Thursday, October 23, 2008

Suggestions on Imaging

To all,

Here is a collection of practical suggestions that we have compiled concerning acquiring good SureTouch scans.

Thanks to Ian, David and Jae for their help with this list.

Best regards,
Denis
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Some Practical Suggestions for Ensuring Good Image Acquisition with the Sure Touch System
  • The SureTouch system is a complementary clinical tool to the Clinical Breast Examination (CBE). It is designed to be used in conjunction with the CBE in order to highlight, enhance and document what the CBE examiner has felt. It should not be viewed as a replacement for CBE. The combination of SureTouch and CBE will provide optimal CBE clinical results.
  • The amount of pressure used on the breast should depend on the breast size and firmness. Ensuring that all four corners of the sensor probe are in contact with the breast tissue should be sufficient pressure for a good examination.
  • Rotate the patient slightly to the side to help flatten the breast region where the exam is being performed. Use your other hand to stabilize the breast tissue being scanned.
  • Use the mesh view to provide better examination feedback.
  • Rocking the probe in a circular motion will provide pressures at the corners to allow more reliable hardness measurement.
  • Be sure to collect sufficient data of the lesion. Continue to apply pressure and scan until the message turns green. This will give optimal results rather than performing just a quick press with the sensor.
  • The hardness calculation is a simple ratio of the peak pressure (subtracting the baseline) divided by the baseline (pressures at the corners) which is then scaled to fit from a 1-5 scale. If there is poor contact at the corners of the sensors, the system will return a hardness value of 5.
  • For patients with small breasts (or who have regions where it is not possible to load the entire probe), the hardness value may not be accurate due to insufficient tissue in contact with the probe. Typically in such cases, very little pressure is needed to load the probe enough for a good image. Since the calculated hardness may not be accurate, it is recommended that the operator examine all areas of the breast to see normal tissue, as well as the corresponding area in the opposite breast, using the same force level as used for the lesion. This can give us a comparison to assess how much the area of interest differs from the patient's baseline tissue hardness.
  • The algorithm size calculation is based on % peak so it can be adjusted to provide desired results. Lower percentage provides larger lesion size estimations, higher percentages provide smaller lesions estimations.
  • In a fatty breast where the background is consistently smooth, any small bump warrants further investigation.
  • A young women with fibrocystic breast tissue can be made to look very worrisome by pressing too hard or setting the color map pressure level very low (such as 10-20 kPa). Keep in mind the age and the monthly cycle and check the other breast if there is a concern. For these patients, set the color map to 40 kPa to visually flatten out the background. A cancerous lump will still show up much harder and prominent. (see earlier post on this topic)
  • For optimal calibration results, we suggest that the SureTouch system be turned on and stabilized for 30 minutes before tuning and calibrating the unit. Once calibration has been performed and remains on, then you shouldn’t have to recalibrate for the remainder of the day.
  • Just prior initiating to the examination, we suggest that the operator test the probe response by pressing down on the calibration pad to ensure that it is functional.
  • Finally, the five keys to collecting optimal SureTouch studies are: (1) use plenty of lubricant, (2) keep the sensor level against the breast when scanning, (3) keep the area of interest centered in the view area, (4) gently move the probe over the breast and (5) apply just sufficent pressure to the probe to load the edges of the sensor.

If you have any suggestions for the above list or suggestions for topics, please contact me at denis@medicaltactile.com.

Best regards,
Denis
Slide 13

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