Maximum intensity projection based on high frame rate contrast-enhanced ultrasound for the differentiation of breast tumors

Jia Li; Cong Wei; Xinxin Ma; Tao Ying; Di Sun; Yuanyi Zheng

doi:10.3389/fonc.2023.1274716

Maximum intensity projection based on high frame rate contrast-enhanced ultrasound for the differentiation of breast tumors

Front Oncol. 2023 Oct 30:13:1274716. doi: 10.3389/fonc.2023.1274716. eCollection 2023.

Authors

Jia Li^#¹, Cong Wei^#¹, Xinxin Ma¹, Tao Ying¹, Di Sun¹, Yuanyi Zheng¹

Affiliation

¹ Department of Ultrasound in Medicine, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.

^# Contributed equally.

Abstract

Objective: We explored the role of maximum intensity projection (MIP) based on high frame rate contrast-enhanced ultrasound (H-CEUS) for the differentiation of breast tumors.

Methods: MIP imaging was performed in patients with breast tumors who underwent H-CEUS examinations. The microvasculature morphology of breast tumors was assessed. The receiver operating characteristic curve was plotted to evaluate the diagnostic performance of MIP.

Results: Forty-three breast tumors were finally analyzed, consisting of 19 benign and 24 malignant tumors. For the ≤30-s and >30-s phases, dot-, line-, or branch-like patterns were significantly more common in benign tumors. A tree-like pattern was only present in the benign tumors. A crab claw-like pattern was significantly more common in the malignant tumors. Among the tumors with crab claw-like patterns, three cases of malignant tumors had multiple parallel small spiculated vessels. There were significant differences in the microvasculature morphology for the ≤30-s and >30-s phases between the benign and malignant tumors (all p < 0.001). The area under the curve, sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of the ≤30-s phase were all higher than those of the >30-s phase for the classification of breast tumors.

Conclusion: MIP based on H-CEUS can be used for the differentiation of breast tumors, and the ≤30-s phase had a better diagnostic value. Multiple parallel small spiculated vessels were a new finding, which could provide new insight for the subsequent study of breast tumors.

Keywords: angiogenesis; breast tumors; contrast-enhanced ultrasound; maximum intensity projection; microvasculature.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was supported by the Key Project of the National Natural Science Foundation of China (No. 82030050), Medical Innovation Research Special Key Project of 2021 Science and Technology Innovation Action Plan in Shanghai (No. 21Y21901100), and Shanghai Municipal Key Clinical Specialty (No. shslczdzk03203).