Is There a Role for Contrast-Enhanced Ultrasound in the Detection and Biopsy of MRI-Only Visible Breast Lesions?
Purpose: This study aimed to evaluate the feasibility of CEUS and CEUS-guided interventions in the diagnostics of MRI-visible targeted US-occult breast lesions.
Methods: This retrospective study examined 10 females with 10 occult, MRI-only detected breast lesions between July 2014 and April 2017. Targeted second-look US followed by CEUS with 2.4 ml of SonoVue® were performed for all of the lesions. After positive CEUS localization the same dose was repeated for confirmation and CEUS-guided interventions were performed.
Results: MRI revealed 8 mass lesions with a mean size of 9 mm (range 5-16 mm) and 2 non-mass enhancing lesions of 10 and 20 mm in largest diameters. Targeted US revealed no morphological correlate for the lesions. Five out of 10 lesions (50 %) were visible on CEUS. CEUS-guided core biopsy was performed on 4 lesions and 1 was marked with a clip for later surgical removal. Histopathological analysis confirmed 4 of them to be malignant. Three out of 5 nonvisible lesions on CEUS underwent MRI-guided interventions, 1 lesion was scheduled for follow-up as it was non-amenable for MRI-biopsy, and 1 lesion was biopsied under US-guidance. Three of these nonvisible lesions on CEUS were confirmed to be malignant.
Conclusion: Based on our preliminary results, CEUS is a feasible tool for detecting many MRI-only visible breast lesions, resulting in a more cost effective and less time-consuming practice. It is a more convenient alternative than MRI-guided biopsy and has the potential to be included in the diagnostic algorithm which evaluates MRI-only visible breast lesions.