Patent Publication Number: US-2022233165-A1

Title: All-in-one mammography and breast ultrasonography apparatus

Description:
CROSS-REFERENCE TO RELATED APPLICATION OF THE INVENTION 
     The present application claims the benefit of Korean Application No. 10-2021-0009513, filed on Jan. 22, 2021, in the Korean Intellectual Property Office, the disclosure of which is incorporated by reference herein in its entirety. 
     Technical Field 
     The present invention relates to a technique for diagnosing breast cancer, and more particularly, to an all-in-one mammography and breast ultrasonography apparatus capable of performing mammography and breast ultrasonography under the same conditions. 
     Background Art 
     The most basic tests for diagnosing breast cancer are mammography and breast ultrasonography. Mammography is a method of imaging a breast using X-rays and is used to examine breast cancer by imaging tumors, mammary gland enlargement and fibrosis inside a breast, and microcalcification of a breast. Breast ultrasonography is a method of imaging a breast using ultrasound, and makes it easy to distinguish fat, muscles, and mammary glands inside a breast and to check lesions such as tumors or the like. Breast ultrasonography is mainly used when examining a dense breast with a high mammary gland density or a breast having nodules. Breast ultrasonography has been performed as a secondary examination when abnormal findings are found on mammography. In recent years, breast ultrasonography is also performed as a primary examination together with mammography. 
     The reason why mammography and breast ultrasonography are performed in parallel is that different kinds of information are obtained from the same object due to the difference in characteristics between X-rays and ultrasound. For example, in the case of mammography, it is difficult to distinguish between a mammary gland and a tumor, and it is difficult to identify an accurate lesion in a dense breast. Therefore, in mammography, the lesion is inferred through microcalcification. Breast ultrasonography is capable of distinguishing a mammary gland from a tumor, which makes it possible to accurately identify a lesion. However, it is difficult to identify microcalcification. In general, ultrasound equipment for breast ultrasonography is composed of a handheld type in which medical staff directly hold and use the ultrasound equipment with their hands. In the case of handheld type ultrasound equipment, the image of the breast may be taken differently depending on the skill level of the medical staff. Therefore, it is difficult to diagnose breast cancer uniformly and accurately because there are variations in the accuracy of the location of a breast cancer lesion. 
     “Apparatus for ultrasonic examination of deformable object” disclosed in Korean Patent No. 10-0668766 (U.S. Pat. No. 7,963,918 B2) includes: a frame; a caterpillar having a flat surface on which a deformable object with rigidity in the width direction is placed, the caterpillar installed on the frame to move forward and backward with a constant movable distance in the longitudinal direction; a driving means for moving the caterpillar forward and backward; and at least one ultrasound probe arranged long in the width direction of the caterpillar, so that the ultrasound transmission/reception surface is located on the substantially same plane as the upper surface of the caterpillar, and fixed to the caterpillar so that the ultrasound probe is located more inward from both sides in the longitudinal direction than the movable distance of the upper surface of the caterpillar. The apparatus disclosed in this patent document has an advantage in that an ultrasound examination can be performed while moving the ultrasound probe in a state in which the position and shape of an object are maintained. 
     “Dual-Modality Mammography” disclosed in U.S. Pat. No. 9,636,073 B2 is configured to implement mammography and breast ultrasonography using one scanner. The scanning assembly includes a housing configured to define a scanning surface, an ultrasound transducer mounted inside the housing so that it can move on a plane parallel to the scanning surface to image biological tissue, and an X-ray detector mounted inside the housing to take X-ray images by X-rays passing through biological tissue from an X-ray source. The X-ray detector may be configured as a linear slot X-ray detector or a flat panel detector. The dual-modality mammography disclosed in this patent document has an advantage in that mammography and breast ultrasonography can be performed by a single scanner. The contents disclosed in the above patent documents are incorporated herein by reference. 
     As described above, Korean Patent No. 10-0668766 discloses that breast ultrasonography can be performed while the ultrasound probe is moved by the caterpillar. However, mammography cannot be performed. Therefore, there is a problem that a separate mammography apparatus is required. In addition, since the X-ray image of the mammography apparatus and the ultrasound image of the breast ultrasonography are acquired under the condition in which the position and pressing level of the breast are different, there is a limitation in accurately examining a lesion by matching the two images. 
