THREE DIMENSIONAL SONOGRAPHIC STUDY OF BREAST NODULES

Purpose: We examined breast nodules with three-dimensional (3D) sonography and power Doppler to identify new parameters that might be useful for differentiating benign and malignant lesions.

Methods and Materials: Breast nodules in 41 women were examined with a Voluson-GE 730 scanner and a linear-array dedicated 3D probe. Each nodule was examined in the B-mode, and its vascular characteristics were evaluated with power Doppler; 3D reconstruction was used in both studies. The examiner classified each lesion as benign or malignant based on B-mode appearance, margin characteristics, infiltration, and blood vessel distribution on power Doppler. Results were compared with those of nodule biopsies, which were performed on all nodules after the 3D sonographic examination.

Results: Biopsy findings revealed that 35 nodules were benign and 6 malignant. Based on the 3D sonographic examination, 32 lesions were considered benign and nine were classified as malignant. Three of the latter diagnoses were false positives; there were no false negatives (Specificity: 92%, sensitivity: 100%, accuracy: 93%).

Conclusions: 3D sonography can be used to calculate lesional mass for T1 staging of malignant breast nodules. It can also reveal wall irregularities in benign lesions that are missed on two-dimensional scans and the limits of infiltration of malignant lesions. The 3D power Doppler examination provides a full-length view of blood vessels supplying the nodule and the number of vessels visualized with this approach is higher than that observed on two-dimensional studies.