Contrast-enhanced ultrasound in the characterisation of breast masses: utility of quantitative analysis in comparison with MRI

Abstract

CE-US quantitative analysis offers an objective and reproducible assessment of lesion vascularisation, with good correlation with the results of MRI.

Comparative Study of Contrast-Enhanced Ultrasound Qualitative and Quantitative Analysis for Identifying Benign and Malignant Breast Tumor Lumps

“…The results of this study showed that six indicators of qualitative analysis exhibited the differences in the benign and malignant groups, which reflected that the malignant breast tumor lumps were often rapid perfused, with heterogeneous enhancement, when reaching the peak, they exhibited the high enhancement and expanded diameters, the borders were not clear, and the edges would exhibit the feature of radial enhancement; while the benign tumor exhibited the slow perfusion progress, homogeneous enhancement, equal or low enhancement when reaching the peak, clear boundary, non-expanded diameter, and no radial enhanced edge. the multivariate analysis revealed that the enhanced homogeneity, expanded diameter or not, as well as the peak intensity grade were the main factors, and the enhanced homogeneity were the most prominent factor, indicating that the enhanced homogeneity would play the most role in determining the benign and malignant tumors, similar to the previous studies (Caproni et al, 2010;Zhao et al, 2010;Du et al, 2012). The relative pathophysiological basis lied in that the tumor cells would often secrete a large number of vascular endothelial growth factor (VEGF), thus generating a large number of fresh tiny blood vessels, but due to the vigorous growth of malignant cells, the tiny blood vessels could not supply the sufficient nutrients needed by the tumor cells, so the tumors would occur the internal necrosis, furthermore, the metastasis of tumor cells would often block these new blood vessels, further causing the tumor internal ischemia (Metz et al, 2003;Du et al, 2008), followed by the appearance of uneven distribution or filling defect of contrast agent inside the malignant tumors.…”

“…CEUS quantitative parameters are obtained from time-intensity (T/I) curve using dedicated software, which offers an objective and reproducible assessment of lesion vascularisation. Although there are many quantitative researches towards the breast US imaging, and the types of quantization parameters are also plenty (Caproni et al, 2010;Palmowski et al, 2010;Paolo et al, 2011;Wan et al, 2012), the research about the evaluation of diagnostic capability of US quantitative analysis is still rare, this study aimed to investigate and compare the application values of CEUS qualitative and quantitative analysis towards the identification of benign and malignant breast tumor lumps.…”

Optimization of Region of Interest Drawing for Quantitative Analysis

“…[10][11][12] In this study, the peak signal intensity was significant only for the 15-mm ROI. The initial slope was significant in only 1 previous report, 12 but our results suggested that the initial slope was the most significant parameter.…”

“…However, the methods of ROI selection varied between studies, and previous reports have not discussed appropriate ROI selection. [10][11][12][13][14] This study was performed to investigate whether there are significant differences in kinetic parameters between benign and malignant breast lesions using different ROIs based on raw data from the same contrast-enhanced breast sonographic examinations. To our knowledge, this study is the first quantitative analysis of breast contrast-enhanced sonography using the perflubutane-based contrast agent Sonazoid, and the results were compared with previous quantitative studies using another second-generation contrast agent (SonoVue).…”

Quantitative correlational study of microbubble‐enhanced ultrasound imaging and magnetic resonance imaging of glioma and early response to radiotherapy in a rat model

“…This allows CEUS to evaluate angiogenesis quantitatively. [42][43][44] Currently, CEUS is widely applied clinically and has significantly improved the measurement of tumor tissue at the microcirculation level. [45][46][47][48] CEUS has also been applied to the assessment of therapy response in additional to traditional 2D anatomical or Doppler imaging.…”