     U.S. Pat. No. 9,636,073 B2 discloses that mammography using an X-ray source and an X-ray detector and breast ultrasonography using an ultrasound transducer can be performed by one scanner. However, as the scanning distance, i.e., the feeding distance of the ultrasound transducer for mammography increases, the length of the housing increases and the size of the driver for moving the ultrasound transducer also increases. Therefore, there is a problem in that the size and weight of the scanner are increased, thereby lowering the operability, and increasing the manufacturing cost. In addition, as the scanning distance increases, the time required for breast ultrasonography increases, which leads to a problem in that the efficiency of breast cancer examination is reduced. 
     SUMMARY 
     In view of the problems inherent in the mammography and the breast ultrasonography mentioned above, it is an object of the present invention to provide a novel all-in-one mammography and breast ultrasonography apparatus that can perform mammography by an X-ray imaging device and breast ultrasonography by two ultrasound probes arranged on both sides of an X-ray flat panel detector, under the same condition. 
     Another object of the present invention is to provide a novel all-in-one mammography and breast ultrasonography apparatus that can perform breast ultrasonography for each of left and right breasts by each of two ultrasound probes arranged on both sides of an X-ray flat panel detector, thereby shortening the scanning distance, reducing the size and weight of the apparatus, improving the operability, and enhancing the efficiency of breast cancer examination. 
     A further object of the present invention is to provide a novel all-in-one mammography and breast ultrasonography apparatus that has a simple structure for enabling an X-ray flat panel detector and two ultrasound probes to scan breasts according to the orbital motion of an orbital motion device, thereby enhancing the productivity, and reducing the manufacturing cost. 
     A still further object of the present invention is to provide a novel all-in-one mammography and breast ultrasonography apparatus in which an X-ray flat panel detector and two ultrasound probes are mounted on a carriage to move together, thereby reducing a position error between an X-ray image and an ultrasound image acquired in the apparatus. 
     A yet still further object of the present invention is to provide a novel all-in-one mammography and breast ultrasonography apparatus in which a caterpillar for moving an X-ray flat panel detector and two ultrasound probes together can firmly support pressed breasts. 
     An even yet still further object of the present invention is to provide a novel all-in-one mammography and breast ultrasonography apparatus that can freely adjust the height and orientation thereof according to the body type and the examination area of a subject. 
     According to one aspect of the present invention, there is provided an all-in-one mammography and breast ultrasonography apparatus. The all-in-one mammography and breast ultrasonography apparatus according to the present invention includes: a scanning table on which breasts are placed, the scanning table having a first axis aligned with a scanning direction of breasts and a second axis orthogonal to the first axis; an X-ray imaging device including an X-ray source arranged above the scanning table to generate X-rays for mammography and an X-ray flat panel detector arranged on the scanning table to detect the X-rays generated from the X-ray source; first and second ultrasound probes arranged on the scanning table so as to be adjacent to both ends of the X-ray flat panel detector to perform breast ultrasonography, the first and second ultrasound probes elongated along the second axis; and an orbital motion device installed on the scanning table to reciprocate the X-ray flat panel detector and the first and second ultrasound probes together along the first axis. 
     In the all-in-one mammography and breast ultrasonography apparatus according to the present invention, the orbital motion device may include: a carriage arranged on the scanning table to reciprocate along the first axis and having an upper surface on which the X-ray flat panel detector is mounted and on which the first and second ultrasound probes are mounted so as to be adjacent to both ends of the X-ray flat panel detector; a pair of caterpillars connected at one ends to both ends of the carriage so as to reciprocate the carriage along the first axis and including a plurality of links elongated along the second axis; a pair of sliding plates arranged on the scanning table to reciprocate along the first axis and connected to the other ends of caterpillars; and a horizontal linear actuator configured to drive the caterpillars along the first axis. The orbital motion device is configured to simultaneously move the X-ray flat panel detector and the first and second ultrasound probes and is configured to firmly support the breasts pressed against the scanning surface of the scanning table by the caterpillars. 
