Contrast-enhanced nonlinear 3D ultrasound imaging of breast lesions in a clinical population

Anush Sridharan, John R. Eisenbrey, Maria Stanczak, Annemarie Daecher, Priscilla Machado, Annina Wilkes, Alexander Sevrukov, Haydee Ojeda-Fournier, Robert F. Mattrey, Kirk Wallace, Flemming Forsberg

Research output: Chapter in Book/Report/Conference proceedingConference contribution

1 Scopus citations


The ability to visualize breast lesion vascularity and quantify the vascular heterogeneity using contrast-enhanced 3-D nonlinear ultrasound imaging was investigated in a clinical population. Patients (n = 236) identified with breast lesions on mammography were scanned using power Doppler imaging, contrast-enhanced 3D HI, and 3D SHI on a modified Logiq 9 scanner (GE Healthcare). Time-intensity curve volumes were developed corresponding to ultrasound contrast agent flow in the lesions after being identified in 4D View (GE Medical Systems). Time points corresponding to, wash-in, baseline, peak intensity, and washout of ultrasound contrast agent were identified and used to generate and compare vascular heterogeneity plots for malignant and benign lesions. Vascularity was observed with power Doppler imaging in 93 lesions (69 benign and 24 malignant). The 3D HI showed flow in 8 lesions (5 benign and 3 malignant), whereas 3D SHI visualized flow in 83 lesions (58 benign and 25 malignant). Analysis of vascular heterogeneity in the 3D SHI volumes found benign lesions having a significant difference in vascularity between central and peripheral sections (1.8 ± 0.16 vs. 1.2 ± 0.09 dB, p = 0.0003, respectively), whereas malignant lesions showed no difference (1.7 ± 0.33 vs. 1.3 ± 0.21 dB, p = 0.23), indicative of more vascular coverage. Parametric volumes, that contained a single parametric value for every voxel within the 3D volume in order to visualize localized variations, were generated based on perfusion (PER) and area under the curve (AUC). These maps highlighted the variations in the vascularity for individual voxels in the lesion volume. Finally, a preliminary measure for lesion characterization, based on vascular heterogeneity, achieved an area under the ROC of 0.72. These preliminary results suggest quantitative evaluation of vascular heterogeneity in breast lesions using contrast-enhanced 3D SHI is feasible and able to detect variations in vascularity between central and peripheral sections for benign and malignant lesions to aid in characterization.

Original languageEnglish (US)
Title of host publication2016 IEEE International Ultrasonics Symposium, IUS 2016
PublisherIEEE Computer Society
ISBN (Electronic)9781467398978
StatePublished - Nov 1 2016
Event2016 IEEE International Ultrasonics Symposium, IUS 2016 - Tours, France
Duration: Sep 18 2016Sep 21 2016

Publication series

NameIEEE International Ultrasonics Symposium, IUS
ISSN (Print)1948-5719
ISSN (Electronic)1948-5727


Other2016 IEEE International Ultrasonics Symposium, IUS 2016


  • breast cancer
  • microbubbles
  • subharmonic imaging
  • ultrasound
  • ultrasound contrast agents

ASJC Scopus subject areas

  • Acoustics and Ultrasonics


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