Ultrasound Imaging of Breast Cancer Associated with the Study of Microvessel Density
|Course||Medical Imaging and Nuclear Medicine|
|Keywords||breast cancer contrast-enhanced ultrasound microvessel density|
Background: Breast cancer is the one of multiple malignancies for women, it isserious harm to health and life for women and its incidence increased year by year.Currently, breast cancer still has no effective means of prevention, the prognosis istotally dependent on early diagnosis and early treatment. Therefore, early diagnosisand treatment of breast cancer draw more and more clinical attentions.The microvessel density of tumor may reflect the state of tumor angiogenesis, it is thekey indicators to determine tumor progression and metastatic potential,it is also theindependent prognostic factor of affecting survival of patients,but its measurementdepends on the pathological examination after surgery ,which can not achieve in thein vivo assessment of tumor angiogenesis.Therefore, the study of a good correlation with microvessel density, low-invasiveimaging technique,is the focus of attention for the differential diagnosis ,those who donot want surgery or preoperative evaluation of patients wanting tumor angiogenesisactivity . Time - intensity curve parameters of ultrasound can be quantitativelyanalyzed in vivo indirect assessment of tumor angiogenesis activity. Application ofreal-time contrast-enhanced ultrasound of breast tumor vessels allows us to studyphase into the tiny blood vessels to obtain a more comprehensive diagnosticinformation.Ultrasound contrast agent showed special sensitivity and specificity ofultrasound ,which can improve the benign and malignant breast tumors discrimination.And contrast-enhanced ultrasound imaging is real-time, dynamic, non-invasive,repeatable and so on.Objective: Ultrasound imaging technology, QLAB software from time - intensitycurves were analyzed, including the curve shape, by the beginning of time, peak time,peak intensity and area under the curve, the quantitative parameters and thecorrelation of microvessel density can for the preoperative diagnosis of breast tumorimaging evidence.Materials and Methods: Experimental group: Second Hospital of Shanxi MedicalUniversity, Vascular breast surgery in October 2009 and October 2010 wity 25cases of breast cancer patients, tumor in 30 lesions, including malignant tumors werediagnosed after 16, 14 benign . This study examined 30 patients first withconventional two-dimensional ultrasound scanning of breast lumps, lesions observedinternal echo, edge, shape, and with or without microcalcifications and lesions usingcolor Doppler flow signals within and around the distribution and imaging withmammography before making the initial diagnosis. Then enter the imaging conditions,adjust the sound power output, mechanical index (MI) is set to 0.07. Injection ofcontrast agent in ultrasound machines built at the same time start the timer, real-timedynamic observation of the whole process of developing lesions, and save all thedevelopment process, and then jointly by the two doctors analyze the data, application imaging analysis software (QLAB time - intensity curves) on imaging process forquantitative analysis, the quantitative parameters, including intralesional contrastagent by the beginning of time (Arriving Time, AT), peak intensity (Peak Intensity,PI), time to peak (Peak Time, PT) and the area under the curve (Aear under curve,AUC), and time - intensity curve shape analysis.ResultsResults:1. Breast tumors of ultrasound contrast agent by the beginning of time and peak timewere not significant.2.. Benign and malignant tumors between the time - intensity curve shape weresignificantly different.3. The peak intensity of benign and malignant breast area under the curve werestatistically significant4. The peak intensity of breast cancer and area under the curve were correlated withmicrovessel density.Conclusion:The association of ultrasound imaging and pathologic analysis has the potential toprovide a diagnosis of breast cancer preoperative non-invasive, fast imaging methods.