Homogeneously enhancing breast lesions on contrast enhanced US: differential diagnosis by conventional and contrast enhanced US findings

• Published in: Japanese journal of radiology 2016-07, Vol.34 (7), p.508-514
• Main Authors: Fujimitsu, Ritsuko, Shimakura, Mikiko, Urakawa, Hiroshi, Morita, Ayako, Shinagawa, Yoshinobu, Sakamoto, Keiko, Yoshimitsu, Kengo
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Breast - diagnostic imaging; Breast Neoplasms - diagnostic imaging; Contrast Media; Diagnosis, Differential; Female; Humans; Image Enhancement - methods; Imaging; Medicine; Medicine & Public Health; Middle Aged; Nuclear Medicine; Original Article; Radiology; Radiotherapy; Reproducibility of Results; Retrospective Studies; Sensitivity and Specificity; Ultrasonography, Mammary - methods
• ISSN: 1867-1071; 1867-108X
• DOI: 10.1007/s11604-016-0549-z

Objective To clarify the details of homogeneously enhancing lesions on contrast-enhanced ultrasonography (CEUS) and also to elucidate whether their differential diagnosis is possible. Methods Seventy-three homogeneously enhancing lesions on CEUS were retrospectively selected. Two radiologists first assessed conventional US findings alone in consensus to differentiate malignant vs. benign lesions. Then, qualitative and quantitative CEUS findings were analyzed to determine the useful findings for the differential diagnosis. Determined CEUS findings were applied to the indeterminate lesions based on conventional US findings to see whether CEUS can improve the diagnostic performance. Results There were 42 cancers (58 %) out of 73. Sensitivity and specificity using conventional US findings alone were 91 and 55 %, respectively. Among the CEUS findings tested, multivariate analysis revealed only the type 3 enhancement pattern, which indicates a larger enhancing area than the precontrast hypoechoic lesion, was related to malignancy ( p