ABUS Automated Breast Ultrasound

Digital Mammography is the method of choice and reference for the diagnosis of breast cancer, but it is complemented by Ultrasound to reduce ionizing radiation (X-rays) and to overcome the “obstacle” that can be caused by the so-called dense breast.

40% of women have dense breasts. And because it is precisely from the glandular elements that breast cancer originates, dense breasts are 4 to 6 times more likely to develop cancer. It is known that 71% of breast cancers occur in dense breasts.

On mammography the fibroglandular elements appear white. But cancer also appears white. It is therefore very possible in dense breasts that some cancer is “missed” in the mammogram image, because it is “camouflaged” by the dense fibrous and glandular elements. It is reported that in 1/3 of dense breasts the diagnosis of cancer can escape mammography.

Ultrasound comes to help with this important problem because in most of these difficult situations it can highlight the “hidden” tumors. Classic Ultrasound is a subjective examination and depends significantly on the skill and experience of the radiologist.

For this reason, the so-called “Automated Breast Ultrasound System” ABUS: Automated Breast Ultrasound System has recently been developed. This system is already installed and in full operation at the General Ultrasound Department of HYGEIA.

The aim of this system is to limit to the minimum the intervention of the radiologist during the acquisition of the images and to increase the objectivity of the findings.

With the ABUS system, the examinee is placed in a supine and slightly oblique position with the breast under examination spread out symmetrically. The machine has a specially shaped arm, which carries a frame designed to adapt to the curvature and contour of the breast. Inside the frame is a curved ultrasound head that scans the entire breast from end to end. The procedure usually takes 15 minutes.

The images taken with each scan are transferred to the special unit of a highly sophisticated computer that accompanies the system. The stored data is analyzed by the computer, enabling the specialist radiologist to process the images in three axes in order to obtain the final objective diagnosis.

The ABUS system when combined with digital mammography, in dense breasts, increases the diagnosis of breast cancer by 37.5%.

Hybrid Imaging (Fusion Imaging) in Ultrasonography of the Prostate

By the term Hybrid Imaging we mean those medical imaging tests, which combine and merge simultaneously images from two different imaging methods, in order to increase the useful diagnostic data for various diseases.

Hybrid Imaging (Fusion Imaging) in Ultrasound

This is the most revolutionary technological development in the field of diagnostic ultrasound. The method can be applied to the study of various organs. It combines the immediacy and ease of use of Ultrasound with the objective precision of cross-sectional imaging methods (X-ray & Magnetic Tomography).

Specifically for ultrasound-guided prostate biopsy, images from a recent previous Prostate Multiparametric Magnetic Tomography examination are imported into a specially equipped and configured ultrasound machine. With a specialized electronic navigation system, the imported MRI images are precisely topographically linked to the images produced in real time during the ultrasound examination. Next to each ultrasound section, the corresponding MRI section in the same anatomical position is displayed on the screen. Thus, during the ultrasound-guided biopsy of the prostate, the placement of the biopsy needle is done with extreme precision and safety, as additional guidance is provided by the corresponding MRI image.

Why is Hybrid Imaging considered necessary in the ultrasound study of prostate cancer today?

Some cancers are not visually distinguishable on ultrasound images from adjacent normal prostate tissue. Others are found in areas of the prostate that may already be showing changes from other benign conditions that visually mimic cancer.

Magnetic resonance imaging compared to transrectal ultrasound is largely more sensitive in detecting focal lesions in the prostatic tissue. On the other hand, transrectal ultrasound remains an unsurpassed precision method for obtaining biopsies from suspected foci for definitive diagnosis of cancer.

It is therefore obvious the advantage of the simultaneous composition of the Ultrasound images with those of the Magnetic Tomography.

The Hybrid Imaging method at the Department of General Ultrasound of HYGEIA has been applied to obtain biopsies since 2016 and it was found that 33% of cases diagnosed with prostate cancer did not have visible ultrasound findings, while they had findings on the corresponding MRI images that guided the rectal biopsy acquisition by combining the images of the two methods.

From the current scientific literature, hybrid (fusion) imaging increases the frequency of detection of clinically significant cancers, guides sampling with the aim of reducing the uptake of clinically insignificant and low-risk neoplasms. It also contributes to the selection of patients who can be placed in protocols of systematic monitoring or even localized treatment.