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Extra info for Fundamentals in Oncologic Ultrasound: Sonographic Imaging and Intervention in the Cancer Patient
33). 8 Gray-Scale Ultrasound: Examination Technique 29 a b Fig. 30a, b Periductal breast nodule in a patient with nipple discharge. The conventional breast scan (a) identifies a small hypoechoic nodule adjacent to a dilated duct. The EFOV image (b) offers a comprehensive view of the entire dilated duct from the nipple to the nodule (calipers) Fig. 31 Phyllodes breast tumor, 3D US scan. Multiplanar and 3D images of large heterogeneous hypoechoic breast nodule Fig. 32 Breast carcinoma, 3D US. Multiplanar and 3D images of the hypoechoic nodule with beam attenuation Fig.
Reference imaging performed at the beginning of treatment, or for example immediately after surgery for the primary tumor; (2) the same technique or combination of techniques used in the baseline study should also be used in the subsequent phases of evaluation between treatment rounds and restaging until the end of treatment. It would also be desirable that the baseline and follow-up examinations were always performed with the same scanner, the same examination technique (including the scanner settings) and the same operator, although this is clearly difficult to obtain in clinical practice.
Alternatively, the calculation can be based on measurement of the lesion perimeter. However, these are at least in part abstractions, since the measurements can be influenced by a number of factors, including the irregular shape of the lesion or ill-defined and infiltrating margins. Volumetric measurements performed in 3D are more accurate than those in 2D, with less interobserver variability and a greater repeatability. The measurements obtained are less dependent on the dimensions, morphology and echostructure of the lesion [114,121].