Anush Sridharan, Abstract Co-Author: Nothing to Disclose

John Robery Eisenbrey PhD, Abstract Co-Author: Nothing to Disclose

Flemming Forsberg PhD, Presenter: Equipment support, Toshiba Corporation Research collaboration, General Electric Company Research collaboration, Analogic Corporation Research collaboration, Toshiba Corporation Speakers Bureau, Toshiba Corporation

Priscilla Machado MD, Abstract Co-Author: Grant, Toshiba Corporation Equipment support, Toshiba Corporation

Kelly Dulin, Abstract Co-Author: Nothing to Disclose

Samantha Jaffe, Abstract Co-Author: Nothing to Disclose

Daniel Arthur Merton, Abstract Co-Author: Nothing to Disclose

Haydee Ojeda-Fournier MD, Abstract Co-Author: Nothing to Disclose

Robert Frederick Mattrey MD, Abstract Co-Author: Nothing to Disclose

Kirk Wallace PhD, Abstract Co-Author: Employee, General Electric Company

Carl Chalek PhD, Abstract Co-Author: Employee, General Electric Company

Kai E. Thomenius PhD, Abstract Co-Author: Nothing to Disclose

To investigate the feasibility of using contrast-enhanced 3D subharmonic ultrasound imaging (SHI) to visualize tumor vascularity, evaluate vascular heterogeneity and develop quantitative 3D parametric maps of vascularity in breast lesions.

Patients (n = 134) identified with breast lesions on mammography were scanned using power Doppler imaging (PDI), contrast-enhanced 3D harmonic imaging (HI) and 3D SHI on a modified Logiq 9 scanner (GE Healthcare, Milwaukee, WI) equipped with a 4D10L probe. The contrast agent Definity (Lantheus Medical Imaging, N Billerica, MA) was administered as a bolus of 0.25 ml for HI and as 20 μl/kg for SHI. All lesions were subsequently biopsied. A region-of-interest (ROI) corresponding to ultrasound contrast agent (UCA) flow was identified using 4D View (GE Healthcare) and mapped onto the raw slice data to generate a map of the time-intensity curve (TIC) for the lesion volume. Time-points corresponding to baseline, peak intensity and complete washout of UCA were identified to generate vascular heterogeneity plots of the lesion volume. This was subsequently broken down into central and peripheral lesion sections. Finally, 3D parametric volumes were produced for perfusion (PER) and area under the curve (AUC).

There were a total of 99 benign and 35 malignant lesions. Vascular activity was observed with PDI in 82 lesions (61 benign and 21 malignant). UCA flow was observed in 8 (5 benign and 3 malignant) lesions for 3D HI and 68 (49 benign and 19 malignant) for 3D SHI. Analysis of vascular heterogeneity in 3D SHI volumes showed benign lesions to have a significant difference in vascularity between central and peripheral sections (1.71 ± 0.96 vs. 1.13 ± 0.79, p < 0.001) whereas malignant lesions showed no significant difference (1.66 ± 1.39 vs. 1.24 ± 1.14, p = 0.24), indicative of more vascular coverage, which was validated by the vascular visualization in the PER and AUC parametric volumes.

Our preliminary results suggest that 3D SHI has improved sensitivity to UCA in vascular lesions compared to 3D HI based on difference in the overall number of cases with UCA activity. Furthermore, 3D SHI is able to detect variations in vascular heterogeneity.

Quantitative evaluation of vascular heterogeneity combined with vascular visualization of parametric volumes could aid in characterizing breast lesions.

Sridharan, A, Eisenbrey, J, Forsberg, F, Machado, P, Dulin, K, Jaffe, S, Merton, D, Ojeda-Fournier, H, Mattrey, R, Wallace, K, Chalek, C, Thomenius, K, Visualization of Breast Lesion Vasculature Using Three-dimensional (3D) Subharmonic Parametric Maps.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14014502.html