     The all-in-one mammography and breast ultrasonography apparatus according to the present invention can accurately and easily perform mammography by the X-ray imaging device and breast ultrasonography by the two ultrasound probes arranged on both sides of the X-ray flat panel detector, under the same condition, thereby shortening the scanning distance, reducing the size and weight of the apparatus, improving the operability, and enhancing the efficiency of breast cancer examination. Further, the all-in-one mammography and breast ultrasonography apparatus has the simple structure for enabling the X-ray flat panel detector and the two ultrasound probes to scan breasts according to the orbital motion of the orbital motion device, thereby enhancing the productivity, and reducing the manufacturing cost. Further, in the all-in-one mammography and breast ultrasonography apparatus, the X-ray flat panel detector and the two ultrasound probes are mounted on the carriage of the orbital motion device to move together, thereby reducing the position error between the X-ray image and the ultrasound image acquired in the apparatus and enhancing the examination accuracy. Further, in the all-in-one mammography and breast ultrasonography apparatus, the caterpillar for moving the X-ray flat panel detector and the two ultrasound probes together can firmly support pressed breasts, thereby reducing the error caused by the deformation of the breasts. Further, the all-in-one mammography and breast ultrasonography apparatus can freely adjust the height and orientation of the scanning table according to the body type and the examination area of the subject, thereby enhancing the ease of use. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         FIG. 1  is a perspective view showing an all-in-one mammography and breast ultrasonography apparatus according to the present invention. 
         FIG. 2  is a perspective view showing an operation of a gantry in the apparatus according to the present invention. 
         FIG. 3  is a front view showing the apparatus according to the present invention.  FIG. 4  is a side view showing the apparatus according to the present invention. 
         FIG. 5  is a perspective view showing a scanning table of the apparatus according to the present invention. 
         FIG. 6  is a plan view showing the scanning table of the apparatus according to the present invention. 
         FIG. 7  is a sectional view taken along line VII-VII in  FIG. 6 . 
         FIG. 8  is a perspective view showing the scanning table and the flat cover separated from each other in the apparatus according to the present invention. 
         FIG. 9  is a perspective view showing the scanning table and the inner frame separated from each other in the apparatus according to the present invention. 
         FIG. 10  is a perspective view showing the scanning table, the orbital motion device, the X-ray flat panel detector, the first and second ultrasound probes and the inner frame separated from each other in the apparatus according to the present invention. 
         FIG. 11  is a plan view illustrating the orbital motion device, the X-ray flat panel detector, the first and second ultrasound probes and the inner frame in the apparatus according to the present invention. 
         FIGS. 12A, 12B and 12C  are views showing a zero state of the apparatus according to the present invention. 
         FIGS. 13A, 13B and 13C  are views illustrating a left mediolateral oblique imaging state of the apparatus according to the present invention. 
         FIGS. 14A, 14B and 14C  are views illustrating a left mediolateral oblique imaging state of the apparatus according to the present invention. 
     
    
    
     DETAILED DESCRIPTION 
     Other objects, specific advantages and novel features of the present invention will become more apparent from the following detailed description and preferred embodiments taken in conjunction with the accompanying drawings. In describing the present invention, the size or shape of the components shown in the drawings may be exaggerated or simplified for clarity and convenience of description. In addition, the terms specifically defined in consideration of the configuration and operation of the present invention may vary depending on the intention or custom of a user or an operator. These terms should be interpreted as meanings and concepts consistent with the technical spirit of the present invention based on the contents throughout this specification. 
     Hereinafter, preferred embodiments of the all-in-one mammography and breast ultrasonography apparatus according to the present invention will be described in detail with reference to the accompanying drawings. 
     Referring first to  FIGS. 1 to 4 , the all-in-one mammography and breast ultrasonography apparatus  10  according to the present invention includes an upright stand  20  and a gantry  30  arranged on the front side of the upright stand  20 . The upright stand  20  has a first axis X 1 , a second axis Y 1  orthogonal to the first axis X 1 , and a third axis Z 1  orthogonal to the first axis X 1  and the second axis Y 1 . The upright stand  20  is composed of a hollow housing. The upright stand  20  may be configured as a portable upright stand that can be freely moved by a plurality of casters. A computer device  22  or a central processing unit (CPU) is installed on one side of the upright stand  20  so as to process an X-ray image and an ultrasound image by a program. A display  24  is mounted on the upright stand  20  so as to be connected to the computer device  22 . The gantry  30  is connected to the front side of the upright stand  20  so as to make translational motion along the third axis Z 1  direction (height direction) and make rotational motion about the second axis Y 1 . 
