Twinkling-guided ultrasound detection of polymethyl methacrylate as a potential breast biopsy marker: a comparative investigation

Christine U. Lee, Matthew W. Urban, A. Lee Miller, Susheil Uthamaraj, James W. Jakub, Gina K. Hesley, Benjamin G. Wood, Nathan J. Brinkman, James L. Herrick, Nicholas B. Larson, Michael J. Yaszemski, James F. Greenleaf

Research output: Contribution to journalArticlepeer-review


Since its first description 25 years ago, color Doppler twinkling has been a compelling ultrasound feature in diagnosing urinary stones. While the fundamental cause of twinkling remains elusive, the distinctive twinkling signature is diagnostically valuable in clinical practice. It can be inferred that if an entity twinkles, it empirically has certain physical features. This work investigates a manipulable polymeric material, polymethyl methacrylate (PMMA), which twinkles and has measurable surface roughness and porosity that likely contribute to twinkling. Comparative investigation of these structural properties and of the twinkling signatures of breast biopsy markers made from PMMA and selected commercially available markers showed how twinkling can improve ultrasound detection of devices intentionally designed to twinkle. While this specific application of detecting breast biopsy markers by twinkling may provide a way to approach an unmet need in the care of patients with breast cancer, this work ultimately provides a platform from which the keys to unlocking the fundamental physics of twinkling can be rigorously explored.

Original languageEnglish (US)
Article number26
JournalEuropean radiology experimental
Issue number1
StatePublished - Dec 2022


  • Artifact
  • Polymethyl methacrylate
  • Porosity
  • Surface properties
  • Ultrasonography

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


Dive into the research topics of 'Twinkling-guided ultrasound detection of polymethyl methacrylate as a potential breast biopsy marker: a comparative investigation'. Together they form a unique fingerprint.

Cite this