Three-dimensional sonographic study of breast nodules

Area of Science:

• Radiology
• Oncology
• Medical Imaging

Background:

• Distinguishing benign from malignant breast nodules is crucial for appropriate patient management.
• Traditional two-dimensional (2D) ultrasound has limitations in fully characterizing nodule features and vascularity.

Purpose of the Study:

• To investigate the utility of three-dimensional (3D) sonography and power-Doppler in identifying new parameters for differentiating benign and malignant breast lesions.
• To assess the accuracy of 3D ultrasound in lesion characterization and staging.

Main Methods:

• 34 women with breast nodules underwent examination using a 3D Voluson-GE 730 scanner and a 7.5 MHz linear-array probe.
• Nodules were assessed using B-mode and power-Doppler with 3D reconstruction; operator was blinded to clinical data.
• Lesion classification (benign/malignant) was based on B-mode appearance, margins, infiltration, vascularity, and volume, with results compared to biopsy findings.

Main Results:

• Biopsies confirmed 29 benign and 5 malignant nodules.
• 3D sonography classified 27 lesions as benign and 7 as malignant, yielding a specificity of 93.1%, sensitivity of 100%, and accuracy of 94.1%.
• No false negatives were reported, indicating high diagnostic performance.

Conclusions:

• 3D sonography enables accurate calculation of lesional mass for T1 staging of malignant breast nodules.
• This technique reveals subtle wall irregularities in benign lesions and infiltration limits in malignant ones, often missed by 2D scans.
• 3D power-Doppler provides a comprehensive view of nodule vascularity, visualizing more vessels than 2D studies.