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© 2002 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 21:1227-1235 • 0278-4297

Correlation Between Color Power Doppler Sonographic Measurement of Breast Tumor Vasculature and Immunohistochemical Analysis of Microvessel Density for the Quantitation of Angiogenesis

Wei Tse Yang, MBBS, FRCR, Gary M. K. Tse, MBBS, FRCPC, Peggo K. W. Lam, MPhil, Constantine Metreweli, MBBChir, FRCR and Jenny Chang, MD, PhD

Department of Diagnostic Radiology and Organ Imaging (W.T.Y., C.M.) and Center for Clinical Trials and Epidemiological Research (P.K.W.L.), Chinese University of Hong Kong, Prince of Wales Hospital, and Department of Anatomical and Cellular Pathology, Prince of Wales Hospital (G.M.K.T.), Shatin, New Territories, Hong Kong; and Breast Care Center, Baylor College of Medicine, Houston, Texas (J.C.).

Address correspondence and reprint requests to Wei Tse Yang, MBBS, FRCR, Division of Diagnostic Imaging, Section of Breast Imaging, M. D. Anderson Cancer Center, 1515 Holcombe Blvd, Box 57, Houston, TX 77030-4095.

Objective. To record the correlation between color power Doppler sonographic measurement of breast tumor vasculature and immunohistochemical analysis of microvessel density for the quantitation of angiogenesis. Methods. Women with palpable breast masses scheduled for excision biopsy were scanned with two- and three-dimensional color power Doppler sonography before and after the administration of a sonographic contrast agent. Vessel counts were performed on two- and three-dimensional sonographic images before and after contrast agent administration. All tumors were surgically removed and underwent immunohistochemical analysis for microvessel density assessment. The sonographic measure of tumor vascularity was correlated with microvessel density. Results. Pathologic examination showed 43 breast cancers and 14 benign breast masses. Higher microvessel density was noted in malignant than benign breast masses (P < .0005). Color power Doppler sonographic measurement of tumor vessel number showed a significant positive correlation with tumor size (P < .05) and progesterone receptor negativity (P < .05). A significant positive correlation was observed between microvessel density and the number of intratumoral blood vessels assessed by both two- and three-dimensional color power Doppler sonography (P < .05). Regression models showed three-dimensional color power Doppler sonography to have a significantly higher correlation with microvessel density when compared with two-dimensional color power Doppler sonography at baseline (P < .005). The administration of a sonographic contrast agent did not improve correlation with microvessel density. Conclusions. A significant correlation was shown between color power Doppler sonographic measurement of tumor vascularity and microvessel density by immunohistochemical analysis. Further improvement in Doppler sonographic techniques to map capillary vessel flow should be explored to improve the current association with pathologic findings.

Key Words: angiogenesis • breast neoplasms • sonography, Doppler studies

Abbreviations: CPD, color power Doppler • ER, estrogen receptor • IHC, immunohistochemical • MR, magnetic resonance • MVD, microvessel density • PR, progesterone receptor • 3D, three-dimensional • 2D, two-dimensional




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