Can Doppler or Contrast-enhanced Ultrasound Analysis Add Diagnostically Important Information About the Nature of Breast Lesions?

Overview

Journal Clinics (Sao Paulo)

Publisher Elsevier

Specialty General Medicine

Date 2014 Feb 13

PMID 24519198

Citations 11

Authors

Daniela Stanzani

Luciano F Chala

Nestor de Barros

Giovanni G Cerri

Maria Cristina Chammas

Affiliations

Soon will be listed here.

Abstract

Objectives: Despite evidence suggesting that Doppler ultrasonography can help to differentiate between benign and malignant breast lesions, it is rarely applied in clinical practice. The aim of this study was to determine whether certain vascular features of breast masses observed by duplex Doppler and color Doppler ultrasonography (before and/or after microbubble contrast injection) add information to the gray-scale analysis and support the Breast Imaging-Reporting and Data System (BI-RADS) classification.

Methods: Seventy solid lesions were prospectively evaluated with gray-scale ultrasonography, color Doppler ultrasonography, and contrast-enhanced ultrasonography. The morphological analysis and lesion vascularity were correlated with the histological results.

Results: Percutaneous core biopsies revealed that 25/70 (17.5%) lesions were malignant, while 45 were benign. Hypervascular lesions with tortuous and central vessels, a resistive index (RI)≥ 0.73 before contrast injection, and an RI≥ 0.75 after contrast injection were significantly predictive of malignancy (p<0.001).

Conclusion: The combination of gray-scale ultrasonography data with unenhanced or enhanced duplex Doppler and color Doppler US data can provide diagnostically useful information. These techniques can be easily implemented because Doppler devices are already present in most health centers.

Citing Articles

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A systematic review and meta-analysis comparing the diagnostic capability of automated breast ultrasound and contrast-enhanced ultrasound in breast cancer.

Zhang H, Hu J, Meng R, Liu F, Xu F, Huang M Front Oncol. 2024; 13:1305545.

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The Importance of Superb Microvascular Imaging for the Differentiation of Malignant Breast Lesions from Benign Lesions.

Arslan F, Altunkeser A, Korez M, Aksoy N, Bayramoglu Z, Karagulle M Eur J Breast Health. 2022; 18(1):48-54.

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Superb Microvascular Imaging Technology Can Improve the Diagnostic Efficiency of the BI-RADS System.

Cai S, Wang H, Zhang X, Zhang L, Zhu Q, Sun Q Front Oncol. 2021; 11:634752.

PMID: 34249681 PMC: 8263934. DOI: 10.3389/fonc.2021.634752.

References

Raza S, Baum J . Solid breast lesions: evaluation with power Doppler US. Radiology. 1997; 203(1):164-8. DOI: 10.1148/radiology.203.1.9122386. View

Buadu L, Murakami J, Murayama S, Hashiguchi N, Toyoshima S, Sakai S . Colour Doppler sonography of breast masses: a multiparameter analysis. Clin Radiol. 1997; 52(12):917-23. DOI: 10.1016/s0009-9260(97)80224-3. View

Hollerweger A, Rettenbacher T, Macheiner P, Gritzmann N . New signs of breast cancer: high resistance flow and variations in resistive indices evaluation by color Doppler sonography. Ultrasound Med Biol. 1997; 23(6):851-6. DOI: 10.1016/s0301-5629(97)00029-x. View

Berg W, Blume J, Cormack J, Mendelson E, Lehrer D, Bohm-Velez M . Combined screening with ultrasound and mammography vs mammography alone in women at elevated risk of breast cancer. JAMA. 2008; 299(18):2151-63. PMC: 2718688. DOI: 10.1001/jama.299.18.2151. View

Cao X, Xue J, Zhao B . Potential application value of contrast-enhanced ultrasound in neoadjuvant chemotherapy of breast cancer. Ultrasound Med Biol. 2012; 38(12):2065-71. DOI: 10.1016/j.ultrasmedbio.2012.07.027. View

Wan C, Du J, Fang H, Li F, Zhu J, Liu Q . Enhancement patterns and parameters of breast cancers at contrast-enhanced US: correlation with prognostic factors. Radiology. 2012; 262(2):450-9. DOI: 10.1148/radiol.11110789. View

