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Efficient Strategies for Targeted and Second-Look Ultrasound: Enhancing Visualization and Simplifying Techniques

  • Breast Imaging (Haydee Ojeda-Fournier and Azadeh Elmi, Section Editors)
  • Published:
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Abstract

Purpose of Review

This article addresses the complexities involved in targeted ultrasound for lesions identified in mammograms and MRIs. We aim to provide clarity and guidance in performing targeted ultrasound by utilizing simple schematics and adopting a case-based approach.

Recent Findings

Targeted ultrasound is a vital component of diagnostic breast imaging, particularly for nonpalpable abnormalities detected on mammograms. In addition, with the increasing use of MRI in high-risk screening and staging breast cancer, second-look ultrasound is increasingly employed to evaluate incidental findings from MRI and guide tissue sampling, offering cost, availability, and patient comfort advantages. While the accuracy and technical aspects of second-look ultrasound for MRI-detected enhancements have been extensively examined, less attention has been given to targeted ultrasound for mammographically detected lesions.

Accurately targeting nonpalpable lesions presents challenges due to the differences in patient positioning and breast compression between mammography, MRI, and ultrasound. Mental fallacies, mainly caused by the non-orthogonal tube angling in mammography, can cloud judgment and impact targeting accuracy.

Summary

This article provides forthright explanations and practical solutions for accurately targeted ultrasounds on nonpalpable lesions found in mammograms and MRIs. It utilizes diagrams and everyday case examples to illustrate the concepts effectively. The goal is to offer practical solutions that can be readily applied in real-world scenarios.

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Data Availability

No datasets were generated or analyzed during the current study.

References

Papers of particular interest, published recently, have been highlighted as: ∙Of importance

  1. Abe H, Schmidt RA, Shah RN, Shimauchi A, Kulkarni K, Sennett CA, et al. MR-directed (“Second-Look”) ultrasound examination for breast lesions detected initially on MRI: MR and sonographic findings. Am J Roentgenol. 2010;194(2):370–7.

    Article  Google Scholar 

  2. Spick C, Baltzer PAT. Diagnostic utility of second-look US for breast lesions identified at MR imaging: systematic review and meta-analysis. Radiology. 2014;273(2):401–9.

    Article  PubMed  Google Scholar 

  3. Bumberger A, Clauser P, Kolta M, Kapetas P, Bernathova M, Helbich TH, et al. Can we predict lesion detection rates in second-look ultrasound of MRI-detected breast lesions? A systematic analysis. Eur J Radiol. 2019;113:96–100.

    Article  PubMed  Google Scholar 

  4. ∙Izumori A, Kokubu Y, Sato K, Gomi N, Morizono H, Sakai T, et al. The usefulness of second-look ultrasonography using anatomical breast structures as indicators for magnetic resonance imaging-detected breast abnormalities. Breast Cancer. 2020;27(1):129–39. This study illustrates the importance of using internal landmarks when correlating lesions between different imaging modalities.

  5. ∙Ziada K, Siu M, Qassid O, Krupa J. A new scoring system for differentiating malignant from benign “second-look” breast lesions detected by MRI in patients with known breast cancer. Clinical radiology. 2023;78(8):e560-e7. This study shows that second look ultrasound can in fact improve lesion characterization.

  6. Telegrafo M, Rella L, Stabile Ianora AA, Angelelli G, Moschetta M. Supine breast US: how to correlate breast lesions from prone MRI. Br J Radiol. 2016;89(1059):20150497.

    Article  PubMed  PubMed Central  Google Scholar 

  7. ∙Goto M, Nakano S, Saito M, Banno H, Ito Y, Ido M, et al. Evaluation of an MRI/US fusion technique for the detection of non-mass enhancement of breast lesions detected by MRI yet occult on conventional B-mode second-look US. Journal of Medical Ultrasonics. 2022;49(2):269–78. This study shows the difficulty of locating non-mass enhancements on second look ultrasound.

  8. Miyake T, Shimazu K. Third-look contrast-enhanced ultrasonography plus needle biopsy for differential diagnosis of magnetic resonance imaging-only detected breast lesions. J Med Ultrason (2001). https://doi.org/10.1007/s10396-023-01298-8

  9. ∙Jeon T, Kim YS, Son HM, Lee SE. Tips for finding magnetic resonance imaging-detected suspicious breast lesions using second-look ultrasonography: a pictorial essay. Ultrasonography. 2022;41(3):624. This study gives practical tips for breast imagers to locate enhancing lesions detected in MRI using ultrasound.

  10. Cardenosa G. Breast imaging companion. Lippincott Williams & Wilkins; 2011.

  11. Ikeda D, Miyake KK. Breast imaging: the requisites E-book. Elsevier Health Sciences. 2016;12:130.

    Google Scholar 

  12. Baker JA, Lo JY. Breast tomosynthesis: state-of-the-art and review of the literature. Acad Radiol. 2011;18(10):1298–310.

    Article  PubMed  Google Scholar 

  13. Gil BM, Jung NY, Kim SH, Kang BJ, Lee J, Chung MH. Value of shear wave elastography during second-look breast ultrasonography for suspicious lesions on magnetic resonance imaging. J Med Ultrason. 2022;49(4):719–30.

    Article  Google Scholar 

  14. Kolta M, Clauser P, Kapetas P, Bernathova M, Pinker K, Helbich TH, et al. Can second-look ultrasound downgrade MRI-detected lesions? A retrospective study. Eur J Radiol. 2020;127: 108976.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Hellerhoff K, Dietrich H, Schinner R, Rjosk-Dendorfer D, Sztrókay-Gaul A, Reiser M, et al. Assessment of MRI-detected breast lesions: a benign correlate on second-look ultrasound can safely exclude malignancy. Breast Care. 2021;16(5):435–43.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Izumori A, Kokubu Y. Ultrasound diagnosis of non-mass MRI-detected lesions. J Med Ultrason. 2023;50(3):351–60.

    Article  Google Scholar 

  17. Huang J, Lin Q, Cui C, Fei J, Su X, Li L, et al. Correlation between imaging features and molecular subtypes of breast cancer in young women (≤30 years old). Jpn J Radiol. 2020;38(11):1062–74.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

    Sepideh Sefidbakht & Parisa Pishdad

  2. Saba Women Imaging Clinic, Shiraz, Iran

    Lobat Ataei

  3. Sutter Imaging (SMG), University of California Davis Medical Center, Sacramento, CA, USA

    Bijan Bijan

Authors
  1. Sepideh Sefidbakht
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  2. Parisa Pishdad
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  3. Lobat Ataei
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  4. Bijan Bijan
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Contributions

Dr. Sefidbakht and Ataee contributed the patients, Dr. Sefidbakht designed the schematics; All authors contributed in study design, drafting the manuscript, and reviewing the final article.

Corresponding author

Correspondence to Sepideh Sefidbakht.

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The authors declare no competing interests.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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Sefidbakht, S., Pishdad, P., Ataei, L. et al. Efficient Strategies for Targeted and Second-Look Ultrasound: Enhancing Visualization and Simplifying Techniques. Curr Radiol Rep 12, 51–64 (2024). https://doi.org/10.1007/s40134-024-00426-7

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  • DOI: https://doi.org/10.1007/s40134-024-00426-7

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