Three-dimensional sonographic study of breast nodules

• Published in: Journal of ultrasound 2007-06, Vol.10 (2), p.93-98
• Main Authors: Abbattista, T., Serri, L., Busilacchi, P.
• Format: Article
• Language: English
• Subjects: 3D sonography; Breast nodules; Power-Doppler
• ISSN: 1971-3495; 1876-7931
• DOI: 10.1016/j.jus.2007.04.003

We examined breast nodules with three-dimensional (3D) sonography and power-Doppler to identify new parameters that might be useful in differentiating benign and malignant lesions. Breast nodules in 34 women were examined with a Voluson-GE 730 scanner and a 7.5 MHz linear-array dedicated 3D probe. Each nodule was examined in the B-mode, and its vascular characteristics were evaluated with power-Doppler; 3D reconstruction was used in both studies. All examinations were performed by the same operator, who was unaware of the case characteristics. The examiner classified each lesion as benign or malignant based on B-mode appearance, margin characteristics, infiltration, and blood vessel distribution on power-Doppler; lesion volume was also calculated for T staging. Results were compared with those of biopsies, which were performed on all nodules after the sonographic examination. Biopsy findings revealed that 29 nodules were benign and 5 malignant. Based on the 3D sonographic examination, 27 lesions were considered benign, and 7 were classified as malignant. Two of the latter diagnoses were false-positives; there were no false negatives (specificity: 93.1%, sensitivity: 100%, accuracy: 94.1%). 3D sonography can be used to calculate lesional mass for T1 staging of malignant breast nodules. It can also reveal wall irregularities in benign lesions that are missed on two-dimensional (2D) scans and the limits of infiltration of malignant lesions. The 3D power-Doppler examination provides a panoramic full-length view of blood vessels supplying the nodule, and the number of vessels visualized with this approach is higher than that observed on 2D studies. Lo scopo di questo studio è stato quello di valutare le lesioni mammarie benigne e maligne con esame ecografico 3D per mettere in evidenza i rapporti delle lesioni con i tessuti circostanti e altri segni che potessero meglio differenziare tra loro i due tipi di lesioni. Sono state studiate 34 pazienti non consecutive affette da lesioni mammarie benigne (29) e maligne (5). È stato effettuato l'esame ecografico con un apparecchio Voluson-GE con sonda lineare 6–12 MHz dedicata alla ricostruzione 3D e l'esame power-Doppler con ricostruzione 3D per mettere in evidenza la vascolarizzazione delle lesioni. Tutte le 34 pazienti sono state sottoposte successivamente ad agoaspirato ecoguidato con prelievo di materiale per l'esame citopatologico, che è stato considerato il gold standard. Oltre al calcolo del volume delle lesioni