title: Tumor characterization and treatment monitoring of postsurgical human breast specimens using harmonic motion imaging (HMI).
abstract: High-intensity focused ultrasound (HIFU) is a noninvasive technique used in the treatment of early-stage breast cancer and benign tumors. To facilitate its translation to the clinic, there is a need for a simple, cost-effective device that can reliably monitor HIFU treatment. We have developed harmonic motion imaging (HMI), which can be used seamlessly in conjunction with HIFU for tumor ablation monitoring, namely harmonic motion imaging for focused ultrasound (HMIFU). The overall objective of this study was to develop an all ultrasound-based system for real-time imaging and ablation monitoring in the human breast in vivo.
  
  
  
  HMI was performed in 36 specimens (19 normal, 15 invasive ductal carcinomas, and 2 fibroadenomas) immediately after surgical removal. The specimens were securely embedded in a tissue-mimicking agar gel matrix and submerged in degassed phosphate-buffered saline to mimic in vivo environment. The HMI setup consisted of a HIFU transducer confocally aligned with an imaging transducer to induce an oscillatory radiation force and estimate the resulting displacement.
  
  
  
  3D HMI displacement maps were reconstructed to represent the relative tissue stiffness in 3D. The average peak-to-peak displacement was found to be significantly different (p = 0.003) between normal breast tissue and invasive ductal carcinoma. There were also significant differences before and after HMIFU ablation in both the normal (53.84 % decrease) and invasive ductal carcinoma (44.69 % decrease) specimens.
  
  
  
  HMI can be used to map and differentiate relative stiffness in postsurgical normal and pathological breast tissues. HMIFU can also successfully monitor thermal ablations in normal and pathological human breast specimens. This HMI technique may lead to a new clinical tool for breast tumor imaging and HIFU treatment monitoring.
authors.affiliation: Department of Biomedical Engineering, Columbia University, 351 Engineering Terrace, 1210 Amsterdam Avenue, New York, NY, USA.
authors.forename: Yang
authors.initials: Y
authors.lastname: Han
authors.affiliation: Department of Biomedical Engineering, Columbia University, 351 Engineering Terrace, 1210 Amsterdam Avenue, New York, NY, USA.
authors.forename: Shutao
authors.initials: S
authors.lastname: Wang
authors.affiliation: Department of Pathology and Cell Biology, NewYork-Presbyterian Hospital, New York, NY, USA.
authors.forename: Hanina
authors.initials: H
authors.lastname: Hibshoosh
authors.affiliation: Department of Surgery, NewYork-Presbyterian Hospital, New York, NY, USA.
authors.forename: Bret
authors.initials: B
authors.lastname: Taback
authors.affiliation: Department of Biomedical Engineering, Columbia University, 351 Engineering Terrace, 1210 Amsterdam Avenue, New York, NY, USA. ek2191@columbia.edu.|Department of Radiology, Columbia University, New York, NY, USA. ek2191@columbia.edu.
authors.forename: Elisa
authors.initials: E
authors.lastname: Konofagou
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy*; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D005260:Female; D018226:Fibroadenoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D057086:High-Intensity Focused Ultrasound Ablation / Q000379:methods; D006801:Humans; D021621:Imaging, Three-Dimensional; D008875:Middle Aged; D011182:Postoperative Care; D016896:Treatment Outcome; D055815:Young Adult
keywords: HIFU monitoring; HMIFU; Human breast tumor