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Advanced Technologies Flashcards

1
Q

What are 8 types of advanced technologies in U/S?

A
  1. Tissue harmonic imaging (THI)
  2. U/S contrast agents
  3. Elastography (vibrational doppler imaging
  4. Shear-wave elastography
  5. 3D imaging redering
  6. Automated breast U/S (ABUS)
  7. Artificial intelligence (AI)
  8. Cryoablation
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2
Q

THI

A

Tissue harmonic imaging

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3
Q

What does THI help with? (3)

A
  1. Reducing image artifacts
  2. Reducing side lobes
    - eg) speckle, clutter and reverberation
  3. Enhance tissue contrast
    - resulting in better images
    Improves tissue contrast
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4
Q

What does THI utilize?

A

Multiples of the transmission frequency

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5
Q

What are 3 ways to eliminate fundamental frequencies?

A
  1. Frequency filtering
  2. Pulse inversion/phase cancellation
  3. Coded harmonics
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6
Q

What are weak echoes called?

A

Harmonics

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7
Q

What is the key to improving the image use THI?

A

Better signal to noise ratio

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8
Q

What increases with depth when involving harmonic signal?

A

Intensity

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9
Q

What are 2 disadvantages of THI?

A
  1. Depth penetration suffers
  2. Dynamic range is reduced
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10
Q

What does depth penetration suffer when using THI?

A

Because we are using higher frequency to produce the image
- indirectly proportional

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11
Q

What happens with dynamic range is reduced?

A

Image is more smooth and less contrasty

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12
Q

What are 3 advantages of THI?

A
  1. Better signal to noise ratio
  2. Creates greater tissue contrast
  3. Improves image quality
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13
Q

System sensitivity

A

The ability go an ultrasound system to receive and display weak echoes form deep structures

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14
Q

Spatial compound imaging

A

Views the target area from multiple lines of sight to form an image that has fewer artifacts

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15
Q

What is spatial compounding imaging also know as?

A

SonoCT

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16
Q

What does spatial compounding imaging help with?

A

To remove artifacts

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17
Q

What does ultrasound contrast agents usually consist of? What does it serve as?

A
  1. 5-7 micron sized encapsulated bubbles
  2. Which server to increase ultrasound backscatter by a factor of 3 when performing colour or power doppler
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18
Q

What can ultrasound contrast agents help with?

A

Helps to track blood flow
- can help predict whether a breast lesion is benign or malignant

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19
Q

What are 5 benefits of 3D breast ultrasound?

A
  1. Improved visualization of the infiltration zone using the coronal plane
    - common for invasive ductal carcinomas
  2. Added benefit of tumour surface imaging not available using 2D alone
  3. Ability to analyze data blocks after the examination is complete, including rotation of 3D images in any plane
  4. Estimation of tumour volume from 3D images allows for monitoring of tumour size following therapy
  5. May reduce false positives
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20
Q

What is Digital breast tomosynthesis (DBT)?

A

Is an advanced form of breast imaging of mammo that uses lose dose x-ray and computer reconstruction to reconstruct 3D images of the breast

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21
Q

What is DBT also done with?

22
Q

What does DBT reduce?

A

Radiation dose

23
Q

What is an advantage of DBT?

A

Identifies smaller breast cancers with less axillary lymph node metastasis

24
Q

DBT

A

Digital breast tomosynthesis

25
What is 4D ultrasound?
3D ultrasound with real time scanning
26
What place is DBT best visualized in? Why?
1. Coronal 2. Can demonstrate the infiltrative zone which is where we typically see invasive ductal carcinoma
27
What is elastography an adaption of a technique known as?
Fremitus
28
What is Fremitus helpful with?(3)
1. Differentiating isoechoic lesions - eg. Fat lobbies from solid lesions 2. Deciding whether shadowing is real or artifactual 3. Identifying multifocal disease when it is present
29
What does a patient do when being scanning with elasography?
Hum
30
What do softer components of a normal breast do more of compared to firmer components when vibrational energy is applied to the chest wall?
Vibrate more - cancer lesions don't vibrate very much
31
VDI
Vibrational Doppler Imaging
32
SWE
Shear-Wave Elastography
33
What does Shear-Wave Elastography?
Techniques used to visualize and measure tissue elasticity
34
What happens to tissue that has more elasticity to it do?
Deform more than abnormally stiff and pathological tissue
35
When a lesion shows as blue on SWE, what does that mean?
Indicates that that tissue is soft with low stiffness - most likely benign
36
When a lesion shows as red or yellow on SWE, what does that mean?
Indicates that the tissue has increased stiffness - most likely malignant
37
What does strain elastography use to provide a qualitative assessment for stiffness?
Manual compression
38
How do malignant lesions appear on an elastogram rather than on a high resolution grey scale image?
Larger
39
ABUS
Automated Breast Ultrasound
40
What is ABUS designed for?
To automatically scan a women’s breast, capturing multiple, sequential ultrasound images in orthogonal planes, to be displayed later on a 3D workstation
41
What are 2 things ABUS use to generate better images?
1. High frequency 2. Broad bandwidth transducer
42
What are 3 limitations for hand held breast US?
1. Length of exam - 30 mins 2. Operator dependency - better results with the more skilled operators 3. Lack of well trained certified breast sonographers
43
Brachytherapy
A type of internal radiation therapy where a radioactive source is placed directly into or near a cancerous tumour - radiation treatment that is given directly into your body
44
What is the most common form of treatment post mastectomy or if lymph nodes are involved?
Radiation therapy
45
What are the 2 forms of Brachytherapy?
1. Interstitial 2. Intercavitary
46
What is interstitial also known as?
Tube and button
47
48
What is intercavitary also known as?
Balloon catheter
49
Intercavitary (5 points)
- Device that is placed into the lumpectomy cavity and left until the treatment is completed - The device is inserted into the breast as a small tube and expands on one end in order to stay in place - A pellet of radon is inserted and removed after a short time - Typically occurs for 5 days twice a day - More common type
50
What are 5 advantages for brachytherapy?
1. One week treatment time vs 6-7 weeks for external beam radiation therapy 2. Reduces radiation to lungs and opposite breast 3. Causes no delay in other treatments such as chemo 4. Treatments are given on an outpatient basis, so no hospital stats are required
51

Breast (12 decks)

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