Strain Elastography & Tissue Characterisation as a Tool to Differentiate Tumor from Healthy Tissue
Keywords:Elastography, Texture analysis, Breast, Tumor
The purpose of this study was to compare diagnostic values of normal and effected tissues with two techniques using strain elastography and tissues characterization. This study was carried out on a breast phantom containing all human body parameters. Analysis was performed using a lone phantom to correlate a relation between the values of Strain Elastography (SE) and first order texture parameters results. For SE SonixTouch Q+ (Ultrasonix Medical Corporation, 130-4311 Viking Way, Richmond, Canada) device using a linear-array ultrasound probe at a frequency of 10MHz with a gain of 40%. Elastography breast phantom was purchased from CAE healthcare USA, 3600 Edgelake Drive Sarasota FL, USA. For tissue characterization a Region of Interest (ROI) that encompasses both (normal and stiffer) areas were selected. MAZDA software was used to carry out the image analysis (mean and variance) of the tumour and healthy tissue, ROI of 1600 pixels at both regions was selected. An affirmative and resilient outcome was observed between the numerals of normal and tumor tissues, both for SE and first order texture parameters values. After our study we suggest that SE and tissue characterisation via first order texture parameter is a reliable technique to highlight normal and tumor tissue (with respect to same reference, for SE technique only). SE and first order texture parameters (mean and variance) paved way in highlighting the breast tumors fully. It is suggested that SE being more reliable approach in determining the stiffness for breast lesion, as it produces the results with real time imaging. However texture parameter gives an objective assessment of the image with a discriminating feature of the tissue.
(1) Murray, C.J. and A.D. Lopez, Mortality by cause for eight regions of the world: Global Burden of Disease Study. The lancet, 1997. 349(9061): p. 1269-1276.
(2) Carter, C.L., C. Allen, and D.E. Henson, Relation of tumor size, lymph node status, and survival in 24,740 breast cancer cases. Cancer, 1989. 63(1): p. 181-187.
(3) Key, T.J., P.K. Verkasalo, and E. Banks, Epidemiology of breast cancer. The lancet oncology, 2001. 2(3): p. 133-140.
(4) Cancer, C.G.o.H.F.i.B., Breast cancer and hormone replacement therapy: collaborative reanalysis of data from 51 epidemiological studies of 52 705 women with breast cancer and 108 411 women without breast cancer. The Lancet, 1997. 350(9084): p. 1047-1059.
(5) Krouskop, T.A., et al., Elastic moduli of breast and prostate tissues under compression. Ultrasonic imaging, 1998. 20(4): p. 260-274.
(6) Ophir, J., et al., Elastography: a quantitative method for imaging the elasticity of biological tissues. Ultrasonic imaging, 1991. 13(2): p. 111-134.
(7) Manning, F.A., C.M. Hill, and L.D. Platt, Qualitative amniotic fluid volume determination by ultrasound: antepartum detection of intrauterine growth retardation. American journal of obstetrics and gynecology, 1981. 139(3): p. 254-258.
(8) Ophir, J., et al., Elastography: ultrasonic estimation and imaging of the elastic properties of tissues. Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine, 1999. 213(3): p. 203-233.
(9) Bamber, J., et al., EFSUMB guidelines and recommendations on the clinical use of ultrasound elastography. Part 1: Basic principles and technology. Ultraschall in der Medizin-European Journal of Ultrasound, 2013. 34(02): p. 169-184.
(10) Vural, M., et al., The evaluation of the retrobulbar orbital fat tissue and optic nerve with strain ratio elastography. Medical ultrasonography, 2015. 17(1): p. 45.
(11) Park, H., et al., Strain elastography features of epidermoid tumours in superficial soft tissue: differences from other benign soft-tissue tumours and malignant tumours. The British journal of radiology, 2015. 88(1050): p. 20140797.
(12) Cortes, D.H., et al., Continuous shear wave elastography: a new method to measure viscoelastic properties of tendons in vivo. Ultrasound in Medicine and Biology, 2015. 41(6): p. 1518-1529.
(13) Athanasiou, A., et al., Feasibility of imaging and treatment monitoring of breast lesions with three-dimensional shear wave elastography. Ultraschall in der Medizin-European Journal of Ultrasound, 2017. 38(01): p. 51-59.
(14) Barr, R.G., et al., WFUMB guidelines and recommendations for clinical use of ultrasound elastography: Part 2: breast. Ultrasound in Medicine and Biology, 2015. 41(5): p. 1148-1160.
(15) Rickert, R.R., L. Kalisher, and R.V. Hutter, Indurative mastopathy: a benign sclerosing lesion of breast with elastosis which may simulate carcinoma. Cancer, 1981. 47(3): p. 561-571.
(16) Gordon, P.B. and S.L. Goldenberg, Malignant breast masses detected only by ultrasound. A retrospective review. Cancer, 1995. 76(4): p. 626-630.
(17) Hayes, R., M. Michell, and H. Nunnerley, Acute inflammation of the breast—the role of breast ultrasound in diagnosis and management. Clinical Radiology, 1991. 44(4): p. 253-256.
(18) Houssami, N., et al., Sydney Breast Imaging Accuracy Study: comparative sensitivity and specificity of mammography and sonography in young women with symptoms. American Journal of Roentgenology, 2003. 180(4): p. 935-940.
(19) Rizzatto, G., et al., High-resolution sonography of breast carcinoma. European journal of radiology, 1997. 24(1): p. 11-19.
(20) Al-Qahtani, M., Shear-Wave and Strain Elastography: A Comparative Review on Principles, Basic Techniques and Applications. Current Medical Imaging Reviews, 2016. 12(4): p. 269-278.
(21) Cho, N., et al., Sonoelastographic strain index for differentiation of benign and malignant nonpalpable breast masses. Journal of Ultrasound in Medicine, 2010. 29(1): p. 1-7.
(22) Hiltawsky, K.M., et al., Freehand ultrasound elastography of breast lesions: clinical results. Ultrasound in Medicine and Biology, 2001. 27(11): p. 1461-1469.
(23) Al-Qahtani, M., et al., A Comparative Study of Shear-Wave Elastography and Strain Elastography on a Breast Phantom for Diagnosis of Tumor and Cyst. Journal of Biomedical Engineering and Medical Imaging, 2015. 2(3): p. 24.
(24) Monpeyssen, H., et al., Elastography of the thyroid. Diagnostic and interventional imaging, 2013. 94(5): p. 535-544.
(25) Rykhtik, P., et al., Experience of Using Elastography in the Diagnosis of Liver Fibrosis in the Practice of Hepatology Center. Radiology, 2015. 1: p. 49.
(26) Nicolas, E., S. Callé, and J.-P. Remenieras, Generating shear waves in the human brain for ultrasound elastography: a new approach. Physics Procedia, 2015. 70: p. 1255-1259.
(27) Uramoto, H., et al., Intraoperative ultrasound elastography has little diagnostic benefit for deeper tumours of the lung. European Journal of Cardio-Thoracic Surgery, 2015. 49(5): p. 1538-1539.
(28) Fleury, E.d.F.C., et al., New elastographic classification of breast lesions during and after compression. Diagnostic and Interventional Radiology, 2009. 15(2): p. 96.