Project: Three-dimensional ELASTOgraphic imaging using Circular breast Ultrasound Scanner for diagnosic purpose

Cancer has a very high incidence, with 10 million new cases diagnosed worldwide every year. Breast cancer is one of the most frequent type of cancer in women in Europe and worldwide. Since the last estimations in 2004, breast cancer has become the most diagnosed cancer with 430,000 new cases in 2006 (13.5% of all new cases) more than colon cancer (413,000 new cases) and lung cancer (387,000). Breast cancer represents currently the second cause of female death by cancer making it a major public health problem._x000D__x000D_The detection of breast cancer is typically done with low-dose X-rays, but, in recent years, breast imaging devices that use ultrasound and magnetic resonance imaging (MRI) have been developed. However, mammography reCOs by far the dominant technology for breast imaging, since it is the "gold standard" for cancer screening. But, these imaging techniques exhibit sensitivity and specificity results that are limited by intrinsic tradeoffs._x000D__x000D_The ELASTOBUS project aims to cope with this issue by developing a novel whole breast imaging system based on ultrasound technology. This system is using 3D ultrasound and elastography imaging. The approach proposed in this project is based on the association of a 3D mechanical scanning system and a reconstruction software developed by Helix medical systems and a novel ultrasound medical imaging platform from SuperSonic Imagine that provides, in addition to conventional imaging modes, an elastography mode that offers the capability to map tissue elasticity._x000D__x000D_2D gray-scale ultrasound imaging displays planar information that requires the practitioner to mentally integrate 2D images to form a three-dimensional impression of patient anatomy. Whereas, whole breast 3D ultrasound will allow multiple planes to be reconstructed from a single data acquisition, with an improved access to multiple viewing angles. It will lead to unique coronal vizualization of breast to perform an accurate examination of the ductal system, an enhanced evaluation of cancer extent, more particularly in the case of multifocal tumours._x000D__x000D_The development of this whole breast ultrasound imaging will be focused on the development and optimization of all sub-systems that compose the complete 3D diagnosis device. The breast will be positioned in a specific fixation device that will preserve breast anatomy without any form of compression. Patient will lay in prone position on a specially designed examination table. The exam table will be electrically operated to provide easy access of the patient and easy operation. An integrated "floating arm" mechanism will enable the technician to easily adjust the scanner and the breast fixation device. Ultrasound and elastography data will be acquired with specific developed ultrasound linear arrays moved around the contention device to acquire full 3D data set. Specific beamforming techniques will be developed to provide full breast imaging from nipple to chest wall with quality as high as for superficial imaging. High performance 3D reconstruction techniques for 3D volume analysis will be combined to specific software to display anatomic and elastographic 3D information in the whole breast volume. Novel postprocessing techniques will be implemented to enhance US and elastography information and registration and segmentation of sonograms and elastograms_x000D_ _x000D_This novel high performance 3D diagnosis will be assessed through clinical evaluation with 50 patients. CO study objective will be to evaluate the 3D reconstructed images and elastograms quality in term contrast, resolution and penetration as compared to reference 2D ultrasound images. Clinical trials will be performed in two French breast imaging centers of excellence in Aix en Provence and Marseille, France. Synthesis of the clinical study will provide all necessary information for system industrialization and market introduction planning. _x000D__x000D_The anticipated increase of specificity and sensitivity of the combination of 3D imaging capability of the Helix System and elastography imaging of the SuperSonic Imagine platform has a tremendous potential for breast imaging. This will lead to better patient management in breast cancer diagnosis, screening, therapy monitoring and improve patient care._x000D__x000D__x000D__x000D_

Acronym	ELASTOBUS (Reference Number: 4267)
Duration	02/06/2008 - 02/06/2008
Project Topic	The ELASTOBUS project aims to develop a novel whole breast imaging system based on ultrasound technology and elastography techniques, this to provide better strategies in breast cancer screening, diagnosis, therapy monitoring, while improving patient care and lowering provider costs.
Project Results (after finalisation)	ELASTOBUS : Three-dimensional ELASTOgraphic imaging using Circular breast Ultrasound Scanner for diagnosic purpose_x000D__x000D_ELASTOBUS : Three-dimensional ELASTOgraphic imaging using Circular breast Ultrasound Scanner for diagnostic purpose_x000D__x000D_Cancer has a very high incidence, with 10 million new cases diagnosed worldwide every year. Breast cancer is one of the most frequent type of cancer in women in Europe and worldwide. Since the last estimations in 2004, breast cancer has become the most diagnosed cancer with 430,000 new cases in 2006 (13.5% of all new cases) more than colon cancer (413,000 new cases) and lung cancer (387,000). Breast cancer represents currently the second cause of female death by cancer making it a major public health problem._x000D__x000D_The detection of breast cancer is typically done with low-dose X-rays, but, in recent years, breast imaging devices that use ultrasound and magnetic resonance imaging (MRI) have been developed. However, mammography reCOs by far the dominant technology for breast imaging, since it is the "gold standard" for cancer screening. But, these imaging techniques exhibit sensitivity and specificity results that are limited by intrinsic tradeoffs._x000D__x000D_The ELASTOBUS project aims to cope with this issue by developing a novel whole breast imaging system based on ultrasound technology. This system is using 3D ultrasound and elastography imaging. The approach proposed in this project is based on the association of a 3D mechanical scanning system and a reconstruction software developed by Helix medical systems and a novel ultrasound medical imaging platform from SuperSonic Imagine that provides, in addition to conventional imaging modes, an elastography mode that offers the capability to map tissue elasticity._x000D__x000D_The development of this whole breast ultrasound imaging system was focused on the development and optimization of all sub-systems that compose the complete 3D diagnosis device. The breast is positioned in a specific fixation device that preserve breast anatomy without any form of compression. Patient lay in prone or supine position on a specially designed examination table. The exam table is electrically operated to provide easy access of the patient and easy operation. An integrated "floating arm" mechanism enable the technician to easily adjust the scanner and the breast fixation device. Ultrasound and elastography data are acquired with specific developed ultrasound linear arrays moved around the contention device to acquire full 3D data set. Specific reconstruction techniques were developed to provide full breast imaging from nipple to chest wall with quality as high as for superficial imaging. High performance 3D reconstruction techniques for 3D volume analysis were combined to specific software to display anatomic and elastographic 3D information in the whole breast volume. _x000D__x000D_Finally, the new whole breast ultrasound device was evaluated during a clinical trial. The purpose of the study was to assess the performances of three-dimensional imaging modes acquired with the Elastobus System acquisition modality as compared to conventional two-dimensional (2D) modes of the Aixplorer® system._x000D_This study includes 25 patients in order to evaluate the quality of a 3D whole breast acquisition system and a 3D software package. _x000D_25 patients were scanned during this study. Most of the work was devoted to the optimization of the scanning protocole, optimization of the workflow and optimization of the reconstructed image quality._x000D_From the results the consortium was able to define what the best imaging parameters in order to perform a 3D reconstructed as high as possible and comparable to the image quality obtained by handheld ultrasound. The different options available from Elastobus developments such as ultrasound probe type, scanning system prone or supine, strategy for patient management were analysed and from the experience obtained with the radiologist the optimum setup was defined._x000D__x000D__x000D_ _x000D__x000D_
Network	Eurostars
Call	Eurostars Cut-Off 1

Project partner

Number	Name	Role	Country
2	Helix Medical Systems	Partner	Israel
2	SuperSonic Imagine	Coordinator	France