title: New potential and applications of contrast-enhanced ultrasound of the breast: Own investigations and review of the literature.
abstract: Imaging of angiogenesis is a challenge for modern imaging. Velocimetry in malignant breast lesions and density of malignant vessels are very low. In breast imaging, first results of contrast-enhanced ultrasound (CEUS) were disappointing. Microbubbles are fragile when examined with high frequency US, commonly used in breast imaging. Second-generation contrast agents increase intensively the signal level of breast lesions and new sequences like CPS (Coherence Pulse Sequencing) might be accurate to detect malignant vessels in breast lesions for characterization, to assess the extent of infiltrative breast carcinoma or to evaluate the tumor response after chemotherapy. Another interesting clinical application is the differentiation between post-operative changes and recurrences. In this review, we detail the main results obtained with contrast ultrasonography in a characterization study. In malignant lesions, enhancement was fast, starting with less than 20s. Compared to MR, enhancement appeared faster. Malignant vessels were predominant in the external ring of the nodule, conversely vessels were seen in the center of the lesion in benign nodules. Malignant vessels were also seen outside the lesion. This knowledge could lead the surgeon to perform a larger lumpectomy in these cases, to obtain sane margins and to reduce recurrences.
authors.affiliation: Radiology Department, Institut Gustave Roussy, 39 rue Camille Desmoulins, 94805 Villejuif Cedex, France. balleyguier@igr.fr
authors.forename: Corinne
authors.initials: C
authors.lastname: Balleyguier
authors.forename: Paule
authors.initials: P
authors.lastname: Opolon
authors.forename: Marie Christine
authors.initials: MC
authors.lastname: Mathieu
authors.forename: Alexandra
authors.initials: A
authors.lastname: Athanasiou
authors.forename: Jean Rémi
authors.initials: JR
authors.lastname: Garbay
authors.forename: Suzette
authors.initials: S
authors.lastname: Delaloge
authors.forename: Clarisse
authors.initials: C
authors.lastname: Dromain
mesh_terms: D001943:Breast Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging*; D003287:Contrast Media; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D009389:Neovascularization, Pathologic / Q000000981:diagnostic imaging*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016217:Ultrasonography, Mammary / Q000379:methods*
chemical_list: D003287:Contrast Media