This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Forsberg, F. Articles by Needleman, L. Search for Related Content PubMed PubMed Citation Articles by Forsberg, F. Articles by Needleman, L.

Diagnosing Breast Lesions With Contrast-Enhanced 3-Dimensional Power Doppler Imaging

Departments of Radiology (F.F., B.B.G., C.R.B.M., L.P., A.J.M., D.A.M., S.M.S., L.N.) and Pathology (J.J.P.), Thomas Jefferson University, Philadelphia, Pennsylvania USA.

Address correspondence and reprint requests to Flemming Forsberg, PhD, Department of Radiology, Division of Ultrasound, Thomas Jefferson University, Suite 763J, Main Building, 132 S 10th St, Philadelphia, PA 19107 USA. E-mail: flemming.forsberg{at}jefferson.edu.

Objective. To compare mammography with contrast-enhanced 2- and 3-dimensional power Doppler imaging for the diagnosis of breast cancer. Methods. Fifty-five patients, who underwent breast biopsies with histopathologic assessment, participated in a study of mammography and contrast-enhanced sonography. Levovist (Berlex Laboratories, Montville, NJ) and Optison (Mallinckrodt, St Louis, MO) were administrated to 22 and 33 patients, respectively. Precontrast and postcontrast 2-dimensional power Doppler data of the lesion were obtained with an HDI 3000 system (Philips Medical Systems, Bothell, WA), and 3-dimensional data were acquired with an LIS 6000A system (Life Imaging Systems Inc, London, Ontario, Canada). Two independent and blinded readers assessed diagnosis. Receiver operating characteristic curves were computed individually and in combination for mammography and 2- and 3-dimensional sonography (before and after contrast). Histopathologic and imaging parameters were compared by Mann-Whitney statistics. Results. Mammographic findings were available for 50 patients, biopsy for 54, and 2- and 3-dimensional sonographic images for 53 and 52, respectively. Of the 50 patients who had all 4 measures, 15 (30%) had malignancies. The areas under the receiver operating characteristic curve for the diagnosis of breast cancer were 0.51 for 2-dimensional contrast-enhanced imaging, 0.60 for 3-dimensional power Doppler imaging, and 0.76 for 3-dimensional contrast-enhanced imaging (P < .01). Mammography produced an area of 0.86, which increased when combined with 3-dimensional contrast-enhanced imaging to 0.90 and with all sonographic modalities to 0.96 (P < .001). The histopathologic diagnosis of benign or malignant correlated with the presence or absence of anastomoses and with the degree of vascularity assessed with contrast-enhanced 3-dimensional power Doppler imaging (P = .007 and .02). Conclusions. Contrast-enhanced 3-dimensional power Doppler imaging increases the ability to diagnose breast cancer relative to conventional 2- and 3-dimensional sonographic imaging.

Key Words: breast cancer • mammography • sonographic contrast media • 3-dimensional sonographic imaging

Abbreviations: A_z, area under the ROC curve • DCIS, ductal carcinoma in situ • ROC, receiver operating characteristic • 3D, 3-dimensional • 2D, 2-dimensional

This article has been cited by other articles:

				H. Liu, Y.-X. Jiang, J.-B. Liu, Q.-L. Zhu, Q. Sun, and X.-Y. Chang Contrast-Enhanced Breast Ultrasonography: Imaging Features With Histopathologic Correlation J. Ultrasound Med., July 1, 2009; 28(7): 911 - 920. [Abstract] [Full Text] [PDF]

				W. Luo, K. Numata, M. Morimoto, A. Nozaki, Y. Nagano, K. Sugimori, and K. Tanaka Three-Dimensional Contrast-Enhanced Sonography of Vascular Patterns of Focal Liver Tumors: Pilot Study of Visualization Methods Am. J. Roentgenol., January 1, 2009; 192(1): 165 - 173. [Abstract] [Full Text] [PDF]

				F. Forsberg, C. W. Piccoli, D. A. Merton, J. J. Palazzo, and A. L. Hall Breast Lesions: Imaging with Contrast-enhanced Subharmonic US Initial Experience Radiology, September 1, 2007; 244(3): 718 - 726. [Abstract] [Full Text] [PDF]

				R.-F. Chang, S.-F. Huang, W. K. Moon, Y.-H. Lee, and D.-R. Chen Solid Breast Masses: Neural Network Analysis of Vascular Features at Three-dimensional Power Doppler US for Benign or Malignant Classification Radiology, April 1, 2007; 243(1): 56 - 62. [Abstract] [Full Text] [PDF]

				F. Forsberg, D. A. Merton, and B. B. Goldberg In Vivo Destruction of Ultrasound Contrast Microbubbles Is Independent of the Mechanical Index J. Ultrasound Med., January 1, 2006; 25(1): 143 - 144. [Full Text] [PDF]