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

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Abstract

Objective

To evaluate the reliability of contrast-enhanced ultrasound quantitative analysis (CE-US) in characterizing breast lesions, in comparison with MRI.

Materials

Thirty-nine patients with breast lesions BI-RADS 3–5 at US or mammography underwent CE-US and MRI. All lesions underwent histological and quantitative enhancement evaluation with both imaging methods. B-mode US, colour/power Doppler US and CE-US were used; an amplitude and phase modulation technique (CPS) read the signals produced by microbubbles and dedicated software produced the following parameters on time/intensity (T/I) curves: peak %, time to peak (TTP), mean transit time (MTT), regional blood volume (RBV) and regional blood flow (RBF). Student’s t test was used to calculate the diagnostic accuracy of CE-US parameters compared with histological results. MRI (1.5 T) was performed before and after bolus gadolinium enhancement. Time/intensity curves were generated for all nodules and Fischer’s multimodal score was used to classify them.

Results

Pathology showed 43 nodules (11 benign; 32 malignant). Peak and RBF were the most significant parameters in differential diagnosis, with p values of 0.02 and 0.004, respectively. Positive predictive value (PPV) of CE-US evaluation was 91%, negative predictive value (NPV) was 73% with a high concordance index (k = 0.59) with MRI.

Conclusions

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

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Authors and Affiliations

  1. Department of Radiology, Az. Ospedaliero-universitaria Policlinico, via del pozzo 71, 41100, Modena, Italy

    Natalia Caproni, Annarita Pecchi, Barbara Canossi, Rachele Battista & Piero D’Alimonte

  2. Department of Radiology, Nuovo Ospedale Civile di Sassuolo, 41049, Sassuolo, Modena, Italy

    Francesca Marchisio

  3. Department of Radiology, Università degli Studi di Modena e Reggioemilia, via del pozzo 71, 41100, Modena, Italy

    Pietro Torricelli

Authors
  1. Natalia Caproni
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  2. Francesca Marchisio
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  3. Annarita Pecchi
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  4. Barbara Canossi
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  5. Rachele Battista
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  6. Piero D’Alimonte
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  7. Pietro Torricelli
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Correspondence to Natalia Caproni or Pietro Torricelli.

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Caproni, N., Marchisio, F., Pecchi, A. et al. Contrast-enhanced ultrasound in the characterisation of breast masses: utility of quantitative analysis in comparison with MRI. Eur Radiol 20, 1384–1395 (2010). https://doi.org/10.1007/s00330-009-1690-1

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  • DOI: https://doi.org/10.1007/s00330-009-1690-1

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