     The actuator means for providing a driving force for the Z-axis translational motion, i.e., the lifting of the gantry  30  may be composed of a vertical linear actuator (not shown) such as a chain transmission mechanism, a lead screw linear actuator, a belt driven linear actuator, a rack and pinion actuator, or the like, which is mounted inside the upright stand  20 . The actuator means for providing a driving force for the Y-axis rotational motion of the gantry  30  may be composed of a rotary actuator (not shown) such as an electric motor, a pneumatic motor, or the like, which is mounted inside the upright stand  20 . 
     Referring to  FIGS. 1 to 7 , the apparatus  10  according to the present invention includes a scanning table  40  disposed under the gantry  30  so that the breasts  2  can be placed on the scanning table  40  for mammography and breast ultrasonography. The scanning table  40  has a first axis X 2  (longitudinal direction) aligned with the scanning direction  4  of each breast  2 , a second axis Y 2  (width direction) orthogonal to the first axis X 2 , and a third axis Z 3  orthogonal to the first axis X 2  and the second axis Y 2 . The scanning table  40  defines a scanning surface  42  on which the breasts  2  are placed and includes a casing having a closed chamber  44 . A pair of liquid injection ports  46  are respectively coupled to both sides of the upper surface of the scanning table  40 . 
     Liquid  48 , for example, deionized water or non-conductive liquid as a medium (acoustic coupling medium) for transmission of X-rays and propagation of ultrasound waves is filled in the chamber  44  through the liquid injection ports  46 . Deionized water prevents attenuation and refraction of ultrasound waves, thereby improving the reliability of breast ultrasonography. Deionized water may flow out of the chamber  44  through the liquid injection ports  46 . A phenomenon in which air bubbles affect an ultrasound image when an air pocket is generated in the chamber  44  can be prevented by forming the liquid injection ports  46  on both sides of the upper surface of the scanning table  40  to allow injection and discharge of deionized water. A flat cover  50  is mounted on the upper surface of the scanning table  40  to form a scanning surface  42  for placing and scanning the breasts  2 . The cover  50  has transmittance enough to transmit X-rays and ultrasound waves. The cover  50  may be made of a polymethyl pentene film having excellent transmittance of ultrasound waves. 
     Referring to  FIGS. 1 to 12 , the apparatus  10  according to the present invention includes an X-ray imaging device  60  for mammography. The X-ray imaging device  60  includes an X-ray source  62  and an X-ray flat panel detector  64 . The X-ray source  62  or an X-ray generator or an X-ray tube is mounted on the upper side of the gantry  30  so as to be arranged above the scanning table  40 . The X-ray flat panel detector  64  or a two-dimensional X-ray detector is arranged at the upper portion of the chamber  44  so as to reciprocate along the first direction X 1 . The upper surface of the X-ray flat panel detector  64  is aligned with an arbitrary horizontal plane  66  parallel to the scanning surface  42 . The X-ray flat panel detector  64  may have a width of 300 mm and a length of 240 mm. 
     The apparatus  10  according to the present invention includes first and second ultrasound probes  70  and  72  for breast ultrasonography. The first and second ultrasound probes  70  and  72  are arranged to be adjacent to both ends of the X-ray flat panel detector  64  and are elongated in the second axis Y 2  direction. The reception/transmission surface  74  of each of the first and second ultrasound probes  70  and  72  is arranged on a horizontal plane  66  that is substantially flush with the upper surface of the X-ray flat panel detector  64 . Each of the first and second ultrasound probes  70  and  72  may have a width of 10 mm and a length of 240 mm. Each of the first and second ultrasound probes  70  and  72  is configured as a phased array type probe. In the phased array method, a plurality of elements is formed in a probe to perform breast ultrasonography by electronic scanning. 
     As shown in  FIGS. 6 to 12 , the apparatus  10  according to the present invention includes an orbital motion device  80  mounted inside the scanning table  50  so as to reciprocate the X-ray flat panel detector  64  and the ultrasound probes  70  and  72  together along the first axis X 2  of the scanning table  50 . The orbital motion device  80  includes a carriage  82 , a pair of caterpillars  84 , a pair of sliding plates  86 , and a horizontal linear actuator  90 . 
