Technical and Practical Use of Automated Breast Ultrasound in Breast Sonography

George Tsoukatos, BPS, RT(R)*

*Medical Imaging Consultant, Germantown, NY

Address correspondence to: George Tsoukatos, BPS, RT(R)Radiology Support ServicesPO Box 215, Germantown, NY 12526. Email:

Disclosure Statement: The author reports having no significant financial or advisory relationships with corporate organizations related to this activity.


In addition to digital mammography, digital breast tomosynthesis, and breast magnetic resonance imaging (MRI), diagnostic ultrasound (US)/sonography is a valuable supplementary tool in breast imaging. Breast sonography is often used as an additional breast cancer detection modality in women who have dense breast tissue and a negative mammogram. Sonography is currently the primary imaging modality recommended for guiding breast biopsies and other types of interventional breast procedures for its ability to monitor real-time needle-to-lesion guidance as well as for closer examination of suspicious lesions found on screening mammography.

However, conventional handheld US (HHUS) has several limitations such as operator dependence, small field-of-view, lack of reproducibility and standardization, as well as requiring a considerable amount of time from the radiologist for scanning oversight. To remedy some of these limitations, the incorporation and use of automated breast ultrasound scanners (ABUS) may be employed. ABUS is a dedicated method that scans the breast in an automated, standardized manner, with a transducer that is larger than that used in conventional breast sonography. It is a 3-dimensional imaging tool that can be used for supplemental screening primarily in women with dense breasts. In order to provide patients with high-quality and thorough breast screenings and in-depth examinations, radiologic technologists and sonographers should be familiar with the unique display mode, imaging features, patient positioning, and artifacts associated with using ABUS, which differ from those used in HHUS. This course will provide a review of breast anatomy, general information about sonography and the physics of sonography, as well as an update on the types of equipment used in breast sonography, the concepts, technical aspects, pitfalls, and the use of ABUS in clinical practice compared with traditional targeted HHUS.

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