Ariel Saracco MD, Presenter: Nothing to Disclose

Peter Aspelin MD, PhD, Abstract Co-Author: Speaker, General Electric Company Speaker, Bayer AG (Bayer Schering Pharma AG)

Karin Leifland MD, PhD, Abstract Co-Author: Nothing to Disclose

Raquel Espregueira Themudo MD, Abstract Co-Author: Nothing to Disclose

Brigitte Wilczek MD, PhD, Abstract Co-Author: Nothing to Disclose

Rimma Axelsson MD, PhD, Abstract Co-Author: Nothing to Disclose

Contrast enhanced ultrasound has gained a vast interest in the last years, trying to improve the ability to gather vascular information in different organs. In the heart, infusion of microbubbles is routinely used while in most other organs bolus is preferred. The aim of this study is to compare- in equal doses- bolus versus continuous infusion of microbubbles using real time contrast harmonic imaging in breast tumours.

A total of 30 female patients with 30 lesions in the breast or axila, evident by ultrasound, were evaluated. Eighteen lesions were classified as malignant and 12 lesions were classified as benign or probably benign. FNAB or core biopsy were obtained from all lesions. The basic ultrasonography examination in B mode was performed with a Philips iU22 using a high resolution multifrequency probe L17-5 MHz and special modalities SonoCT and XRES. Power Doppler was performed as a standard procedure, aiming to get an adequate vascularity detection related with the scan plane. The contrast harmonic imaging US was performed with the same equipment and special modalities using a multifrequency L9-3 MHz probe, specially design for this purpose. A low mechanical index (0.06) was used to avoid early destruction of microbubbles. A dose of 2,4 ml of Sono Vue® was first infused intravenously during 1 minute with a pump (while recorded) and then the same dose was injected as a bolus in 2 seconds with a flush of 10 ml saline solution. The waiting period between both procedures was 10 minutes. Enhancement and wash-out of the tumours were recorded for a total of 2 minutes in both cases.

Bolus administration of contrast agent provide clearly delineated intensity/time curves, as well as sharply demarcated enhancement and wash-out pattern for all lesions. The continuous infusion of the same contrast agent failed to show any wash-in/wash out or time to peak/ peak intensity phenomena in all cases.

Bolus contrast injection is better than continuous infusion in CEUS imaging of breast tumours.

Contrast enhanced ultrasound using real time harmonic imaging to study breast tumours, should be performed by using bolus injection for better intensity/time curves outcomes.

Saracco, A, Aspelin, P, Leifland, K, Themudo, R, Wilczek, B, Axelsson, R, Bolus Compared with Continuous Infusion of Microbubbles Contrast Agent Using Real Time Contrast Harmonic Imaging in Breast Tumours.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5009300.html