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A 3D ultrasound computer tomography (USCT) device with a nearly isotropic and spatially invariant 3D point spread function has been constructed at Institute for Data Processing and Electronic (IPE), Karlsruhe Institute of Technology (KIT). This device is currently applied in clinical studies for breast cancer screening. In this paper, a new method to develop an automated segmentation algorithm for USCT acquired images is proposed. The method employs distance regularized level set evolutionary (DRLSE) active contours along with surface fitting extrapolation and 3D binary mask generation for fully automatic segmentation outcome. In the first stage of the proposed algorithm, DRLSE is applied to those 3D USCT slice images which contain breast and are less affected by noise and ring artifacts named as Cat2. The DRLSE segmentation results are employed to extrapolate the rest of slice images known as Cat1. To overcome defectively segmented slice images, a 3D binary mask is generated out of USCT attenuation images. The 3D binary mask is multiplied by the DRLSE-based segmentation results to form finally segmented 3D USCT images. The method was tested on 12 clinical dataset images. According to F-measure criterion, the proposed method shows higher performance than the previously proposed semiautomatic segmentation one.

A promising candidate for improved imaging of breast cancer is ultrasound computer tomography (USCT). Current experimental USCT systems are still focused in elevation dimension resulting in a large slice thickness, limited depth of field, loss of out-of-plane reflections, and a large number of movement steps to acquire a stack of images. 3D USCT emitting and receiving spherical wave fronts overcomes these limitations. We built an optimized 3D USCT, realizing for the first time the full benefits of a 3D system. The point spread function could be shown to be nearly isotropic in 3D, to have very low spatial variability and fit the predicted values. The contrast of the phantom images is very satisfactory in spite of imaging with a sparse aperture. The resolution and imaged details of the reflectivity reconstruction are comparable to a 3 T MRI volume. Important for the obtained resolution are the simultaneously obtained results of the transmission tomography. The KIT 3D USCT was then tested in a pilot study on ten patients. The primary goals of the pilot study were to test the USCT device, the data acquisition protocols, the image reconstruction methods and the image fusion techniques in a clinical environment. The study was conducted successfully; the data acquisition could be carried out for all patients with an average imaging time of six minutes per breast. The reconstructions provide promising images. Overlaid volumes of the modalities show qualitative and quantitative information at a glance. This paper gives a summary of the involved techniques, methods, and first results.

Image reconstruction of ultrasound computed tomography based on the wave equation is able to show much more structural details than simpler ray-based image reconstruction methods. However, to invert the wave-based forward model is computationally demanding. To address this problem, we develop an efficient fully learned image reconstruction method based on a convolutional neural network. The image is reconstructed via one forward propagation of the network given input sensor data, which is much faster than the reconstruction using conventional iterative optimization methods. To transform the ultrasound measured data in the sensor domain into the reconstructed image in the image domain, we apply multiple down-scaling and up-scaling convolutional units to efficiently increase the number of hidden layers with a large receptive and projective field that can cover all elements in inputs and outputs, respectively. For dataset generation, a paraxial approximation forward model is used to simulate ultrasound measurement data. The neural network is trained with a dataset derived from natural images in ImageNet and tested with a dataset derived from medical images in OA-Breast Phantom dataset. Test results show the superior efficiency of the proposed neural network to other reconstruction algorithms including popular neural networks. When compared with conventional iterative optimization algorithms, our neural network can reconstruct a 110 × 86 image more than 20 times faster on a CPU and 1000 times faster on a GPU with comparable image quality and is also more robust to noise.

Ultrasound Computer Tomography (USCT) is a promising new imaging system for breast cancer diagnosis. An essential step before further processing is to remove the water background from the reconstructed images. In this paper we present a fully-automated image segmentation method based on three-dimensional active contours. The active contour method is extended by applying gradient vector flow and encoding the USCT aperture characteristics as additional weighting terms. A surface detection algorithm based on a ray model is developed to initialize the active contour, which is iteratively deformed to capture the breast outline in USCT reflection images. The evaluation with synthetic data showed that the method is able to cope with noisy images, and is not influenced by the position of the breast and the presence of scattering objects within the breast. The proposed method was applied to 14 in-vivo images resulting in an average surface deviation from a manual segmentation of 2.7 mm. We conclude that automated segmentation of USCT reflection images is feasible and produces results comparable to a manual segmentation. By applying the proposed method, reproducible segmentation results can be obtained without manual interaction by an expert.

