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Differentiation of Cancerous Lesions in Excised Human Breast Specimens Using Multiband Attenuation Profiles From Ultrasonic Transmission Tomography

Alfred E. Mann Institute for Biomedical Engineering (J.-W.J., D.C.S., C.B.), Departments of Clinical Pathology (N.E.K.), Clinical Surgery (D.R.H.), and Radiology (L.J.H.-L.), Keck School of Medicine, and Department of Biomedical Engineering, Viterbi School of Engineering (V.Z.M.), University of Southern California, Los Angeles, California USA; and Massachusetts General Hospital, Boston, Massachusetts USA (S.-H.D.).

Address correspondence to Jeong-Won Jeong, PhD, Alfred E. Mann Institute for Biomedical Engineering, University of Southern California, 1042 W 36th Pl, DRB B21, Los Angeles, CA 90089 USA. E-mail: jeongwon.jeong{at}gmail.com.

Objective. This study examines the tissue differentiation capability of the recently developed high-resolution ultrasonic transmission tomography (HUTT) system in the context of differentiating between benign and malignant tissue types in mastectomy specimens. Methods. Eight mastectomy patients provided breast specimens with benign and malignant lesions. The specimens were scanned by the HUTT system with a pair of either 8- or 4-MHz transducers. Multiband HUTT images over the frequency range from 2 to 10 MHz provide characteristic profiles of frequency-dependent attenuation, termed "multiband profiles," at individual pixels. These features are classified through a novel algorithm of "segment-wise classification" that identifies the disjoint segments of various tissue types and subsequently classifies them into respective diagnostic categories using a measure of proximity to the respective multiband profile templates that have been previously obtained from reference data. Results. We preformed intraspecimen and interspecimen analyses of 108 slices from 8 mastectomy specimens for which "ground truth" was provided by pathology reports. The average performance indices for 2-way classification (malignant versus nonmalignant tissue) in these intraspecimen (interspecimen) specimen studies were found to be sensitivity of 81.9% (89.6%), specificity of 92.9% (92.1%), and accuracy of 89.2% (89.4%), whereas the indices for the 3-way classification were moderately lower. Conclusions. The results have shown the potential of the HUTT technology for reliable differentiation of cancerous lesions from benign changes and normal tissue in mastectomy specimens using frequency-dependent ultrasound attenuation profiles.

Key Words: breast cancers • frequency-dependent attenuation • mastectomy specimens • multiband profile • soft tissue differentiation • ultrasonic transmission tomography

Abbreviations: AC, active contour • FP, false-positive • HUTT, high-resolution ultrasonic transmission tomography • MBP, multi-band profile • 3D, 3-dimensional • TP, true-positive • 2D, 2-dimensional • UC, unsupervised clustering