title: Impact of parametric imaging on contrast-enhanced ultrasound of breast cancer.
abstract: OBJECTIVE
  To prospectively evaluate the usefulness of contrast-enhanced ultrasound (CEUS) using parametric imaging for breast cancer in a multicenter study.
  
  
  METHODS
  A total of 65 patients with breast cancer were included in this study. CEUS was performed, and still images on peak time (S), accumulated images (A) and parametric images (P) were generated from the raw data. Four blind reviewers ranked the best visible images as first place, and determined second and third place consecutively. We compared the average ranking of each image. The maximal diameter of the tumor determined on ultrasonography and MRI was compared with the corresponding pathological maximal diameter for 48 of the 65 patients. The correlation between the diameter determined by two experts and two beginners was analyzed.
  
  
  RESULTS
  The average rank of visibility was as follows: P, 1.44; A, 2.04; and S, 2.52. The correlation between each image and the pathology was as follows: P, r = 0.664; A, r = 0.630; S, r = 0.717; and MRI, r = 0.936. There were no significant differences among the correlation between the experts and beginners in each image.
  
  
  CONCLUSIONS
  The use of parametric imaging improves the visibility of CEUS. The maximal diameter of the tumor determined on CEUS correlates substantially with the pathology.
authors.affiliation: Department of Breast Surgery, Mie University Hospital, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan. xxxme_heavenly@yahoo.co.jp.
authors.forename: Aya
authors.initials: A
authors.lastname: Noro
authors.affiliation: Department of Breast Surgery, Nabari City Hospital, Nabari, Mie, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Nakamura
authors.affiliation: Department of Endoscopy and Ultrasound, Nara Medical University Hospital, Kashihara, Nara, Japan.
authors.forename: Toshiko
authors.initials: T
authors.lastname: Hirai
authors.affiliation: Department of Radiology, Nara Medical University Hospital, Kashihara, Nara, Japan.
authors.forename: Masayo
authors.initials: M
authors.lastname: Haga
authors.affiliation: Department of Breast Surgery, Nara Medical University Hospital, Kashihara, Nara, Japan.
authors.forename: Toyoki
authors.initials: T
authors.lastname: Kobayashi
authors.affiliation: Department of Pathology, Mie University Hospital, Tsu, Mie, Japan.
authors.forename: Akinobu
authors.initials: A
authors.lastname: Hayashi
authors.affiliation: Department of Pathology, Mie University Hospital, Tsu, Mie, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kozuka
authors.affiliation: Department of Pathology, Nara Medical University Hospital, Kashihara, Nara, Japan.
authors.forename: Tokiko
authors.initials: T
authors.lastname: Nakai
authors.affiliation: Center of Development of Clinical Study, Mie University Hospital, Tsu, Mie, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Ogura
authors.affiliation: Department of Breast Surgery, Mie University Hospital, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Ogawa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D002277:Carcinoma / Q000000981:diagnostic imaging* / Q000473:pathology; D003287:Contrast Media; D005260:Female; D005290:Ferric Compounds; D006801:Humans; D007501:Iron; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D015588:Observer Variation; D010087:Oxides; D011446:Prospective Studies; D016037:Single-Blind Method; D047368:Tumor Burden; D016217:Ultrasonography, Mammary / Q000379:methods*
chemical_list: D003287:Contrast Media; D005290:Ferric Compounds; D010087:Oxides; C069727:Sonazoid; D007501:Iron
keywords: Breast cancer; Contrast-enhanced ultrasound; Parametric image; Sonazoid®; Visibility