For iterative image reconstruction of transmission tomography we apply the paraxial approximation of the Helmholtz equation for a spherical transducer arrangement. We choose this approach due to its three order of magnitude lower complexity than full wave solutions with the same precision for transmission tomography. In homogeneous media we prove that our forward solution is exact. With the help of this forward solution 2D and 3D ultrasound measurements could be simulated for transmission tomography. 2D reconstructions of a breast-like numerical phantom had a deviation in sound speed of 0.14 m/s and a deviation in attenuation of 6.5% from the ground truth. Applications up to now are breast cancer diagnostics and non-destructive testing.

In our first clinical study with a full 3D Ultrasound Computer Tomography (USCT) system patient data was acquired in eight minutes for one breast. In this paper the patient movement during the acquisition was analyzed quantitatively and as far as possible corrected in the resulting images. The movement was tracked in ten successive reflectivity reconstructions of full breast volumes acquired during 10 s intervals at different aperture positions, which were separated by 41 s intervals. The mean distance between initial and final position was 2.2 mm (standard deviation (STD) ± 0.9 mm, max. 4.1 mm, min. 0.8 mm) and the average sum of all moved distances was 4.9 mm (STD ± 1.9 mm, max. 8.8 mm, min. 2.7 mm). The tracked movement was corrected by summing successive images, which were transformed according to the detected movement. The contrast of these images increased and additional image content became visible.

Ultrasound Computer Tomography (USCT) is a promising new imaging method for breast cancer diagnosis. We developed a 3D USCT system and tested it in a pilot study with encouraging results: 3D USCT was able to depict two carcinomas, which were present in contrast enhanced MRI volumes serving as ground truth. To overcome severe differences in the breast shape, an image registration was applied. We analyzed the correlation between average sound speed in the breast and the breast density estimated from segmented MRIs and found a positive correlation with R=0.70. Based on the results of the pilot study we now carry out a successive clinical study with 200 patients. For this we integrated our reconstruction methods and image post-processing into a comprehensive workflow. It includes a dedicated DICOM viewer for interactive assessment of fused USCT images. A new preview mode now allows intuitive and faster patient positioning. We updated the USCT system to decrease the data acquisition time by approximately factor two and to increase the penetration depth of the breast into the USCT aperture by 1 cm . Furthermore the compute-intensive reflectivity reconstruction was considerably accelerated, now allowing a sub-millimeter volume reconstruction in approximately 16 minutes. The updates made it possible to successfully image first patients in our ongoing clinical study.

Ultrasound Computer Tomography (USCT), developed at KIT, is a promising new imaging system for breast cancer diagnosis, and was successfully tested in a pilot study. The 3D USCT II prototype consists of several hundreds of ultrasound (US) transducers on a semi-ellipsoidal aperture. Spherical waves are sequentially emitted by individual transducers and received in parallel by many transducers. Reflectivity volumes are reconstructed by synthetic aperture focusing (SAFT). However, straight forward SAFT imaging leads to blurred images due to system imperfections. We present an extension of a previously proposed approach to enhance the images. This approach includes additional a priori information and system characteristics. Now spatial phase compensation was included. The approach was evaluated with a simulation and clinical data sets. An increase in the image quality was observed and quantitatively measured by SNR and other metrics.

3D Ultrasound Computer Tomography (USCT) is a new imaging method for breast cancer diagnosis. In the current state of development it is essential to correlate USCT with a known imaging modality like MRI to evaluate how different tissue types are depicted. Due to different imaging conditions, e.g. with the breast subject to buoyancy in USCT, a direct correlation is demanding. We present a 3D image registration method to reduce positioning differences and allow direct side-by-side comparison of USCT and MRI volumes. It is based on a two-step approach including a buoyancy simulation with a biomechanical model and free form deformations using cubic B-Splines for a surface refinement. Simulation parameters are optimized patient-specifically in a simulated annealing scheme. The method was evaluated with in-vivo datasets resulting in an average registration error below 5mm. Correlating tissue structures can thereby be located in the same or nearby slices in both modalities and three-dimensional non-linear deformations due to the buoyancy are reduced. Image fusion of MRI volumes and USCT sound speed volumes was performed for intuitive display. By applying the registration to data of our first in-vivo study with the KIT 3D USCT, we could correlate several tissue structures in MRI and USCT images and learn how connective tissue, carcinomas and breast implants observed in the MRI are depicted in the USCT imaging modes.

