Tumor vascularity of breast lesions: potentials and limits of contrast-enhanced Doppler sonography.
OBJECTIVE
We investigated improving the evaluation of benignity in breast lesions using Doppler sonography with galactose palmitic acid-coated microbubbles.


METHODS
In 77 patients with 84 breast tumors scheduled for surgical tumor removal, color-coded duplex sonography was performed before and after administration of Levovist. Of the 77 patients, 25 with 28 lesions had been treated for prior breast carcinoma. The parameters investigated were the following: degree of enhancement, number of tumor vessels, time to maximum enhancement, and the pattern of vascular morphology and course.


RESULTS
Findings in malignant tumors (n = 53) showed a greater number of vessels and a faster stronger enhancement after Levovist administration, whereas a definite partial overlap with results from benign tumors (n = 31) was found. The best distinction was produced by vascular morphology and course, with a sensitivity of 90% and a specificity of 81 %. In 23 of the 25 patients who previously underwent surgery, a clear distinction was possible between a postoperative scar (n = 11) and a tumor recurrence (n = 17).


CONCLUSIONS
Although administration of the contrast agent clearly improved evaluation of benign features on Doppler sonography, absolute certainty cannot be achieved. The feasibility of making an otherwise difficult distinction between a scar and tumor recurrence on sonography and mammography appears to be promising, but further studies are necessary.
Stuhrmann
M
M
All authors: Röntgenabteilung, Gemeinschaftskrankenhaus Herdecke, Universität Witten-Herdecke, Beckweg 4, 58313 Herdecke, Germany.
Aronius
R
R
Schietzel
M
M
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; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000098:blood supply / Q000000981:diagnostic imaging; D011134:Polysaccharides; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D018615:Ultrasonography, Doppler, Color; D016217:Ultrasonography, Mammary / Q000379:methods*
D003287:Contrast Media; D011134:Polysaccharides; C059891:SHU 508