     The carriage  82  is mounted inside the scanning table  50  so as to reciprocate along the first axis X 2 . The X-ray flat panel detector  64  is mounted at the center of the upper surface of the carriage  82 . The first and second ultrasound probes  70  and  72  are respectively mounted on both edges of the upper surface of the carriage  82  so as to be adjacent to both ends of the X-ray flat panel detector  64 . 
     Each of the caterpillars  84  is mounted inside the scanning table  50  so as to reciprocate the carriage  82  by orbital motion along the first axis X 2 . One end of each of the caterpillars  84  is connected to each of both ends of the carriage  82 . Each of the caterpillars  84  includes an upper track  84   a  flatly arranged on the upper side, and a lower track  84   b  horizontally arranged below the upper track  84   a  at a distance from the upper track  84   a.  The upper surface of the upper track  84   a  may be arranged flatly or horizontally on an arbitrary horizontal plane  66  that is substantially flush with the upper surfaces of the X-ray flat panel detector  64  and the first and second ultrasound probes  70  and  72 . The flat upper track  84   a  supports the breasts  2  pressed against the cover  52 , for example, a polymethyl pentene film to prevent deformation of the cover  52  and maintains the pressed state of the breasts  2 . Each of the caterpillars  84  is formed by the connection of a plurality of links  84   c  which are elongated along the second axis Y 2 . The upper surface of each of the links  84   c  is formed to be flat and has rigidity along the second axis Y 2 . 
     Each of the sliding plates  86  is arranged below the chamber  44  so as to reciprocate along the first axis X 2 . The sliding plates  86  are connected to each other by a hinge  86   a.  The other end of each of the caterpillars  84  is connected to each of the sliding plates  86  so as to interlock with each of the sliding plates  86 . 
     The horizontal linear actuator  90  or an X-axis linear actuator includes a belt transmission device  92  and a horizontal linear motion guide  94 . The belt transmission device  92  is mounted inside the scanning table  50  along the first axis X 2  to provide a driving force for orbital motion of the caterpillars  84 . The belt transmission device  92  includes a driving motor  92   a,  a pair of driving pulleys  92   b,  a pair of driven pulleys  92   c,  and a pair of belts  92   d.    
     The driving motor  92   a  is mounted on one side of the back surface of the scanning table  50  to provide a driving force and may be configured as an electric motor. The driving pulleys  92   b  are connected to the driving motor  92   a  by a driving shaft  92   e  so as to be rotated by the driving force of the driving motor  92   a  and are mounted on one side inside the scanning table  50  so as to be adjacent to the caterpillars  84 . The driven pulleys  92   c  are mounted on one side inside the scanning table  50  so as to be able to rotate adjacent to both sides of each of the caterpillars  84  and are connected to each other by a driven shaft  92   f.  The belts  92   d  travels while being wound around the driving pulleys  92   b  and the driven pulleys  92   c.  The belts  92   d  may be configured as timing belts. The carriage  82  is fixed to one side of the belts  92   d  so that it can be moved together with the belts  92   d.  The carriage  82  is fixed to the lower tracks  82   b  of the caterpillars  84 . In some embodiments, the belt transmission device  92  may be configured as a lead screw linear actuator, a pinion actuator, or the like that can reciprocate the carriage  82  along the first axis X 2 . 
     The horizontal linear motion guide  94  is mounted inside the scanning table  50  so as to allow the carriage  82  to reciprocate in a linear motion along the X-axis direction. The horizontal linear motion guide  94  includes a pair of guide bars  94   a  and a plurality of sliders  94   b . The guide bars  94   a  are mounted on the bottom of the scanning table  50  side by side along the X-axis direction. The sliders  94   b  are mounted to slide along each of the guide bars  94   a  and are coupled to the carriage  82 . Each of the sliders  94   b  is coupled to each of the sliding plates  86  so as to guide the orbital motion of the caterpillar  84  into a linear motion. In some embodiments, the horizontal linear motion guide  94  may be configured as a monorail type linear motion guide having a guide rail and a slider sliding along the guide rail. 
     The apparatus  10  according to the present invention further includes an inner frame  100  configured to be mounted inside the chamber  44  of the scanning table  40  while holding the components of the orbital motion device  80  such as the carriage  82 , the pair of caterpillars  84 , the pair of sliding plates  86  and the horizontal linear actuator  90 . The inner frame  100  includes front and rear spacer plates  102  and  104 , a pair of side plates  106 , a rear cover plate  108 , and a pair of joint plates  110 . 