3D Ultrasound Computer Tomography (3D USCT) promises reproducible high-resolution images for early detection of breast tumors. The KIT prototype provides three different modalities: reflectivity, speed of sound, and attenuation. The reflectivity images are reconstructed using a Synthetic Aperture Focusing Technique (SAFT) algorithm. For high-resolution re ectivity images, with spatially homogeneous reflectivity, attenuation correction is necessary. In this paper we present a GPU accelerated attenuation correction for 3D USCT and evaluate the method by means of image quality metrics; i.e. absolute error, contrast and spatially homogeneous reflectivity. A threshold for attenuation correction was introduced to preserve a high contrast. Simulated and in-vivo data were used for analysis of the image quality. Attenuation correction increases the image quality by improving spatially homogeneous reflectivity by 25 %. This leads to a factor 2.8 higher contrast for in-vivo data.

In a first pilot study with 3D Ultrasound Computer Tomography especially the speed of sound images of the breast showed promising results for breast cancer detection. Yet, the resolution of transmission tomography in our system is limited in comparison to the reflectivity volumes. In this paper we describe a setup for an improved device overcoming this limitation. An optimized geometry of the transducers in a sparse distribution improves both the contrast in reflection and contrast and resolution in transmission tomography by nearly an order of magnitude. Furthermore data acquisition is accelerated from 10 to less than 2 minutes. The derived methods, simulation, and measuring results are described.

A promising candidate for improved imaging of breast cancer is ultrasound computer tomography (USCT). The aim of this work was to design a new aperture for our full 3D USCT which extends the properties of the current aperture to a larger ROI fitting the buoyant breast in water and decreasing artifacts in transmission tomography. The optimization resulted in a larger opening angle of the transducers, a larger diameter of the aperture and an approximately homogeneous distribution of the transducers, with locally random distances. The developed optimization methods allow us to automatically generate an optimized aperture for given diameters of apertures and transducer arrays, as well as quantitative comparison to other arbitrary apertures. Thus, during the design phase of the next generation KIT 3D USCT, the image quality can be balanced against the specification parameters and given hardware and cost limitations. The methods can be applied for general aperture optimization, only limited by the assumptions of a hemispherical aperture and circular transducer arrays.

Ultrasound Computer Tomography (USCT) is a promising modality for breast imaging. We developed and tested the first full 3D USCT system aimed at in-vivo imaging. It is based on approx. 2000 ultrasound transducers surrounding the breast within a water bath. From the acquired signal data, reflectivity, attenuation and sound speed images are reconstructed. In a first in-vivo study we imaged ten patients and compared them to MRI images. To overcome the considerably different breast positioning in both imaging methods, an image registration and image fusion based on biomechanical modeling of the buoyancy effect and surface-based refinement was applied. The resulting images are promising: compared with the MRI ground truth, similar tissue structures can be identified. While reflection images seem to image even small structures, sound speed imaging seems to be the best modality for detecting cancer. The registration of both imaging methods allows browsing the volume images side by side and enables recognition of correlating tissue structures. The first in-vivo study was successfully completed and encourages for a second in-vivo study with a considerably larger number of patients, which is currently ongoing.

The KIT 3D USCT was tested in a pilot study on ten patients. The primary goals of the pilot study were to test the USCT device, the data acquisition protocols, the image reconstruction methods and the image fusion techniques in a clinical environment. The study was conducted successfully; the data acquisition could be carried out for all patients with an average imaging time of six minutes per breast. First reconstructions provide promising images. Overlaid volumes of the modalities show qualitative and quantitative information at a glance. The results led to further optimization of the system and the data acquisition protocol.

3D ultrasound computer tomography (USCT) requires a large number of transducers approx. two orders of magnitude larger than in a 2D system. Technical feasibility limits the number of transducer positions to a much smaller number resulting in a sparse aperture and causing artifacts due to grating lobe effects in the images. Usually, grating lobes are suppressed by using a non-sparse geometry. Thus, there is no quantitative estimation method available how much the image contrast is degraded when a sparse aperture is applied and how much the contrast is improved when adding more transducers, changing the overall aperture or the object. In this paper the effect of the grating lobes on the image quality was analyzed for a spherical, a hemispherical and the semi-ellipsoidal USCT aperture: The background noise due to grating lobes is very similar for the three apertures and mainly influenced by the sparseness and the imaged object. A model for noise reduction was fitted to simulated and experimental data, and can be used to predict the peak-signal-to-noise- ratio for a given object and number of aperture positions.

