Tumor vascularity of breast lesions: Potentials and limits of contrast-enhanced Doppler sonography

OBJECTIVE, We investigated improving the evaluation of benignity in breast lesions using Doppler sonography with galactose palmitic acid-coated microb ubbles, SUBJECTS AND METHODS, In 77 patients with 84 breast tumors scheduled for su rgical tumor removal, color-coded duplex sonography was performed before an d after administration of Levovist. Of the 77 patients, 25 with 28 lesions had been treated for prior breast carcinoma. The parameters investigated we re the following: degree of enhancement, number of tumor vessels, time to m aximum enhancement, and the pattern of vascular morphology and course. RESULTS. Findings in malignant tumors (n = 53) showed a greater number of v essels and a faster stronger enhancement after Levovist administration, whe reas a definite partial overlap with results from benign tumors (n = 31) wa s found. The best distinction was produced by vascular morphology and cours e, with a sensitivity of 90% and a specificity of 81%. In 23 of the 25 pati ents who previously underwent surgery, a clear distinction was possible bet ween a postoperative scar (n = 11) and a tumor recurrence (n = 17). CONCLUSION, Although administration of the contrast agent clearly improved evaluation of benign features on Doppler sonography, absolute certainty can not be achieved. The feasibility of making an otherwise difficult distincti on between a scar and tumor recurrence on sonography and mammography appear s to be promising, but further studies are necessary.