Mammasonografie Update

Zusammenfassung

Neue Entwicklungen der Sonografie umfassen die klinische Erprobung der automatisierten 3D-Ultraschallbildgebung, die technische Optimierung moderner Hochfrequenzschallköpfe, die multiparametrische Bildanalyse aus Elastizitäts-, Durchblutungs- und Architekturinformationen und die Integration der Sonografie in Hybridsysteme. Die automatisierte 3D-Ultraschallbildgebung liefert einen 3D-Bilddatensatz, der ähnlich wie CT- oder MR-Volumendatensätze an einer Workstation ausgelesen werden kann. Die Hochfrequenzsonografie ist erforderlich, um kleinste Details wie DCIS oder invasive multifokale Läsionen zu erfassen. Fortschrittliche Technologien wie Compounding, Harmonic Imaging oder die Verminderung von Speckles erhöhen das Signal-Kontrast-Verhältnis. Die vaskuläre Bildgebung und die Elastografie erlauben es, harte oder hypervaskularisierte BI-RADS-US-3-Herde auf BI-RADS-US 4a hochzustufen.

Abstract

New developments in ultrasound encompass 3-D automated US as an adjunct to screening mammography, handheld high frequency transducers in whole breast US, and hybrid systems. High-frequency ultrasound is relevant for assessing small mammographic masses and for preoperative staging to detect accompanying focal or ductal changes due to DCIS or invasive foci and metastatic axillary lymph nodes. Advanced modes as compounding, tissue harmonic imaging and speckle reduction increase the signal to contrast ratio. Doppler techniques and elastography are additional tools to re-categorize BI-RADS 3 vs. 4a lesions, suggesting to upgrade the former if the lesion is stiff or hyper-vascularised.

Keywords

Diagnostic ultrasound - diagnosis - breast neoplasm - benign breast disease - clinical issues - BI-RADS-ultrasound - state of the art equipment, imaging - Colour Doppler - 3-dimensional ultrasound - elastography - tissue harmonic imaging - automated volume ultrasound - mammography - MRI - histology minimal-invasive procedures - needle biopsy

