Correlation of contrast-enhanced ultrasound kinetics with prognostic factors in invasive breast cancer

• Published in: European radiology 2013-12, Vol.23 (12), p.3228-3236
• Main Authors: Szabó, Botond K., Saracco, Ariel, Tánczos, Ervin, Aspelin, Peter, Leifland, Karin, Wilczek, Brigitte, Axelsson, Rimma
• Format: Article
• Language: English
• Subjects: Adenocarcinoma - diagnostic imaging; Adenocarcinoma - pathology; Adenocarcinoma - secondary; Adenocarcinoma, Mucinous - diagnostic imaging; Adenocarcinoma, Mucinous - pathology; Adenocarcinoma, Mucinous - secondary; Adult; Aged; Aged, 80 and over; Area Under Curve; Axilla - diagnostic imaging; Biopsy; Breast; Breast cancer; Breast carcinoma; Breast Neoplasms - diagnostic imaging; Breast Neoplasms - pathology; Cancer och onkologi; Carcinoma, Ductal - diagnostic imaging; Carcinoma, Ductal - pathology; Carcinoma, Ductal - secondary; Carcinoma, Papillary - diagnostic imaging; Carcinoma, Papillary - pathology; Carcinoma, Papillary - secondary; Contrast Media; Diagnostic Radiology; Female; Humans; Image Enhancement - methods; Imaging; Internal Medicine; Interventional Radiology; Kinetics; Klinisk medicin; Lymph Nodes - diagnostic imaging; Lymph Nodes - pathology; Medicin och hälsovetenskap; Medicine; Medicine & Public Health; Middle Aged; Models, Biological; Multivariate Analysis; Neoplasm Grading; Neuroradiology; Prognosis; Radiologi och bildbehandling; Radiology; Sentinel Lymph Node Biopsy; Sulfur Hexafluoride; Ultrasonography; Ultrasound
• ISSN: 0938-7994; 1432-1084; 1432-1084
• DOI: 10.1007/s00330-013-2960-5

Objectives To correlate contrast-enhanced ultrasound (CEUS) kinetic parameters with traditional and molecular prognostic factors in invasive breast cancer. Methods Seventy-five invasive breast cancers were evaluated with contrast harmonic imaging after the injection of a bolus dose of 2.4 ml sulphur hexafluoride microbubble contrast agent. The lognormal function was used for quantitative analysis of kinetic data. These parameters correlated with traditional prognostic factors (tumour size, histological type, tumour grade, axillary lymph node status) and immunohistochemical biomarkers (ER, PR and HER2 status). Results Statistically significant correlation was found between time-to-peak and tumour grade ( P value = 0.023), PR status ( P value = 0.042) and axillary node status ( P value = 0.025). Wash-out ratio, measured at 21 s was significantly associated with ER status ( P value = 0.042) and PR status ( P value = 0.026). Conclusions Invasive breast carcinomas exhibiting earlier peak enhancement and faster elimination of microbubble contrast agent at CEUS are found to be associated with established predictors of poor prognosis. Key Points • Contrast-enhanced ultrasound (CEUS) can potentially determine the aggressiveness of invasive breast cancers. • Early peak enhancement and accelerated wash-out at CEUS suggest poor prognosis. • CEUS kinetics are similar to that of DCE-MRI in assessing tumour aggressiveness.