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Registration of supine MR mammography with breast ultrasound for surgical planning of breast conserving surgery: a feasibility study

Pickles, Martin D.; Gibbs, Peter; Hubbard, Anne; Rahman, Ayesha; Wieczorek, Joanna; Roychaudhury, Ronjabati; Bradley, Caroline; Turnbull, Lindsay W.


Martin D. Pickles

Peter Gibbs

Anne Hubbard

Ayesha Rahman

Joanna Wieczorek

Ronjabati Roychaudhury

Caroline Bradley

Lindsay W. Turnbull


Purpose To report the feasibility, accuracy and initial clinical experience of the use of real-time magnetic resonance navigated ultrasound (rtMRnUS) in the surgical planning of breast-conserving surgery (BCS) via guide wire insertion. Materials and Methods 29 participants were recruited into this prospective ethics committee approved study. The first 4 cases were utilized as a training set. Participants underwent a supine contrast-enhanced breast MR examination with external fiducials and corresponding ink marks placed on the skin of the affected breast to act as co-registration pairs. MR examinations included both functional and morphological images. A LOGIQ E9 ultrasound system (GE Healthcare, Milwaukee, WI, USA) equipped with a 6 - 15 MHz transducer was utilized for rtMRnUS. To facilitate point co-registration of the previously acquired MR dataset with the real-time ultrasound, co-registration pairs were identified on both imaging modalities. The following co-registration quality metrics were recorded: root mean square deviation (RMSD), lesion and global accuracies. Post co-registration guide wire insertion was performed. Results Co-registration was successfully undertaken in all participants. Results from 25 participants are presented. The median (min, max) RMSD was 3.3 mm (0.6 mm, 8.8 mm). The global accuracy was assessed as very good (8), good (12), moderate (3) and poor (2) while the median (min, max) lesion accuracy was recorded at 8.9 mm (2.1 mm, 33.2 mm). Conclusion The use of rtMRnUS to facilitate guide wire insertion is a feasible technique. Generally, very good or good global registration can be expected. Lesion accuracy results indicate that a median difference, in 3 D space, of 9 mm can be expected between imaging modalities.


Pickles, M. D., Gibbs, P., Hubbard, A., Rahman, A., Wieczorek, J., Roychaudhury, R., …Turnbull, L. W. (2017). Registration of supine MR mammography with breast ultrasound for surgical planning of breast conserving surgery: a feasibility study. Ultraschall in der Medizin : Organ der Deutschen Gesellschaft für Ultraschall in der Medizin, [der] Österreichischen Gesellschaft für Ultraschall in der Medizin, [der] Schweizerischen Gesellschaft für Ultraschall in Medizin und Biologie, 38(4), 420-426.

Journal Article Type Article
Acceptance Date Aug 10, 2015
Online Publication Date Nov 3, 2015
Publication Date 2017-08
Deposit Date Sep 4, 2015
Publicly Available Date Nov 23, 2017
Journal Ultraschall in der Medizin = European journal of ultrasound
Print ISSN 0172-4614
Electronic ISSN 1438-8782
Publisher Thieme Gruppe
Peer Reviewed Peer Reviewed
Volume 38
Issue 4
Pages 420-426
Keywords Mammography, Breast conserving surgery, Ultrasound, Breast cancer
Public URL
Publisher URL
Additional Information This is the authors' accepted manuscript of an article published in: Ultraschall in der Medizin = European journal of ultrasound, 2017, v.38, issue 4.