SEATTLE, Washington—Compound ultrasound imaging improves the evaluation of solid breast nodules and the retroareolar region of the breast, according to two studies from University Health Network, Mt. Sinai Hospital, Toronto, Canada. The studies were reported at the 101st Annual Meeting of the American Roentgen Ray Society.

Images From Various Angles

"In conventional ultrasound, each scan line hits the target object in a single scan plane," said Supriya Kulkarni, MD, a fellow at Mt. Sinai Hospital. "Real-time compound imaging utilizes multiple coplanar tomographic images obtained from various angles to produce a single compound image." The net result is a marked reduction of acoustic artifact and noise, she said.

In the first study (abstract 16), compound imaging with the SonoCT scanner system (ATL Ultrasound, Bothwell, Washington) was compared with conventional (fundamental) ultrasound imaging for the evaluation of solid breast nodules.

The study included 163 image pairs from 51 consecutive patients referred for routine breast sonography; each pair consisted of a conventional image and a compound image obtained with identical projection and compression, Dr. Kulkarni said.

Two blinded reviewers with no previous experience with compound imaging graded the features of each image individually and classified the nodules as benign, malignant, or indeterminate; these classifications were subsequently correlated with pathologic findings. Each image pair was also assessed side by side in a preference study.

"Compound imaging significantly reduced posterior artifact, both shadowing and enhancement, and improved visualization of retrolesional tissue," Dr. Kulkarni said. Shape, echodensity, echotexture, and homogeneity did not change with compound imaging, she added. In 58% of cases, the reviewers felt that the compound image permitted better overall evaluation of the nodules.