Published online before print August 9, 2007, 10.1148/radiol.2443061588
(Radiology 2007;244:718.)
A more recent version of this article appeared on September 1, 2007
Breast Lesions: Imaging with Contrast-enhanced Subharmonic US—Initial Experience1
Flemming Forsberg, PhD,
Catherine W. Piccoli, MD2,
Daniel A. Merton, BS, RDMS,
Juan J. Palazzo, MD, and
Anne L. Hall, PhD
1 From the Departments of Radiology (F.F., C.W.P., D.A.M.) and Pathology (J.J.P.), Thomas Jefferson University, Suite 763J, Main Building, 132 S 10th St, Philadelphia, PA 19107; and GE Healthcare, Milwaukee, Wis (A.L.H.). Received September 13, 2006; revision requested November 9; revision received January 10, 2007; final version accepted February 1. Supported in part by the U.S. Army Medical Research Material Command under DAMD17-00-1-0464 and by GE Healthcare, Princeton, NJ.
Address correspondence to F.F. (e-mail: flemming.forsberg{at}jefferson.edu).
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Figure 2a: Fibroadenoma (arrows) imaged in its largest section by using (a) baseline power Doppler mode and (b) SHI mode after injection of 4.0 mL of Optison. Although the correct diagnosis (probably benign) was obtained with both modalities, note the improved display in SHI mode of small intratumoral vessels (indicating that only minimal bubble destruction is occurring) and the excellent suppression of tissue echoes.
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Figure 2b: Fibroadenoma (arrows) imaged in its largest section by using (a) baseline power Doppler mode and (b) SHI mode after injection of 4.0 mL of Optison. Although the correct diagnosis (probably benign) was obtained with both modalities, note the improved display in SHI mode of small intratumoral vessels (indicating that only minimal bubble destruction is occurring) and the excellent suppression of tissue echoes.
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Figure 3a: Benign ductal microcalcifications and fibrocystic changes, as well as areas of hyperplasia and adenosis (arrows in a), are depicted along the longest axis with (a) contrast-enhanced power Doppler imaging and (b) SHI. Note the excessive color blooming in a compared with the improved depiction of small branching vessels within and around the lesion (arrows) in b. However, the SHI image is dominated by excessive noise outside the focal region, and a false-positive assessment was rendered with both imaging modes.
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Figure 3b: Benign ductal microcalcifications and fibrocystic changes, as well as areas of hyperplasia and adenosis (arrows in a), are depicted along the longest axis with (a) contrast-enhanced power Doppler imaging and (b) SHI. Note the excessive color blooming in a compared with the improved depiction of small branching vessels within and around the lesion (arrows) in b. However, the SHI image is dominated by excessive noise outside the focal region, and a false-positive assessment was rendered with both imaging modes.
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Figure 5: Individual ROC curves for the four imaging modalities: baseline gray-scale US (dotted line), contrast-enhanced power Doppler imaging (dash-and-dot line), SHI (solid line), and mammography (dashed line). Note the increased area under the curve for SHI compared with that for baseline US and contrast-enhanced power Doppler.
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Copyright © 2007 by the Radiological Society of North America.
) visualized in their largest cross sections. (b) Contrast-enhanced power Doppler image shows spotty peripheral flow in the cancer and more complete filling (color blooming artifact) in the cyst. (c) Gray-scale SHI image shows both peripheral and intratumoral flow in the cancer (*), while the cyst (
