hadi tadayyon june 11, 2012. clinical challenge ◦ high risk for metastasis characterized as: ◦...
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Non-invasive breast tumour grading using ultrasound
frequency-dependent backscatter analysis
Hadi TadayyonJune 11, 2012
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Clinical challenge
◦ High risk for metastasis
Characterized as:◦ > 5 cm long axis◦ Skin/chest wall involvement◦ Lymph node involvement
Tumour grade – a histological feature that is a prognostic
indicator and is important for treatment design
◦ Determined from pathological examination of biopsy sample
◦ Higher grade higher degree of malignancy / poorer prognosis
Our goal: ultrasonically detect variation in tumour grades
Locally advanced breast cancer (LABC)
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Midband fit, slope, and intercept used to differentiate:◦ Prostate cancer from benign tumours1
◦ Metastic from non-metastatic lymph nodes2
Acoustic scatterer spacing used to characterize breast lesions as benign or malignant3
Quantitative ultrasound characterization of cancers
1. Feleppa et al., 2004 IEEE Trans UFFC, 43(4), 609-619, (1996)2. Mamou et al., Ultrasound in Med. & Biol., 37(3), 345–357, (2011)3. Y. Bige et al., Ultrasonics 44 , 211–215, (2006)
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Can LABC tumours be characterized in terms of
grade using quantitative ultrasound?
Given:
◦ Retrospective in-vivo clinical breast data (N=43)
◦ A diagnostic ultrasound machine
Research Question
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Methods: data collection and classification
Tumour ROI
1 cm
Normal breast ROI
QUSMidband fit (MBF)
Slope (SS)Intercept (SI)
Scatterer spacing (SAS)
GI (N=3)
GII (N = 22)
GIII(N = 18)
10 MHz fc linear array transducer (Ultrasonix, Canada) 4-7 cm depth 5 MHz 50% bandwidth
Normal tissue ROI
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Methods: Spectral analysis
Depth-dependent spectral normalization (reference phantom)
Variable bandwidth linear regression
Discrete depth spectral normalization (reference reflector)
Auto-regressive (AR) spectral estimation and autocorrelation-derived scatterer spacing
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Results: QUS distributions among tumour grades
Mann-Whitney test: p = 0.032
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Results: parametric images of scatterer spacing
GI GII GIIINT
0
0.5
SA
S (m
m)
10 um
1 cm
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The link of scatterer spacing to biology
Mean spacing between glandular islands = 200 um
100 um
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A potential method to non-invasively characterize tumour
grade was proposed
Scatterer spacing statistically different among tumour grades
(ANOVA test & Mann-Whitney test)
Scatterer spacing is linked to spacing between glandular
islands
Small sample size for GI
◦ In large population study – 362/1409 = 25%
◦ In our study, 3/43 = 7%
Cannot evaluate classification due to insufficient parameters
Future directions: investigate other QUS parameters
Discussion & conclusion
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Acknowledgments
Czarnota Lab, University of Toronto• Dr. Czarnota• Dr. Omar Falou• Mike Papanicolau• Sara Iradji• Ervis Sofroni
Ryerson University• Dr. Lauren Wirtzfeld
University of Illinois• Dr. Michael Oelze
CGSD
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Tumour grade
Increasing risk of metastasis
Grade I Grade II Grade III
Total score 3-5 6-7 8-9
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