Abstract
Purpose
To assess the effectiveness of contrast-enhanced ultrasound (CEUS) in guiding biopsies of breast lesions that were detected on contrast-enhanced mammography (CEM) or contrast-enhanced breast MRI (CE-MRI) but were not clearly visible on B-mode ultrasound (B-US).
Methods
In this study, 23 lesions in 16 patients were selected for CEUS-guided biopsy due to poor visualization on B-US despite being detected on CEM (n = 20) or CE-MRI (n = 3). B-US, color Doppler ultrasound (CDUS), and CEUS were used to visualize the suspicious lesions, followed by a CEUS-guided core needle biopsy using Sonazoid as the contrast agent. The accuracy of the biopsy was assessed based on pathology-radiology concordance and 12-month imaging follow-up. The conspicuity scores for lesion visualization were evaluated using a 5-point conspicuity scale agreed upon by two breast radiologists.
Results
The enhancing lesions detected on CEM/CE-MRI had an average size of 1.6 ± 1.3 cm and appeared as mass-enhancing (61%) or non-mass-enhancing (39%). The lesions had mean conspicuity scores of 2.30 on B-US, 2.78 on CDUS, and 4.61 on CEUS, with 96% of the lesions showing contrast enhancement on CEUS. CEUS-guided biopsy showed increased visibility in 96% and 91% of the lesions compared to B-US and CDUS, respectively. The overall accuracy of CEUS-guided biopsy was 100% based on concordance with histology and 12-month follow-up.
Conclusions
CEUS enhances the visibility of suspicious CEM/CE-MRI lesions that are poorly visible on B-US during biopsy procedures.
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Data availability
Data sharing is restricted by the Kaohsiung Veterans General Hospital IRB due to strict regulations for ethical issues. Access to data will be subject to a data sharing agreement approved by Kaohsiung Veterans General Hospital IRB.
Abbreviations
- B-US:
-
B-mode ultrasound
- CDUS:
-
Color Doppler ultrasound
- CEUS:
-
Contrast-enhanced ultrasound
- CE-MRI:
-
Contrast-enhanced breast MRI
- CEUS-CNB:
-
Contrast-enhanced ultrasound-guided core needle biopsy
- CEM:
-
Contrast-enhanced mammography
- CE-MRI:
-
Contrast-enhanced breast MRI
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Acknowledgements
This work was supported by grants from Kaohsiung Veterans Hospital Research Fund (KSVGH111-109).
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Pi-Yi Huang, Meng-Yuan Tsai, Jer-Shyung Huang, Pei-Ying Lin, and Chen-Pin Chou declare no conflicts of interest.
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Huang, PY., Tsai, MY., Huang, JS. et al. Contrast-enhanced ultrasound-guided biopsy of suspicious breast lesions on contrast-enhanced mammography and contrast-enhanced MRI: a case series. J Med Ultrasonics 50, 521–529 (2023). https://doi.org/10.1007/s10396-023-01345-4
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DOI: https://doi.org/10.1007/s10396-023-01345-4