J Res Med Sci. 2015 Feb;20(2):133-9.

Evaluation of different aspects of power Doppler sonography in differentiating and prognostication of breast masses.

Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences

Mehri Sirous, Reza Sirous, Farnaz Khalighi Nejad, Elham Rabeie, Marzieh Mansouri

PMID: 25983764 PMCID: PMC4400706

Abstract

BACKGROUND: We conducted our study on 1110 patients with breast masses in order to investigate different aspects of power Doppler sonography (PDS) for differentiating between benign and malignant breast lesions and their prognostication.

MATERIALS AND METHODS: This study was conducted on the women who were referred to the sonography units of University Hospitals for breast sonography and had a BIRADS-3 mass or higher in gray scale sonography. Then, PDS was performed for all the patients. Vascularization, number of vessels, resistance index (RI), pulsatility index (PI), and vascularization patterns were evaluated for all the lesions. We compared our radiologic findings concerning different histopathologic and hormonal aspects of the lesions.

RESULTS: The differences between mean vascular density in malignant lesions concerning size of the tumor, histological grade, stage, and hormone receptor status were statistically significant. Although, there was an overlap between benign and malignant values. A resistive index (RI) value higher than 0.83 as a sign for malignancy had sensitivity equal to 75% and specificity equal to 97% (P = 0.04 and 0.03, respectively). A PI value higher than 1.6 has a sensitivity and specificity value of 70% and 98%, respectively, as a malignancy sign (P = 0.02 and 0.04, respectively).

CONCLUSION: It seems that while malignant tumors have significantly higher number of vessels in comparison to benign one, since the number of vessels overlap between benign and malignant tumors, this aspect has little clinical usefulness in distinguishing or prognostication of breast masses. In contrast RI, PI, and vascularization pattern have an ability to differentiate and predict the prognosis of breast lesions.

Keywords: Breast cancer; Doppler sonography; vascular density; vascularization

References

1. Clin Imaging. 2008 May-Jun;32(3):167-71 - PubMed
2. J Clin Ultrasound. 1999 Jun;27(5):231-7 - PubMed
3. Obstet Gynecol Int. 2009;2009:530579 - PubMed
4. Eur J Radiol. 2009 Jan;69(1):6-13 - PubMed
5. AJR Am J Roentgenol. 1993 Oct;161(4):765-71 - PubMed
6. AJR Am J Roentgenol. 1999 Aug;173(2):303-7 - PubMed
7. Eur J Radiol. 2009 Apr;70(1):77-85 - PubMed
8. J Ultrasound Med. 2001 Oct;20(10 ):1091-101; quiz 1102 - PubMed
9. Radiology. 2007 Jan;242(1):63-9 - PubMed
10. J Ultrasound Med. 2002 Nov;21(11):1227-35 - PubMed
11. World J Surg. 2010 Oct;34(10):2308-24 - PubMed
12. AJR Am J Roentgenol. 2005 Jun;184(6):1788-94 - PubMed
13. Ultraschall Med. 2010 Oct;31(5):466-74 - PubMed
14. AJR Am J Roentgenol. 2005 Mar;184(3 Suppl):S53-5 - PubMed
15. Histopathology. 1991 Nov;19(5):403-10 - PubMed
16. Radiology. 1995 Oct;197(1):39-43 - PubMed
17. Br J Cancer. 1995 Jan;71(1):137-9 - PubMed
18. Radiology. 2001 Sep;220(3):795-802 - PubMed
19. Radiology. 2012 Jan;262(1):80-90 - PubMed
20. Br J Surg. 1992 Mar;79(3):259-60 - PubMed
21. Radiology. 1993 Oct;189(1):99-104 - PubMed
22. Radiology. 1990 Jul;176(1):175-80 - PubMed
23. Br J Surg. 1995 Jun;82(6):787-8 - PubMed
24. Cancer Res. 1991 Jan 1;51(1):265-73 - PubMed
25. N Engl J Med. 2005 Oct 27;353(17 ):1784-92 - PubMed
26. Radiology. 1996 Mar;198(3):679-86 - PubMed
27. J Pak Med Assoc. 2009 Sep;59(9):598-601 - PubMed
28. CMAJ. 1992 Nov 15;147(10 ):1459-76 - PubMed
29. J Natl Cancer Inst. 2000 Sep 20;92 (18):1490-9 - PubMed
30. J Natl Cancer Inst. 2005 Oct 5;97(19):1407-27 - PubMed
31. AJR Am J Roentgenol. 2000 Dec;175(6):1585-9 - PubMed

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