Automated Three-dimensional Breast US for Screening: Technique, Artifacts, and Lesion Characterization.

Area of Science:

• Radiology
• Medical Imaging
• Breast Imaging

Background:

• Automated breast (AB) ultrasonography (US) devices utilize wide linear-array transducers for 3D whole-breast imaging.
• AB US aims to overcome limitations of handheld devices, such as operator dependence and reproducibility issues, for breast cancer screening.

Purpose of the Study:

• To review the literature on supplemental whole-breast US for screening.
• To discuss the US appearance of lesions, potential artifacts, and interpretation challenges in AB US.
• To highlight the retraction phenomenon as a key differentiator for malignancy in AB US.

Main Methods:

• Literature review of supplemental whole-breast US screening studies.
• Analysis of AB US performance compared to handheld US.
• Review of common benign and malignant lesion appearances on AB US.

Main Results:

• Both AB US and handheld US detect mammographically negative early-stage invasive breast cancers but increase false-positive recalls.
• A learning curve exists for AB US image acquisition, and interpretation can be challenging.
• The retraction phenomenon on coronal reformatted images is a distinguishing feature of malignancy on AB US, rarely seen with benign findings.

Conclusions:

• Supplemental AB US may benefit women with dense breasts.
• Understanding acquisition pitfalls and interpretation challenges is crucial to reduce false-positive recalls and potential harm.
• The retraction phenomenon is a significant indicator of breast cancer on AB US.