Inter- and Intra-Operator Variability of Regularized Backscatter Quantitative Ultrasound for the Characterization of Breast Masses.

OBJECTIVES: Here we report on the intra- and inter-operator variability of the backscatter coefficient (BSC) estimated with a new low-variance quantitative ultrasound (QUS) approach applied to breast lesions in vivo. METHODS: Radiofrequency (RF) echo signals were acquired from 29 BIRADS 4 and 5 breast lesions in 2 sequential cohorts following 2 imaging protocols: cohort 1) radial and antiradial views, and cohort 2) short- and long-axis views. Protocol 2 was implemented after retraining and discussion on how to improve reproducibility. Each patient was scanned by at least 2 of 3 radiologists; each performed 3 acquisitions with transducer and patient repositioning in between acquisitions. BSC was estimated using a low-variance QUS approach based on regularization. Intra- and inter-operator variability of the intra-lesion median BSC was evaluated with a multifactorial ANOVA test (P-values) and the intraclass correlation coefficient (ICC). RESULTS: Inter-operator variability was only significant in the first protocol (P < .007); ICCinter = .77 (95% CI .71-.82), indicating good inter-operator agreement. In the second protocol, the inter-operator variability was not significant (P > .05) and agreement was excellent (ICCinter = .92 [.89-.94]). In both protocols, the intra-operator variability was not significant. CONCLUSIONS: Our findings demonstrate the need for standardizing image acquisition protocols for backscatter-based QUS to reduce inter-operator variability and ensure its successful translation to the characterization of suspicious breast masses.

A freehand ultrasound framework for spine assessment in 3D: a preliminary study.

X-ray imaging is currently the gold standard for the assessment of spinal deformities. The purpose of this study is to evaluate a freehand 3D ultrasound system for volumetric reconstruction of the spine. A setup consisting of an ultrasound scanner with a linear transducer, an electromagnetic measuring system and a workstation was used. We conducted 64 acquisitions of US images of 8 adults in a natural standing position, and we tested three setups: 1) Subjects are constrained to be close to a wall, 2) Subjects are unconstrained, and 3) Subjects are constrained to performing fast and slow acquisitions. The spinous processes were manually selected from the volume reconstruction from tracked ultrasound images to generate a 3D point-based model depicting the centerline of the spine. The results suggested that a freehand 3D ultrasound system can be suitable for representing the spine. Volumetric reconstructions can be computed and landmarking can be performed to model the surface of the spine in the 3D space. These reconstructions promise to generate computer-based descriptors to analyze the shape of the spine in the 3D space.Clinical Relevance- We provide clinicians with a protocol that could be integrated in clinical setups for the assessment and monitoring of AIS, based on US image acquisitions, which constitutes a radiation-free technology.