COMBINED DIGITAL X-RAY AND ULTRASOUND BREAST IMAGING

3D超声将通过DX机架上的自动扫描机制与全视野数字乳腺X射线摄影（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，用于乳腺癌诊断，并最终检测。在系统中实施和测试的基本和高级模式是那些应该提供关于乳房组织的相对独立的信息的模式，并且我们在密歇根大学和/或通用电气的众多乳房成像组中具有广泛的相关研究经验。先进的模式包括断层合成，与投影成像不同，它提供了通过超声方法评估的特定组织的X射线相互作用特性。非线性弹性和3D彩色超声血流成像（UL）提供了不可用的机械和生理信息 从传统的非造影X射线和超声成像。复合和单视图US成像是互补的，前者提供更好的远端肿瘤边界和其他有助于视觉和计算机辅助诊断的特征。 在单一定位中，在压缩的可能变化的情况下，乳房将通过以下方式成像： 基本模式--投影数字X射线和全视野三维灰阶超声; 2）高级模式--肿块区域的三维X射线断层合成和高级超声（非线性弹性、三维彩色血流和复合成像）。在对160名进行活检的肿块妇女和40名单纯囊肿妇女进行的主要临床评价中，将对相同患者的基本和高级成像模式进行比较，并显示良好的模式组合。第一个假设是，基本的组合技术在诊断上等同于目前由MQSA认证的放射科医生进行的高质量乳腺X线摄影加手持式超声的最佳实践。将评价基本和高级模式的线性组合的相对诊断准确性。 联合系统筛选选定人群的潜力的临床评价必须遵循诊断等效性的证明。发展将客观地说明视觉和计算机辅助诊断（CAD）和检测与这些多种模式的一些方法和潜力。除了组合系统中固有的配准之外，还将应用基于图像的配准来校正不同时间的模态、模式、UL换能器扫描和研究之间的适度不同视图、压缩和组织运动。

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.