Ultrasound Computer Tomography is an upcoming imaging modality for early breast cancer detection. For evaluation of the method, comparison with the standard method X-ray mammography is of strongest interest. To overcome the significant differences in dimensionality and compression state of the breast, in earlier work a registration method based on biomechanical modeling of the breast was proposed. However only homogeneous models could be applied, i.e. inner structures of the breast were neglected. In this work we extend the biomechanical modeling of the breast by estimating patient-specific tissue parameters automatically from the speed of sound volume. Two heterogeneous models are proposed modeling a quadratic and an exponential relationship between speed of sound and tissue stiffness. The models were evaluated using phantom images and clinical data. The size of all lesions is better preserved using heterogeneous models, especially using an exponential relationship. The presented approach yields promising results and gives a physical justification to our registration method. It can be considered as a first step towards a realistic modeling of the breast.

Summary A promising candidate for imaging of breast cancer is ultrasound computer tomography (USCT). The main advantages of a USCT system are simultaneous recording of reproducible reflection, attenuation and speed of sound volumes, high image quality, and fast data acquisition. The here presented 3D USCT prototype realizes for the first time the full potential of such a device. It is ready for a clinical study. Full volumes of a breast can be acquired in four minutes. In this paper images acquired with a clinical breast phantom are presented. The resolution and imaged details of the reflectivity reconstruction are comparable to a 3 tesla MRI volume of the phantom. Image quality and resolution is isotropic in all three dimensions, confirming the successful implementation experimentally.

We designed and built a 3D ultrasound computer tomography (USCT) device with a nearly isotropic and spatially invariant 3D point spread function, to be tested in a clinical study. The objective of this work was to image two healthy volunteers and to evaluate the USCT volumes in comparison to corresponding Magnetic Resonance Images (MRI). The here presented volumes are reflectivity images generated with 3D synthetic aperture focusing technique. The volunteers were imaged with different parameterizations of the data acquisition. The data acquisition time was between four and twelve minutes. For both volunteers we found that the breast surface and inner structures are clearly shown in the USCT volume and fit the structures given by the MRI.

We have developed a three-dimensional ultrasound computer tomography system (3D USCT) for early breast cancer diagnosis. The method gives reproducible volume images of the female breast in 3D. The optimized aperture and transducer array systems show at the used low ultrasound frequency of 2.5 MHz a very high image quality. In contrast to other methods our system has a nearly isotropic and spatially invariant 3D point spread function (PSF) with a resolution of 240 11m as measured with a 70 11m AI bond wire. By simulated spectra including the experimentally measured noise of transmission tomography it could be shown that structures down to 4 mm could be reconstructed in speed of sound images. The reconstruction of the 3D images in reflection tomography could be accelerated by the use of the multi-core structure of PCs and eight graphical processor units by a factor of 94. For a reconstruction of the reflectivity with 64 layers of 10242 pixels we reduce the computing time from 33 hours to about 21 minutes. In a first clinical study and the images of two healthy probands the observed structures in breasts due to 3D USCT are comparable to images obtained with a clinical MRT.

Breast cancer is the most common cancer among women. The established screening method to detect breast cancer in an early state is X-ray mammography. However, X-ray frequently provides limited contrast of tumors located within glandular tissue. A new imaging approach is Ultrasound Computer Tomography generating threedimensional volumes of the breast. Three different images are available: reflectivity, attenuation and speed of sound. The correlation of USCT volumes with X-ray mammograms is of interest for evaluation of the new imaging modality as well as for a multimodal diagnosis. Yet, both modalities differ in image dimensionality, patient positioning and deformation state of the breast. In earlier work we proposed a methodology based on Finite Element Method to register speed of sound images with the according mammogram. In this work, we enhanced the methodology to register all three image types provided by USCT. Furthermore, the methodology is now completely automated using image similarity measures to estimate rotations in datasets. A fusion methodology is proposed which combines the information of the three USCT image types with the X-ray mammogram via semitransparent overlay images. The evaluation was done using 13 datasets from a clinical study. The registration accuracy was measured by the displacement of the center of a lesion marked in both modalities. Using the automated rotation estimation, a mean displacement of 10.4 mm was achieved. Due to the clinically relevant registration accuracy, the methodology provides a basis for evaluation of the new imaging device USCT as well as for multimodal diagnosis.

A promising candidate for improved imaging of breast cancer is ultrasound computer tomography (USCT). Current experimental USCT systems are still focused in elevation dimension resulting in a large slice thickness, limited depth of field, loss of out-of-plane reflections, and a large number of movement steps to acquire a stack of images. 3DUSCT emitting and receiving spherical wave fronts overcomes these limitations. We built an optimized 3DUSCT with nearly isotropic 3DPSF, realizing for the first time the full benefits of a 3Dsystem. In this paper results of the 3D point spread function measured with a dedicated phantom and images acquired with a clinical breast phantom are presented. The point spread function could be shown to be nearly isotropic in 3D, to have very low spatial variability and fit the predicted values. The contrast of the phantom images is very satisfactory in spite of imaging with a sparse aperture. The resolution and imaged details of the reflectivity reconstruction are comparable to a 3TeslaMRI volume of the breast phantom. Image quality and resolution is isotropic in all three dimensions, confirming the successful optimization experimentally.