     The inner frame  100  is configured in the form of a casing or a housing with an open top. Each of the front and rear spacer plates  102  and  104  is mounted between both ends of the upper and lower tracks  92   a  and  92   b  so as to maintain the spacing between the upper and lower tracks  92   a  and  92   b.  Each of the side plates  106  is arranged inside each of the caterpillars  84  to connect each of the front and rear spacer plates  106 . The rear cover plate  108  is spaced apart from the rear spacer plate  104 . The joint plates  110  are arranged on both sides between the rear spacer plate  104  and the rear cover plate  108  to connect the rear spacer plate  104  and the rear cover plate  108 . The ease of assembly and the rigidity can be improved by modularization in which the orbital motion device  80  is mounted on the inner frame  100 . 
     The apparatus  10  according to the present invention further includes a table positioning linear actuator  120  configured to translationally move the scanning table  50  along the first axis X 2  during mammography and breast ultrasonography. The table positioning linear actuator  120  adjusts the position of the scanning table  50  according to the body type of the subject and the positions of the breasts  2 . The table positioning linear actuator  120  translationally moves the scanning table  50  along the first axis X 2  based on a connector  122  or a joint connected to the gantry  30 . The table positioning linear actuator  120  or an X-axis linear actuator is mounted on the back side of the scanning table  50  and may be configured as a lead screw linear actuator, a belt-driven linear actuator, a chain-driven linear actuator, or a rack and pinion actuator. A housing  124  is mounted on the back side of the scanning table  50  to accommodate the table positioning linear actuator  120 . 
     Referring to  FIGS. 1 to 4 and 12 , the apparatus  10  according to the present invention further includes a press plate  130  for pressing the breasts  2  against the scanning table  50 . The press plate  130  is arranged in front of the gantry  30  to press the breasts  2  by translational movement along the third axis Z 1 . The press plate  130  is arranged between the X-ray source  42  and the X-ray flat plate detector  64 . A window  132  is formed at the center of the press plate  130  to transmit the X-rays irradiated from the X-ray source  42 . For the transmission of X-rays and the propagation of ultrasound waves, a gel pad coated with a medium material, for example, semi-solid gel, may be mounted on the upper surface of the press plate  130  to cover the window  132 . The press plate  130  is translationally moved by the operation of a vertical linear actuator (not shown) such as a lead screw linear actuator, a belt-driven linear actuator, a chain-driven linear actuator, a rack and pinion actuator, or the like installed on the gantry  30 , thereby pressing the breasts  2 . 
     Hereinafter, the operation of the all-in-one mammography and breast ultrasonography apparatus according to the present invention having such a configuration will be described. 
     Referring to  FIGS. 1 to 4 and 12 , the height of the scanning table  50  is adjusted by elevating the gantry  30  so that the subject can put the breasts  2  on the upper surface of the cover  52  in a comfortable posture. After the subject places the breasts  2  on the scanning table  50 , the press plate  130  is moved down to press the breasts  2 . By pressing the breasts  2  in this way, it is possible to enhance the sensitivity, accuracy and consistency of ultrasonography for a breast lump. 
     Referring to  FIGS. 12 to 14 , the mammography using the X-ray imaging device  60  and the breast ultrasonography using the first and second ultrasound probes  70  and  72  are performed by cranio-caudal (CC) view imaging and mediolateral oblique (MLO) view imaging as standard imaging methods. The cranio-caudal (CC) view imaging is performed while the breasts  2  are pressed up and down by the scanning table  40  and the press plate  130 . The mediolateral oblique (MLO) view imaging is a method of imaging the breasts  2  at an angle of 30 to 60 degrees and includes left mediolateral oblique (LMLO) view imaging and right mediolateral oblique (RMLO) view imaging. 
       FIG. 12A  shows a zero state of the gantry  30  in which the gantry  30  is vertically arranged and the central ray of the X-rays irradiated from the X-ray source  62  and the center of the X-ray flat panel detector  64  are aligned. In the zero state of the gantry  30 , cranio-caudal (CC) view imaging for the breasts  2  may be performed.  FIG. 13A  shows LMLO view imaging in which the left side of each of the breasts  2  is imaged in a state in which the gantry  30  is rotated counterclockwise by about 45 degrees as indicated by arrow “A”.  FIG. 14A  shows RMLO view imaging in which the right side of each of the breasts  2  is imaged in a state in which the gantry  30  is rotated clockwise by about 45 degrees as indicated by arrow “B”. 
