title: Breast vibro-acoustography: initial experience in benign lesions.
abstract: BACKGROUND
  Vibro-acoustography (VA) is a newly developed imaging technology that is based on low-frequency vibrations induced in the object by the radiation force of ultrasound. VA is sensitive to the dynamic characteristics of tissue. Here, we evaluate the performance of VA in identifying benign lesions and compare the results to those of mammography.
  
  
  METHODS
  An integrated mammography-VA system designed for in vivo breast imaging was tested on a group of female volunteers, age ≥ 18 years, with suspected breast lesions based on clinical examination. A set of VA scans was acquired after each corresponding mammography. Most lesions were classified as benign based on their histological results. However, in 4 cases, initial diagnosis based on clinical imaging determined that the lesions were cysts. These cysts were aspirated with needle aspiration and disappeared completely under direct ultrasound visualization. Therefore, no biopsies were performed on these cases and lesions were classified as benign based on clinical findings per clinical standards. To define the VA characteristics of benign breast masses, we adopted the features that are normally attributed to such masses in mammography. In a blinded assessment, three radiologists evaluated the VA images independently. The diagnostic accuracy of VA for detection of benign lesions was assessed by comparing the reviewers' evaluations with clinical data.
  
  
  RESULTS
  Out of a total 29 benign lesions in the group, the reviewers were able to locate all lesions on VA images and mammography, 100% with (95% confidence interval (CI): 88% to 100%). Two reviewers were also able to correctly classify 83% (95% CI: 65% to 92%), and the third reviewer 86% (95% CI: 65% to 95%) of lesions, as benign on VA images and 86% (95% CI: 69% to 95%) on mammography.
  
  
  CONCLUSIONS
  The results suggest that the mammographic characteristics of benign lesion may also be used to identify such lesions in VA. Furthermore, the results show the ability of VA to detect benign breast abnormalities with a performance comparable to mammography. Therefore, the VA technology has the potential to be utilized as a complementary tool for breast imaging applications. Additional studies are needed to compare the capabilities of VA and traditional ultrasound imaging.
authors.affiliation: Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA. Alizad.azra@mayo.edu.|Division of General Internal Medicine, Department of Medicine, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA. Alizad.azra@mayo.edu.
authors.forename: Azra
authors.initials: A
authors.lastname: Alizad
authors.affiliation: Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA. m.mehrmohammadi@gmail.com.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Mehrmohammadi
authors.affiliation: Division of General Internal Medicine, Department of Medicine, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA. ghosh.karthik@mayo.edu.
authors.forename: Karthik
authors.initials: K
authors.lastname: Ghosh
authors.affiliation: Department of Radiology, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA. glazebrook.katrina@mayo.edu.
authors.forename: Katrina N
authors.initials: KN
authors.lastname: Glazebrook
authors.affiliation: Division of Biomedical Statistics and Informatics, Department of Health Sciences Research Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA. carter.rickey@mayo.edu.
authors.forename: Rickey E
authors.initials: RE
authors.lastname: Carter
authors.affiliation: Bolu IBD Hospital, Radiology, Sanayi Sitesi 32. Blok Demirciler Ve Nalburcular Odasi Hiz. Binasi Alti, No:1, 14100, Bolu, Turkey. lgkarabekmez@gmail.com.
authors.forename: Leman Gunbery
authors.initials: LG
authors.lastname: Karaberkmez
authors.affiliation: Department of Radiology, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA. whaley.dana@mayo.edu.
authors.forename: Dana H
authors.initials: DH
authors.lastname: Whaley
authors.affiliation: Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA. Fatemi.mostafa@mayo.edu.
authors.forename: Mostafa
authors.initials: M
authors.lastname: Fatemi
mesh_terms: D047688:Breast Cyst / Q000473:pathology*; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D042361:Mammary Glands, Human / Q000473:pathology*; D008327:Mammography / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity