Official Proceedings - AIUM

American Institute of Ultrasound in Medicine Proceedings J Ultrasound Med 32(suppl):S1–S134, 2013transducers were found. All 5 transducers detected significant differencesbetween tumor types either through a mean shift model or via changes incurve shape between tumor groups. Higher-frequency transducers producedsignificantly greater separation of mean BSC curves between MAT and4T1 tumors. Mean differences between tumor types were smaller than theinherent variability in the BSC curves as measured by the residual standarderror values, indicating a low signal to noise ratio for classification.Conclusions—All 5 ultrasound-imaging transducers were effectivein detecting significant differences between MAT and 4T1 tumors,either through mean shift or through shape changes. Higher frequencies inthe range above 8.5 MHz were more effective than lower frequencies in detectingtumor differences.1540921 Automatic Detection of Keratoconus From High-Frequency Ultrasound DataRonald Silverman, 1,2 * Raksha Urs, 1 Arindam RoyChoudhury,1 Timothy Archer, 3 Dan Reinstein 3 1 Ophthalmology,Columbia University Medical Center, New York, New YorkUSA; 2 Frederic L. Lizzi Center for Biomedical Engineering,Riverside Research, New York, New York USA; 3 London VisionClinic, London, EnglandObjectives—Keratoconus (KC), a corneal dystrophy characterizedby progressive corneal thinning and bulging, is currently detectedby optically determined corneal topography and curvature. The cornealepithelium, however, tends to remodel to smooth out irregularities in theunderlying stroma, potentially masking early KC topographic changes. Inthis report, we describe automated ultrasound detection of KC based on alteredepithelial thickness patterns.Methods—Corneas of 128 normal and 68 KC subjects (1 randomlychosen eye per subject) were scanned using the Artemis-1 (Arcscan,Inc, Morrison, CO) high-frequency ultrasound system. Scans areperformed with an optical fixation target and video monitoring of eye positionwhile the 50-MHz transducer is scanned in an arc such that curvaturein the focal plane approximately matches that of the corneal surface.Radiofrequency data are digitized at 500 MHz. Scans were acquired in 4planes at 0°, 45°, 90°, and 135°. Postprocessing consisted of automaticdetection of the corneal surfaces and the epithelial/stromal interface. Maps(100 × 100 at 0.1-mm intervals) of epithelial and stromal thickness werethen automatically analyzed to extract 87 features that might potentiallydifferentiate normal from KC eyes. Stepwise linear discriminant analysis(LDA) and neural network (NN) analysis using a radial basis kernel werethen performed. NN analysis was repeated 10 times with different randomtest sets (30% of cases).Results—Stepwise LDA produced a model consisting of 11features with sensitivity of 91.2%, specificity of 99.2%, and an area underthe receiver operating characteristic (ROC) curve of 98.5%. A leave-oneoutprocedure gave identical sensitivity and specificity. The NN showedaverage sensitivity of 93.5% and specificity of 97.4% for the training setand 88.8% and 97.5%, respectively, for the test set. The area under theROC curve was 97.8%.Conclusions—Our results show ultrasound-detected patternsin corneal layered topography to be very effective at distinguishing normalfrom KC corneas. Future studies will combine these methods withoptical data for early detection, which would allow early treatment by collagencross-linking and avoidance of potentially damaging corneal refractivesurgical procedures.Breast Ultrasound and ElastographyModerator: Abid Irshad, MD1538656 Correlation Between Parameters in Ultrasound-GuidedDiffuse Optical Tomography and 18 F-FluorodeoxyglucosePositron Emission Tomography/Computed Tomographyfor Breast CancerWoo Jung Choi,* Hak Hee Kim, Joo Hee Cha, Hee JungShin, Hyunji Kim Radiology, Asan Medical Center, Seoul,KoreaObjectives—The purpose of this study was to correlate parametersin ultrasound (US)-guided diffuse optical tomography and maximumstandardized uptake value in 18 F-fluorodeoxyglucose positron emissiontomography/computed tomography ( 18 F-FDG PET/CT).Methods—We retrospectively evaluated 228 patients (meanage, 46.9 years; range, 29–71 years) diagnosed with breast cancer betweenSeptember 2009 and February 2012. Both US-guided diffuse optical tomographyand 18 F-FDG PET/CT were performed. For each lesion, thetotal hemoglobin concentration (HBT) level and oxygen saturation (SO2)level were calculated, and the synthesis diagnosis index (SDI) was designedusing US-guided diffuse optical tomography. With 18 F-FDGPET/CT, the maximum standardized uptake value (mSUV) was calculated.We compared the parameters in US-guided diffuse optical tomographywith the mSUV of known malignant breast lesion on 18 F-FDGPET-CT using the Spearman correlation coefficient.Results—All 228 malignant lesions were primary breast cancers,and the histologic types included invasive ductal carcinoma (n =210), invasive lobular carcinoma (n = 4), invasive mammary carcinoma(n = 12), and metaplastic carcinoma (n = 2). Correlation between the SO 2level and mSUV was statistically significant (Spearman correlation coefficient= –0.280; P < .001). The HBT level and SDI showed a low correlationcoefficient with the mSUV (spearman correlation coefficients =0.049 and 0.072; P = .458 and .280, respectively).Conclusions—The SO 2level of US-guided diffuse optical tomographycorrelated well with the mSUV of 18 F-FDG PET/CT. A lowSO 2level in optical imaging may predict a high mSUV level on 18 F-FDGPET/CT, and it may serve as a useful tool for predicting the response rateafter neoadjuvant chemotherapy in breast cancer.1540665 Comparison of Strain and Shear Wave Without or With aQuality Measure in Evaluation of Breast MassesRichard Barr Radiology Consultants, Inc, Youngstown, OhioUSAObjectives—Shear wave imaging (SVI) in the breast codessome cancers as soft. Coding a malignancy as soft can be due to poor shearwave propagation. The addition of a quality measure (QM) that determinesif an adequate shear wave formed for accurate measurements. Theaim of this paper was to compare the predictive value of strain (elasticityimaging [EI]) and SVI without and with a QM.Methods—Patients scheduled for an ultrasound breast biopsyhad strain (EI) and SVI on a Siemens S2000 system modified to performSVI with a QM. Lesions were evaluated for shear wave velocity (V s ) andthe QM. The highest V s in the lesion or surrounding ring (if present) wasused. The V s was classified as benign (4.5 m/s).For strain, an EI/B-mode ratio of