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Authors Zhao YX, Liu S, Hu YB, Ge YY, Lv DM
Received 7 October 2016
Accepted for publication 17 December 2016
Published 22 February 2017 Volume 2017:10 Pages 1123—1129
DOI https://doi.org/10.2147/OTT.S124134
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Manfred Beleut
Peer reviewer comments 2
Editor who approved publication: Dr Samir Farghaly
Abstract: This study aimed to explore the diagnostic and prognostic values of
contrast-enhanced ultrasound (CEUS) in breast cancer. Between September 2009
and October 2011, a total of 143 breast cancer patients and 161 healthy
people were selected as case group and control group, respectively. After the
identification of lesions by conventional ultrasound, all patients underwent
CEUS. The CEUS images were analyzed, and time–intensity curves (TICs) were
obtained. Hematoxylin–eosin and immunohistochemistry staining was performed on
tissue specimens, according to which the expressions of estrogen receptor (ER),
c-erb-B2, p53, and Ki-67 were measured. Multivariate logistic regression
analysis was used to compare CEUS and TIC parameters between the two groups.
Compared with the control group, cancer patients showed high enhancement,
heterogeneous enhancement or defects in the central region, expansion of lesion
diameter after enhancement and crab-like blur lesion edges. The peak intensity
(PI), relative start time of enhancement, relative PI, and relative area under
the curve in the case group were significantly higher than those in the control
group. Logistic analysis showed that the uniformity of enhancement, expansion
of lesion diameter, and relative PI were significant diagnostic parameters of
breast cancer, with area under the curve being 0.798, 0.776, and 0.919,
respectively. There were strong associations between CEUS characteristics and
expressions of prognostic factors in breast cancer: the heterogeneous
enhancement was common in c-erb-B2-positive tumors; the centripetal enhancement
occurred more in ER-negative tumors; perforator vessels were often seen in
tumors at high histological grade; perfusion defects were common in
ER-negative, c-erb-B2-positive, and Ki-67-positive tumors. CEUS is a useful
tool for the early diagnosis and prognosis of breast cancer.
Keywords: contrast-enhanced ultrasound, breast
cancer, diagnosis, prognosis