Tissue harmonic imaging sonography of breast lesions: improved margin analysis, conspicuity, and image quality compared to conventional ultrasound.

The purpose of this preference study is to determine if tissue harmonic imaging (THI) is preferred over conventional sonography for imaging breast masses. A prospective evaluation of 73 identical image pairs (one obtained with conventional sonography, one with THI sonography) was performed, examining 25 cysts, 36 solid masses, and 12 indeterminate lesions. Each image was evaluated for lesion contrast, margins, and overall image quality using a graduated score. Statistical analysis was performed using a modified t test. For cystic and solid lesions, THI was preferred for lesion conspicuity, margin, and overall quality (P<.001). For indeterminate lesions, THI was significantly preferred for lesion conspicuity and overall quality (P<.05), but the preference for margins was not significant. Overall, THI of breast lesions was significantly preferred for lesion contrast and margin evaluation compared to conventional sonography. This modality deserves further evaluation and may improve detection and evaluation of breast lesions.

[1]  Charles T. Lancée,et al.  Higher harmonics of vibrating gas-filled microspheres. Part one: simulations , 1994 .

[2]  R. Shapiro,et al.  Tissue harmonic imaging sonography: evaluation of image quality compared with conventional sonography. , 1998, AJR. American journal of roentgenology.

[3]  T. Desser,et al.  Tissue harmonic imaging: Utility in abdominal and pelvic sonography , 1999, Journal of clinical ultrasound : JCU.

[4]  W. K. Law,et al.  Demonstration of nonlinear acoustical effects at biomedical frequencies and intensities. , 1980, Ultrasound in medicine & biology.

[5]  V F Humphrey,et al.  The development of harmonic distortion in pulsed finite-amplitude ultrasound passing through liver. , 1986, Physics in medicine and biology.

[6]  E. Carstensen,et al.  Prediction of nonlinear acoustic effects at biomedical frequencies and intensities. , 1980, Ultrasound in medicine & biology.

[7]  W. J. Conover,et al.  Practical Nonparametric Statistics , 1972 .

[8]  James D. Thomas,et al.  Why does tissue harmonic imaging improve image quality: a quantitative examination demonstrating side-lobe suppression , 1998 .

[9]  S. Goldenberg,et al.  Malignant breast masses detected only by ultrasound. A retrospective review , 1995, Cancer.

[10]  S. C. Chen,et al.  Prospective sonographic study of 3093 breast tumors. , 1999, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[11]  B Olstad.  [Non-linear models for real time image processing and their applications in image enhancement, surface area determination and volume visualization]. , 1993, Ultraschall in der Medizin.

[12]  A. Stavros,et al.  Solid breast nodules: use of sonography to distinguish between benign and malignant lesions. , 1995, Radiology.

[13]  L. Adler,et al.  Determination of the Nonlinearity Parameter B/A for Water and m‐Xylene , 1962 .

[14]  T. M. Kolb,et al.  Occult cancer in women with dense breasts: detection with screening US--diagnostic yield and tumor characteristics. , 1998, Radiology.

[15]  Charles T. Lancée,et al.  Higher harmonics of vibrating gas-filled microspheres. Part two: measurements , 1994 .