Evaluation of breast lesions with contrast-enhanced ultrasound using the microvascular imaging technique: Initial observations

Abstract

The objective of this study was to evaluate the usefulness of contrast-enhanced ultrasound using the microvascular imaging technique in the diagnosis of breast lesions. In 104 patients with 104 breast lesions scheduled for surgery, conventional and contrast-enhanced ultrasound using the microvascular imaging technique were performed after administration of SonoVue. The enhancement patterns of breast lesions were classified as no enhancement, peripheral enhancement, homogeneous enhancement, regional enhancement, or heterogeneous enhancement based on the morphologic features of enhancement. The diagnostic value of contrast-enhanced ultrasound using the microvascular imaging technique was analyzed with the observers blinded to the clinical data and pathology (which served as the gold standard). None of the enhancement patterns was suggestive of benignity, with a sensitivity of 18.3%, specificity of 97.7%, positive predictive value (PPV) of 91.7%, negative predictive value (NPV) of 46.2%, and accuracy of 51.5%. The peripheral enhancement pattern was suggestive of malignancy, with a sensitivity of 39.5%, specificity of 98.3%, PPV of 94.4%, NPV of 69.4%, and accuracy of 73.8%. Homogeneous, regional, and heterogeneous enhancement patterns did not show meaningful diagnostic information. Contrast-enhanced ultrasound using the microvascular imaging technique provides diagnostic information on breast lesions.

Malignant phyllodes tumor in an 11-year-old premenarchal girl

“…Breast lumps in prepubertal and adolescent girls can be imaged using the modalities of ultrasound, computed tomography, and magnetic resonance imaging. Thermography has been used to differentiate phyllodes from fibroadenoma [27], but more recently, the use of contrast-enhanced ultrasound with its ability to image the microvascular characteristics of breast lesions has shown encouraging results in the differentiation of these lesions [28,29]. Management of phyllodes tumor remains controversial, and the decision of how to treat this condition in younger patients can be even more challenging.…”

“…Management of phyllodes tumor remains controversial, and the decision of how to treat this condition in younger patients can be even more challenging. Spread is rare and usually hematogenous, primarily to the lungs, and there are anecdotal successes with adjuvant and palliative therapy [3,[20][21][22][23][24][25][26][27][28][29][30][31].…”

The current status of contrast-enhanced ultrasound in China

“…Liu et al [34] evaluated the usefulness of CEUS using the microvascular imaging technique in the diagnosis of breast lesions. The authors found that nonenhancement was suggestive of benignity, with a sensitivity of 18.3%, specificity of 97.7%, positive predictive value of 91.7%, negative predictive value of 46.2%, and accuracy of 51.5%.…”

Contrast-enhanced ultrasound using real-time contrast harmonic imaging in invasive breast cancer: comparison of enhancement dynamics with three different doses of contrast agent

“…(15) andZhao et al (16) used 2.4 mL dose of MB as a bolus to differentiate benign from malignant lesions in the breast. The same dose of 2.4 mL of contrast agent was used by Wang et al (17) in the study of different histopathological types of breast cancers.…”