Gokalp G, Topal U, Kizilkaya E . Power Doppler sonography: anything to add to BI-RADS US in solid breast masses?. Eur J Radiol. 2008; 70(1):77-85. DOI: 10.1016/j.ejrad.2007.12.007. View

Less J, Skalak T, Sevick E, Jain R . Microvascular architecture in a mammary carcinoma: branching patterns and vessel dimensions. Cancer Res. 1991; 51(1):265-73. View

Chala L, Endo E, Kim S, de Castro F, Moraes P, Cerri G . Gray-scale sonography of solid breast masses: diagnosis of probably benign masses and reduction of the number of biopsies. J Clin Ultrasound. 2006; 35(1):9-19. DOI: 10.1002/jcu.20298. View

10.

Moon W, Im J, Noh D, Han M . Nonpalpable breast lesions: evaluation with power Doppler US and a microbubble contrast agent-initial experience. Radiology. 2000; 217(1):240-6. DOI: 10.1148/radiology.217.1.r00oc03240. View

11.

Du J, Wang L, Wan C, Hua J, Fang H, Chen J . Differentiating benign from malignant solid breast lesions: combined utility of conventional ultrasound and contrast-enhanced ultrasound in comparison with magnetic resonance imaging. Eur J Radiol. 2012; 81(12):3890-9. DOI: 10.1016/j.ejrad.2012.09.004. View

12.

Porter T, Xie F, Kilzer K . Intravenous perfluoropropane-exposed sonicated dextrose albumin produces myocardial ultrasound contrast that correlates with coronary blood flow. J Am Soc Echocardiogr. 1995; 8(5 Pt 1):710-8. DOI: 10.1016/s0894-7317(05)80386-4. View

13.

Crystal P, Koretz M, Shcharynsky S, Makarov V, Strano S . Accuracy of sonographically guided 14-gauge core-needle biopsy: results of 715 consecutive breast biopsies with at least two-year follow-up of benign lesions. J Clin Ultrasound. 2005; 33(2):47-52. DOI: 10.1002/jcu.20089. View

14.

Giuseppetti G, Baldassarre S, Marconi E . Color Doppler sonography. Eur J Radiol. 1998; 27 Suppl 2:S254-8. DOI: 10.1016/s0720-048x(98)00076-x. View

15.

Schroeder R, Bostanjoglo M, Rademaker J, Maeurer J, Felix R . Role of power Doppler techniques and ultrasound contrast enhancement in the differential diagnosis of focal breast lesions. Eur Radiol. 2003; 13(1):68-79. DOI: 10.1007/s00330-002-1413-3. View

16.

Wan C, Du J, Fang H, Li F, Wang L . Evaluation of breast lesions by contrast enhanced ultrasound: qualitative and quantitative analysis. Eur J Radiol. 2011; 81(4):e444-50. DOI: 10.1016/j.ejrad.2011.03.094. View

17.

Choi H, Kim H, Baek S, Kang B, Lee S . Significance of resistive index in color Doppler ultrasonogram: differentiation between benign and malignant breast masses. Clin Imaging. 2000; 23(5):284-8. DOI: 10.1016/s0899-7071(99)00152-7. View

18.

Caproni N, Marchisio F, Pecchi A, Canossi B, Battista R, DAlimonte P . Contrast-enhanced ultrasound in the characterisation of breast masses: utility of quantitative analysis in comparison with MRI. Eur Radiol. 2009; 20(6):1384-95. DOI: 10.1007/s00330-009-1690-1. View

19.

Wilson S, Greenbaum L, Goldberg B . Contrast-enhanced ultrasound: what is the evidence and what are the obstacles?. AJR Am J Roentgenol. 2009; 193(1):55-60. DOI: 10.2214/AJR.09.2553. View

20.

Kedar R, Cosgrove D, McCready V, Bamber J, Carter E . Microbubble contrast agent for color Doppler US: effect on breast masses. Work in progress. Radiology. 1996; 198(3):679-86. DOI: 10.1148/radiology.198.3.8628854. View