Ultraschall Med 2008; 29 - OP_3_6
DOI: 10.1055/s-2008-1079832

Contrast-enhanced ultrasonography (CEUS) with application of time intensity curves (TICS) software – is differential diagnostics of the breast lesion possible? on the basis of chosen pathologies

M Jedrzejczyk 1, K Mlosek 1, W Jakubowski 1
  • 1Medical University of Warsaw, 2nd Medical Faculty, Department of Diagnostic Imaging

Aims: Estimation of usefulness and reliability of CEUS and TICs in differential diagnostics of breast lesions.

Materials and methods: In 55 patients with ultrasound or mammography suspicion for breast solid mass (73 lesions) CEUS examination of each lesion was performed. The ultrasound equipment used in the trial was the Easote Technos MPX machine with CnTi option. Examination was performed using low MI (<0.2) after injection of 2.4ml of SonoVue and was recorded continuously for at least 2 minutes. Enhancement pattern estimation and TIC evaluation were conducted by two physicians involved in patient examination. All lesions were verified by FNAB (n=64) or histopathologicaly after tumor resection (n=32).

Results: In comparison to cyto-/histopathological outcomes (n=73) we brought forward with help of CEUS and TICs 58 correct diagnosis – fibro-adenoma: 17/23, cancer: 22/24, ductal hyperplasia: 0/6, papilloma: 2/3, complicated cyst: 17/17.

We obtained 12 false positive (malignant tumor) results: 5 fibro-adenoma, 1 papilloma, 6 ductal hyperplasia. Rest of the lesions (n=3) were described as indeterminated: 1 fibro-adenoma and 2 malignant tumors.

Malignant tumors were characterized by fast, intensive and prolonged enhancement with many feeding vessels entering lesion from different sides. However it was impossible to differentiate between small cancer and hyperplasia. All cystic lesions did not enhanced at all. Fibro-adenoma lesions were enhancing slower then malignant lesions, mostly from marigns to the center, with single/few large feeding vessels, enhancement was not so intensive as in malignant tumors and wash-out was significantly faster.

Conclusions: CEUS with implementation of TICs software allows differentiation of breast lesions for malignant and benign, moreover it can help in differentiation between some types of pathologies. It is recommended to estimate enhancement pattern of the lesion as well as TIC features.

The work is supported by scientific garnt from the Ministry of Science and Higher Education No. 3C59.