Comparing the extent of breast cancer tumors through contrast-enhanced ultrasound vs B-mode, opposed with pathology: evergreen study

Background To prove the efficacy of contrast-enhanced ultrasound (CEUS) in determining the extent of resection, more evidence about B-mode and CEUS as opposed to pathology is required. We compared maximum tumor width measured on B-mode/CEUS images with that determined pathologically. Methods In this retrospective multicenter study, 152 operable breast cancer patients who had undergone both B-mode and CEUS were analyzed. Maximum tumor width on B-mode and CEUS, and on the postoperative pathological examination (P), was measured by the participating investigators. In addition, maximum width was assessed in B-mode and CEUS image sets by independent reviewers blinded to all patient information. We analyzed differences in maximum width between CEUS, B-mode and P. Results The mean widths as measured by the participating investigators were 15 +/- 7 mm (B-mode), 19 +/- 8 mm (CEUS), and 17 +/- 9 mm (P). The difference subtracted P from B-mode was - 3 +/- 7 mm (p < 0.0001), and that from CEUS was 1 +/- 6 mm (p = 0.0163). The mean widths as measured by the independent reviewers were 16 +/- 7 mm (B-mode) and 18 +/- 7 mm (CEUS). The difference subtracted P from B-mode was - 2 +/- 8 mm (p = 0.0114), while that from CEUS was 1 +/- 7 mm (p = 0.1921). Conclusions Maximum lesion width measurement showed a tendency to increase in the order of B-mode, to P and CEUS. The difference in measurement between P and B-mode was significant, but there was no significant between CEUS and P. These results provide additional information of tendency patterns in measuring the maximum lesion width through enhancement on CEUS.