     The apparatus  10  according to the present invention can easily and accurately perform mediolateral oblique (MLO) view imaging for the side surfaces of the of the breasts  2  and the armpits by means of the X-ray imaging device  60  and the first and second ultrasound probes  70  and  72 . This mediolateral oblique (MLO) view imaging is one of mammography that is basically performed to examine the enlarged lymph glands extending downward from the armpits as an early cause of breast cancer. 
     Referring to  FIGS. 13B and 14B , during the MLO view imaging, the scanning table  40  is moved to the left or right based on the zero state of the gantry  30  by the operation of the table positioning actuator  120 . The breast  2  is aligned with the rotation center of the gantry  30  by the scanning table  40  being moved to the left or right. In addition, while reducing the scanning distance of the first and second ultrasound probes  70  and  72 , it is possible to expand the breast ultrasonography range and improve the examination efficiency. 
     Referring to  FIGS. 6 and 9 to 11 , when the driving motor  92   a  is driven to rotate the driving pulleys  92   b  to scan the breasts  2 , the belts  92   d  wound between the driving pulleys  92   b  and the driven pulleys  92   c  are caused to travel by the rotation of the driving pulleys  92   b.  As the belts  92   d  travel, the belts  92   d  and the fixed caterpillars  84  are orbitally moved to move the carriage  82  along the first axis X 2 , thereby moving the X-ray flat panel detector  64  and the first and second ultrasound probes  70  and  72  together. As shown in  FIGS. 13B and 13C , during the LMLO view imaging, the first ultrasound probe  70  previously moved to the left side of the scanning table  40  is moved to the right side to scan the left side of the breast  2 . As shown in  FIGS. 14B and 14C , during the RMLO view imaging, the second ultrasound probe  72  previously moved to the right side of the scanning table  40  is moved to the left side to scan the right side of the breast  2 . In this way, the right and left sides of the breast  2  can be accurately imaged while simultaneously moving the first and second ultrasound probes  70  and  72  along the first axis X 2  by the operation of the orbital motion device  80  during the MLO view imaging. In addition, the scanning distance of the first and second ultrasound probes  70  and  72  can be reduced to shorten the imaging time, and the size and weight of the scanning table  40  and the orbital motion device  80  can be reduced to improve the operability. 
     Meanwhile, the X-rays irradiated by the operation of the X-ray source  42  pass through the window  132  of the press plate  130 , the breasts  2 , the gel pad  134  and the cover  52  and are detected by the X-ray flat panel detector  64 . The signals detected by the X-ray flat panel detector  64  are displayed as X-ray images on the display  24  through image processing in the computer device  22 . 
     The ultrasound waves transmitted from the reception/transmission surface  74  by the operation of the first and second ultrasound probes  70  and  72  are irradiated to the breasts  2 , reflected from the breasts  2 , and then received by the reception/transmission surface  74 . The signals received by the first and second ultrasound probes  70  and  72  are displayed on the display  30  as ultrasound images through image processing by the computer program. When the mammography and the breast ultrasonography are completed, the press plate  130  is moved up by the operation of the vertical linear actuator  130  to release the pressure from the breasts  2 . 
     In the apparatus  10  according to the present invention, the X-ray flat panel detector  64  and the first and second ultrasound probes  70  and  72  are mounted on the carriage  82  of the orbital motion device  80  so as to move toward or away from the breasts  2  pressed between the scanning table  50  and the press plate  130 . This makes it possible to accurately know the coordinate values of the X-ray images acquired by the X-ray flat panel detector  64  and the coordinate values of the ultrasound images acquired by the ultrasound probes  70  and  72 . Accordingly, the accuracy of breast cancer diagnosis may be enhanced by precisely matching the X-ray image and the ultrasound image through the processing in the computer device  32 . 
     The embodiment described above is merely illustrative of a preferred embodiment of the present invention. The scope of the present invention is not limited to the described embodiment. Those skilled in the art may make various changes, modifications, or substitutions within the technical spirit of the present invention and the claims. Such changes, modifications, or substitutions should be understood to fall within the scope of the present invention.