• Literatur

• 1 Mundinger A. Ultrasound of the breast, including interventions: an update. In: Hodler J, von Schulthess GK, Zollikofer CHL, (eds) Diseases of the heart, chest and breast. 2011–2014. Springer Italy; 2011: 282-289
• 2 Mundinger A. Ultrasound of the breast, including interventions: an update. In: Hodler J, von Schulthess GK, Zollikofer CHL, (eds) Diseases of the heart, chest and breast. 2011–2014. Springer Italy; 2011: 259-266
• 3 Sencha AN, Evseeva EV, Mogutov MS et al. Breast Ultrasound. Springer Science & Business Media; 2013: 23-141
• 4 Providian Medical Equipment LLC. Ultrasound Imaging Guide. Im Internet: http://www.providianmedical.com/ultrasound-imaging-guide ; 23. 4. 2015
• 5 Madjar H, Sauerbrei W, Hansen L. Multivariate analysis of flow data in breast lesions and validation in a normal clinical setting. Ultraschall Med 2011; 32: 511-517
• 6 Svensson WE, Pandian AJ, Hashimoto H. The use of breast ultrasound color Doppler vascular pattern morphology improves diagnostic sensitivity with minimal change in specificity. Ultraschall Med 2010; 31: 466-474
• 7 Bamber J, Cosgrove D, Dietrich CF et al. EFSUMB guidelines and recommendations on the clinical use of ultrasound elastography. Part 1: Basic principles and technology. Ultraschall Med 2013; 34: 169-184
• 8 Cosgrove D, Piscaglia F, Bamber J et al. EFSUMB guidelines and recommendations on the clinical use of ultrasound elastography. Part 2: Clinical applications. Ultraschall Med 2013; 34: 238-253
• 9 Mundinger A, Wilson ARM, Weismann C et al. Where do we stand in advanced breast ultrasound?. EJC 2012; 48 (Suppl. 01) 15-17
• 10 Abe H, Schmidt RA, Shah RN et al. MR-directed („Second-Look“) ultrasound examination for breast lesions detected initially on MRI: MR and sonographic findings. AJR 2010; 194: 370-377
• 11 Price ER, Hargreaves J, Lipson JA et al. The california breast density information group: a collaborative response to the issues of breast density, breast cancer risk, and breast density notification legislation. Radiology 2013; 269: 887-892
• 12 Heywang-Köbrunner SH, Schreer I, Heindel W et al. Imaging studies for the early detection of breast cancer. Dtsch Arztebl Int 2008; 105: 541-547
• 13 Madjar H, Rickard M, Jellins J et al. IBUS guidelines for the ultrasonic examination of the breast. Eur J Ultrasound 1999; 9: 99-102
• 14 Mendelson EB, Böhm-Vélez M, Berg WA et al. ACR BI-RADS^® Ultrasound. In: ACR BI-RADS^® Atlas Breast Imaging Reporting and Data System. Reston, VA: American College of Radiology; 2013
• 15 Madjar H, Ohlinger R, Mundinger A et al. BI-RADS-analogue DEGUM criteria for findings in breast ultrasound – consensus of the DEGUM Committee on Breast Ultrasound. Ultraschall Med 2006; 27: 374-379
• 16 Saleh A, Kurz KD, Mödder U. BI-RADS update: Mammographie, Brustultraschall und Kernspinmammographie. Radiologie up2date 2005; 5: 285-316
• 17 Müller-Schimpfle MP, Heindel W, Kettritz U et al. Consensus Meeting of Course Directors in Breast Imaging, 7 May 2011, in Frankfurt am Main–topic: MRI of the breast. Röfo 2012; 184: 919-924
• 18 Berg WA, Sechtin AG, Marques H et al. Cystic breast masses and the ACRIN 6666 experience. Radiol Clin North Am 2010; 48: 931-987
• 19 Sadigh G, Carlos RC, Neal CH et al. Ultrasonographic differentiation of malignant from benign breast lesions: a meta-analytic comparison of elasticity and BIRADS scoring. Breast Cancer Res Treat 2012; 133: 23-35
• 20 Britton P, Warwick J, Wallis MG et al. Measuring the accuracy of diagnostic imaging in symptomatic breast patients: team and individual performance. Br J Radiol 2012; 85: 415-422
• 21 Mundinger A, Madjar H. Brustdiagnostik – Mammografie, Sonografie und MRT – Wann und warum?. Gyne 2013; 11: 6-8
• 22 Moon HJ, Kim MJ, Kwak JY et al. Malignant lesions initially categorized as probably benign breast lesions: retrospective review of ultrasonographic, clinical and pathologic characteristics. Ultrasound Med Biol 2010; 36: 551-559
• 23 Gruber R, Jaromi S, Rudas M et al. Histologic work-up of non-palpable breast lesions classified as probably benign at initial mammography and/or ultrasound (BI-RADS category 3). Eur J Radiol 2013; 82: 398-403
• 24 Mundinger A. Advanced Breast Ultrasound and Interventions: An Update. In: Hodler J, et al. (eds.) Musculoskeletal Diseases 2013 – 2016. Springer Italy; 2013.
• 25 Fu CY, Hsu HH, Yu JC et al. Influence of Age on PPV of Sonographic BI-RADS Categories 3, 4, and 5. Ultraschall Med 2010; 32: 8-13
• 26 Interdisziplinäre S3-Leitlinie für die Diagnostik, Therapie und Nachsorge des Mammakarzinoms. Langversion 3.0, Aktualisierung 2012. AWMF Registriernummer 032-045-OL. Leitlinienprogramm Onkologie der AWMF, Deutsche Krebsgesellschaft e.V. und Deutsche Krebshilfe e.V. 2012
• 27 Corsetti V, Houssami N, Ghirardi M et al. Evidence of the effect of adjunct ultrasound screening in women with mammography-negative dense breasts: Interval breast cancers at one year follow-up. Eur J Cancer 2011; 47: 1021-1026
• 28 Caumo F, Bernardi D, Ciatto S et al. Incremental effect from integrating 3D-mammography (tomosynthesis) with 2D-mammography: Increased breast cancer detection evident for screening centres in a population-based trial. Breast 2014; 223: 76-80
• 29 Berg WA, Zhang Z, Lehrer D. ACRIN 6666 Investigators et al. Detection of breast cancer with addition of annual screening ultrasound or a single screening MRI to mammography in women with elevated breast cancer risk. JAMA 2012; 7: 1394-1404
• 30 D'Orsi O, Sickles EA, Mendelson EB et al. ACR BI-RADS^® Atlas, Breast Imaging Reporting and Data System. Reston, VA: American College of Radiology; 2013
• 31 Golatta M, Baggs C, Schweitzer-Martin M et al. Evaluation of an automated breast 3D-ultrasound system by comparing it with hand-held ultrasound (HHUS) and mammography. Arch Gynecol Obstet 2015; 291: 889-895
• 32 Britton P, Warwick J, Wallis MG et al. Mensuring the accuracy of diagnostic imaging in symptomatic breast patients: team and individual performance. Br J Radiol 2012; 85: 415-422
• 33 Wojcinski S, Farrokh A, Weber S et al. Multicenter study of ultrasound real-time tissue elastography in 779 cases for the assessment of breast lesions: improved diagnostic performance by combining the BI-RADS^®-US classification system with sonoelastography. Ultraschall Med 2010; 31: 484-491
• 34 Berg WA, Cosgrove DO, Doré CJ et al. (for the BE1 Investigators) Shear-wave elastography improves the specificity of breast US: The multinational study of 939 masses. Radiology 2012; 262: 435-449
• 35 Mundinger A. New frontiers of advanced breast ultrasound. Insights Imaging 2013; 4: S1-S144 , D:392
• 36 Cody 3rd HS, Houssami N. Axillary management in breast cancer: what's new for 2012?. Breast 2012; 21: 411-415
• 37 Marinovich ML, Houssami N, Macaskill P et al. Meta-analysis of magnetic resonance imaging in detecting residual breast cancer after neoadjuvant therapy. J Natl Cancer Inst 2013; 105: 321-333
• 38 Turnbull L, Brown S, Harvey I et al. Comparative effectiveness of MRI in breast cancer (COMICE) trial: A randomised controlled trial. Lancet 2010; 375: 563-571