Breast cancer is the most common cancer among women. The established screening method to detect breast cancer is X-ray mammography. However, X-ray frequently provides poor contrast of tumors located within glandular tissue. In this case, additional modalities like MRI are used for diagnosis in clinical routine. A new imaging approach is Ultrasound Computer Tomography, generating three-dimensional speed of sound images. High speed of sound values are expected to be an indicator of cancerous structures. Therefore, the combination of speed of sound images and X-ray mammograms may benefit early breast cancer diagnosis. In previous work, we proposed a method based on Finite Elements to automatically register speed of sound images with the according mammograms. The FEM simulation overcomes the challenge that X-ray mammograms show two-dimensional projections of a deformed breast whereas speed of sound images render a three-dimensional undeformed breast in prone position. In this work, 15 datasets from a clinical study were used for further evaluation of the registration quality. The quality of the registration was measured by the displacement of the center of a lesion marked in both modalities. We found a mean displacement of 7.1 mm. For visualization, an overlay technique was developed, which displays speed of sound information directly on the mammogram. Hence, the methodology provides a good basis for multimodal diagnosis using mammograms and speed of sound images. It proposes a guidance tool for radiologists who may benefit from the combined information.

Breast cancer is the most common type of cancer among women in Europe and North America. The established screening method to detect breast cancer is X-ray mammography, although X-ray frequently provides poor contrast for tumors located within glandular tissue. A new imaging approach is Ultrasound Tomography generating three-dimensional speed of sound images. This paper describes a method to evaluate the clinical applicability of three-dimensional speed of sound images by automatically registering the images with the corresponding X-ray mammograms. The challenge is that X-ray mammograms show two-dimensional projections of a deformed breast whereas speed of sound images render a three-dimensional undeformed breast in prone position. This conflict requires estimating the relation between deformed and undeformed breast and applying the deformation to the three-dimensional speed of sound image. The deformation is simulated based on a biomechanical model using the finite element method. After simulation of the compression, the contours of the X-ray mammogram and the projected speed of sound image overlap congruently. The quality of the matching process was evaluated by measuring the overlap of a lesion marked in both modalities. Using four test datasets, the evaluation of the registration resulted in an average tumor overlap of 97%. The developed registration provides a basis for systematic evaluation of the new modality of three-dimensional speed of sound images, e.g. allows a greater understanding of tumor depiction in these new images.

In previous work we optimized the aperture of our 3D Ultrasound Computer Tomography (USCT) system with emphasis on reflection tomography. Based on the promising clinical results with speed of sound and attenuation images, the next generation aperture will be upgraded to contain also optimization for transmission tomography. The main changes to be implemented in aperture, transducers, and transducer arrays are: (1) Overall 3D aperture: due to the shape of the buoyant breast a simpler hemispherical aperture can be applied. (2) The diameter of the aperture will be increased and the diameter of the transducers will be decreased for further homogenization of the illumination. (3) The disjunctive sampling of the transducers will be increased and the transducers will be distributed randomly to enhance the uniformity of transmission tomography. (4) Transducers will be connected both as emitters and receivers to decrease the need for mechanical movement of the aperture.

The KIT 3D USCT surrounds the breast with ultrasound transducers on a 3D aperture and emits and receives nearly spherical wave fronts for synthetic aperture focusing. This full 3D system achieves isotropic 3D resolution, has a nearly spatial invariant point spread function, and allows fast data acquisition. The 3D USCT device is equipped with 2041 ultrasound transducers. The acquisition is carried out by sequentially selecting a single emitter, sending a chirp at 2.5 MHz center frequency and recording the transmitted and reflected waves with all receivers. Rotational and translational movement of the aperture is applied to enhance the image contrast. Up to 40 GB of raw data is acquired with 480 parallel channels for digitization at 12 bit and 20 MHz sampling frequency. In a first pilot study, ten patients with different lesions were imaged. Speed of sound, attenuation, and reflection images of each patient were derived from the raw data. Overlaid volumes of the modalities show qualitative and quantitative information at a glance. The results are promising because the breasts' tissue structures and cancerous lesions could be identified in the USCT images.