title: [Tissue harmonic imaging (THI) and contrast harmonic imaging (CHI) for sonographically guided vacuum-assisted biopsy of mammographically occult breast tumors].
abstract: OBJECTIVE
  To assess the guidance of tissue harmonic imaging (THI) and contrast harmonic imaging (CHI) for vacuum assisted biopsies of suspicious breast lesions compared to fundamental B-mode ultrasound-guided biopsies.
  
  
  METHODS
  In 550 patients, ultrasound examinations of the breast were performed prospectively using fundamental B-scan, THI, and CHI. Focal lesions were documented in comparable projections for all three ultrasound modes. As contrast agent, a dose of 0.5 milliliters of Perflutren Protein-Type A microspheres ( Optison) was injected. An ultrasound-guided biopsy was performed in 38 focal lesions. Three radiologists experienced in breast imaging retrospectively assessed the lesions on the ultrasound images.
  
  
  RESULTS
  Thirty-eight suspicious focal lesions [size 4 - 15 mm; median 8 mm] were detected by ultrasound. Of these, 29 were detected by fundamental B-scan images, 34 by THI, and 38 by CHI. Ultrasound-guided biopsy was performed on all of these lesions. No complications related to the biopsy were observed. In 25/38 cases, invasive carcinomas were found; in 6/38 ductal carcinomas in situ; in 3 cases metastases of already known invasive ductal carcinomas; and in 4 cases fibroadenomas. The size of the lesion was best identified using THI, smaller lesions (< 10 mm) using CHI.
  
  
  CONCLUSIONS
  THI and CHI can help to detect focal lesions in dense breasts. Both modes can make it easier to perform ultrasound-guided biopsies of focal breast lesions.
authors.affiliation: Institut für Röntgendiagnostik, Klinikum Passau. jung@fmi.uni-passau.de
authors.forename: E M
authors.initials: EM
authors.lastname: Jung
authors.forename: K-P
authors.initials: KP
authors.lastname: Jungius
authors.forename: M
authors.initials: M
authors.lastname: Lenhart
authors.forename: M
authors.initials: M
authors.lastname: Dengler
authors.forename: H
authors.initials: H
authors.lastname: Becker
authors.forename: N
authors.initials: N
authors.lastname: Rupp
mesh_terms: D001707:Biopsy, Needle; D001940:Breast / Q000473:pathology*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D002278:Carcinoma in Situ / Q000000981:diagnostic imaging* / Q000473:pathology; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging* / Q000473:pathology; D003287:Contrast Media; D005260:Female; D006801:Humans; D008327:Mammography; D008863:Microspheres; D011446:Prospective Studies; D016217:Ultrasonography, Mammary / Q000379:methods*; D014618:Vacuum
chemical_list: D003287:Contrast Media
vernacular_title: Tissue Harmonic Imaging (THI) und Contrast Harmonic Imaging (CHI) zur sonographisch gezielten Vakuumstanzbiopsie mammographisch okkulter Brusttumoren.