾病的检测和诊断。该系统和本方案中开发的方法可以在大规模临床试验中复制，以评估定量机械成像的准确性性能。与公共健康相关：这是一项开发新的超声技术以成像和量化活体乳腺组织的非线性弹性特性的建议，目的是显著提高乳房超声的特异性。这项拟议的工作包括创建一种二维超声阵列换能器，该换能器具有集成的触觉传感器阵列，用于检测弹性成像实验期间的接触压力分布。由此得到的校准的3D应变图像和弹性非线性图像也显示出直接成像原位导管癌的前景，从而潜在地改善了乳腺癌的早期检测。

DESCRIPTION (provided by applicant): This is a proposal to develop new ultrasound technology to image and quantify the nonlinear elastic properties of in vivo breast tissues with the intent of significantly improving the specificity of breast ultrasound. The proposed research will incorporate a pressure sensor array into a two-dimensional (2D) ultrasound transducer array. The combined device will be used to measure the contact pressure during ultrasound elasticity imaging of the breast. Measurements of the total applied pressure distributions and corresponding 3D strain fields in the breast will feed into three principle imaging advances. First, it allows calibrations of relative mechanical strain images for comparing image contrast at known applied stress levels. Second, it provides calibration information to allow quantitative reconstruction in 3D of (linear) shear elastic modulus. Third, measuring the applied stress from the instant of contact allows an unbiased evaluation of elastic nonlinearity. Any of these three goals represents a significant improvement over current technology, and would likely improve differential diagnosis of breast masses. Preliminary data demonstrate the potential gain from such a device. First, significant improvement in strain image quality is available when 3D tracking, enabled by a 2D array, is employed. Second, the elastic nonlinearity of various tissue types appears to be unique, and of potential significance for differentiating stiff malignant masses from stiff benign masses. Recent results suggest that it is possible to image the elastic nonlinearity parameter of breast tissues. Third, measurements of ex vivo breast tissue samples found that ductal carcinoma in situ (DCIS) has the highest elastic nonlinearity of all tissues considered. Thus, although this proposal is targeted toward increasing breast ultrasound specificity, the proposed technology opens the intriguing possibility of directly imaging the 3D distribution of DCIS in the breast, which would have a profound impact on breast cancer screening, early detection and treatment prognosis. The study involves sensor development, extensive laboratory testing and the collection of clinical data to optimize the performance of the combined imaging/pressure sensor device in a clinical environment. This proposal will create a prototype of the next-generation real-time elasticity imaging system for improving breast disease detection and diagnosis. That system and the methods developed in this proposal can be replicated for a large-scale clinical trial to evaluate the accuracy performance of Quantitative Mechanical Imaging. PUBLIC HEALTH RELEVANCE: This is a proposal to develop new ultrasound technology to image and quantify the nonlinear elastic properties of in vivo breast tissues with the intent of significantly improving the specificity of breast ultrasound. The proposed effort involves creating a two-dimensional ultrasound array transducer that has an integrated tactile sensor array for detecting the contact pressure distribution during elasticity imaging experiments. The resulting calibrated 3D strain images and images of elastic nonlinearity also show promise for directly imaging ductal carcinoma in situ, thereby potentially improving early detection of breast cancer.