How To: Breast Elasticity - HD

Patient and Lesion Overview

Our patient is known to us and has a fibroadenoma that was biopsy proven.

And she came back today to be our model to let me show you how I actually perform an elastogram.

I've already done my regular scan, and I found the lesion.

We have it here on B mode. It's her fibroadenoma.

Setting Up Elastography

So what I'm gonna do now is go to do the elastogram.

So we will turn on the elastography.

One thing that I like to do is make sure that our field of view encompasses a large area that includes both the fat, the lesion and some normal breast tissue.

'cause that'll give us the best dynamic range on the elastogram.

Probe Pressure and Imaging Differences

When I usually do my B mode imaging, I apply some pressure.

And the reason we do that is we usually get better B mode images.

However, on the elastogram, that pre compression interferes with getting a good elastogram.

So if you look at this image, right now we really have a very poor elastogram.

We don't see the lesion at all.

Adjusting Probe for Better Elastogram

And if you look, let's take this ligament right here.

I'm just gonna be lifting up the probe and I'm letting that drop down as far as I can.

So we have less pre compression.

As you can see as I'm dropping this, we're getting a much better elastogram and can see the lesion very well.

And I'm getting to the point now where I can't drop any farther without losing coupling on the breast.

And you can see on the elastogram just with the patient breathing, we're getting the lesion and we can see it on every frame.

Observing Lesion and Cyst with Breathing

She also has a cyst nearby here.

We can see the cyst artifact and I'm not doing any pushing on the breast, I'm just holding it and it's just her breathing.

So again, we have the probe perpendicular to the lesion in the floor and as she's doing her breathing, we're holding a lesion in the same plane and we're getting a very good elastogram.

I always look at the B mode image and I can get an idea as she's breathing.

You can see that the lesion is moving and that's just the appropriate amount of motion for us to get a good elastogram.

Taking Measurements

And now that we've got a good image, I'm just gonna freeze.

I'm gonna go ahead and take measurements on the B mode image.

And we have the shadow function on, so it draws a line that it corresponds to the same spot and distance that's on the B mode image.

If we wanted to, we can actually then add another line and I think the lesion actually ends here and we've got another little area there and we can compare then the distances of the two lesions.

You can see that there's a cyst that's sitting to the side of this lesion that we saw when we were doing the exam.

And unfortunately, this happens fairly often and you have to be very careful when you do your measurements.