Effects of a microbubble contrast agent on breast tumors: computer-assisted quantitative assessment with color Doppler US--early experience.
OBJECTIVE
To evaluate objectively the effects of a microbubble contrast agent on the color Doppler ultrasound (US) examination of breast lesions.


METHODS
Forty-seven patients aged 23-71 years underwent color Doppler US before and after intravenous injection of a microbubble contrast agent. A 3-minute computer-assisted assessment of the color pixel density (CPD) was used to evaluate objectively the increase in the number of color Doppler US signals, the transit time of the microbubble bolus, and the potential additional differential diagnostic information.


RESULTS
Peak CPD at contrast agent-enhanced color Doppler US was 14.3% +/- 8.1 (mean +/- 1 standard deviation) for carcinomas and 9.3% +/- 4.9 for benign lesions (P = .04). The time to peak enhancement was shorter in carcinomas (38 seconds +/- 20) than in benign tumors (71 seconds +/- 48, P = .02). Final CPD was close or equal to baseline values. With the median of 13% for peak CPD as a threshold, the sensitivity for this parameter was 55%, the specificity was 79%, and the accuracy was 62% (P = .04). For a median time to peak of 50 seconds, the sensitivity was 84%, the specificity was 57%, and the accuracy was 76%.


CONCLUSIONS
After microbubble contrast agent injection, carcinomas and benign lesions behave differently in degree, onset, and duration of Doppler US enhancement. High interindividual variability and temporal variations in the Doppler US signal still limit the value of these criteria for prospective diagnosis.
Department of Radiology, Lainz Hospital, Vienna, Austria.
S
S
Huber
T
T
Helbich
J
J
Kettenbach
W
W
Dock
I
I
Zuna
S
S
Delorme
D000328:Adult; D000368:Aged; D001783:Blood Flow Velocity / Q000502:physiology; D001943:Breast Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging*; D018270:Carcinoma, Ductal, Breast / Q000098:blood supply / Q000000981:diagnostic imaging*; D018275:Carcinoma, Lobular / Q000098:blood supply / Q000000981:diagnostic imaging*; D003287:Contrast Media; D005260:Female; D018226:Fibroadenoma / Q000098:blood supply / Q000000981:diagnostic imaging*; D005348:Fibrocystic Breast Disease / Q000000981:diagnostic imaging*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008875:Middle Aged; D011134:Polysaccharides; D012680:Sensitivity and Specificity; D018615:Ultrasonography, Doppler, Color
D003287:Contrast Media; D011134:Polysaccharides; C059891:SHU 508