Cliona Cunningham BA, Presenter: Nothing to Disclose

David Owen Cosgrove MD, Abstract Co-Author: Nothing to Disclose

Martin John Blomley MD, Abstract Co-Author: Nothing to Disclose

Patrick Phillips PhD, Abstract Co-Author: Nothing to Disclose

Sagi Schlomo MD, Abstract Co-Author: Nothing to Disclose

Robert John Eckersley PhD, Abstract Co-Author: Nothing to Disclose

Patrick Soutter MD, Abstract Co-Author: Nothing to Disclose

James E. Chomas PhD, Abstract Co-Author: Nothing to Disclose

Xiaohui Hao PHD, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

To evaluate a novel, non-linear contrast-specific imaging mode on a transvaginal probe for the characterization of adnexal masses.

15 women with adnexal masses previously detected on ultrasound and scheduled for surgical excision were invited to participate in a study of microbubble contrast-enhanced ultrasound scanning using a novel non-linear contrast-specific mode (Contrast Pulse Sequencing, CPS) implemented on a tranvaginal probe. Informed consent was obtained from all and the scans were performed transvaginally except in one patient who was scanned transabdominally. Cine captures of sweeps through the masses were acquired at baseline in gray scale (5-8MHz) and with power Doppler (7MHz) using an EV8C4 transducer on a Sequoia scanner (Siemens, Mountain View). The scanner was then switched into CPS mode (4MHz) using a real-time, split-screen display (Live Dual) at low MI (0.3). An i.v. bolus of 4.8 mL SonoVue (Bracco, Milan) was given and the lesion studied with slow sweeps of the transducer. Cine captures were recorded. The three captures were reviewed by 2 readers by consensus without knowledge of the final diagnosis, which was obtained by histology in all cases. The gray-scale captures were assessed for features of malignancy (presence of solid tissue, heterogeneous echotexture) and the Doppler captures for the amount and distribution of flow signals. The CPS captures after contrast were assessed for the amount and distribution of signals in both the macro- and microvasculature.

The procedure was well tolerated by all women. CPS showed more vascular signals than Doppler in 9 cases and was equal in the others. All 3 cancers showed strong CPS signals whereas the 3 borderlines and 8 of 9 benign masses showed no or minimal CPS signals. In 1 borderline and 3 benign cases, CPS allowed a correct diagnosis where the conventional US modes had been suspicious. There was 1 false positive in a patient with an uncommon lesion, a benign sclerosing ovarian tumor.

Transvaginal ultrasound scanning using CPS with SonoVue may improve the non-invasive characterization of adnexal masses. A particular advantage is that it may reduce the number of false positive calls.

P.P.,J.E.C.,X. .: Employees of Siemens Medical

Cunningham, C, Cosgrove, D, Blomley, M, Phillips, P, Schlomo, S, Eckersley, R, Soutter, P, Chomas, J, Hao, X, et al, , Improved Characterization of Adnexal Masses on Transvaginal Ultrasound Scanning Using Phase and Amplitude Non-linear Imaging (CPS) and the Microbubble Contrast Agent SonoVue.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4412252.html