ULTRASOUND Messages for December, 1997: Re: breast Doppler from Karen Ophir & JOB

Re: breast Doppler from Karen Ophir & JOB

From: DuBose, Terry

DuboseTerryJ@exchange.uams.edu

Mon Dec 15 07:28:25 1997

-----Original Message----- From: JONATHAN OPHIR [SMTP:jophir@msrad3.med.uth.tmc.edu]

Terry, Just wanted to let you know, I start a new job tomorrow at MD Anderson Cancer Center working with Dr. Bruno Fornage. I hope to get into some research and publication as well as scanning.

Regarding your network question about breast doppler--

************************************************************************ ** >To: ultrasound@obgyn.net, Multiple recipients of list

-- Sonography can not discriminate between solid malignancies or benign masses. However, there was an article in Radiology (March, 1996, I think, I've slept since then) had an article from England that claimed 100% specificity and sensitivity for separating benign and malignant masses in the breast. They were using a Doppler contrast agent that gave enhanced Doppler signals around the periphery for about 20 minutes after injection. The population was small, 35 I think. Sounds promising. There have also been a few articles and presentations about using Doppler without contrast, but with very mixed results, can't give you more than that. Anyone else?

Also, Jon Ophier in Houston has done considerable work using "Elastography" to evaluate the compression of tissues using the sonographic transducer. I will forward this to him as well and see if he will give you (us) more information. > -----Original Message----- From: Diana Connor [SMTP:dconnor@netcom.ca]

Hi again- I'm wondering if there is anyone amongst us that has an interest in solid breast lesions, expecially reagarding colour flow in them, and how comfortable they are in predicting B vs M by u/s? Any studies done? >

I don't know if any of the gyn's scan breasts, maybe one of my fellow sonographers or a Radiologist (? do we have one here yet?) may be able to help.

Thx Diana Connor MRT(R), RDMS ************************************************************** A few years ago Dr. Madjar of Freiberg, Germany published an article on

breast Doppler. His findings were not conclusive but were very interesting. 1) Naturally, the number of vessels in a malignant was higher than benign. 2) The wave form was surprisingly HIGH resistance for malignancy. If over .7 (I think) indicated always malignant.

This is all I can remember now and of course I can't find the article just now. If I find it, I will write more later. You can reach Dr. Helmut Madjar at Universitats Frauenklinik Hugstetter Strasse 55 D 7800 Freiburg Germany Ph: 49 (0)761-270-3002 fax 49(0)761-270-3053

Jonathan says the only thing we know right now based on a large number of in vitro samples is that glandular tissue is 3 times harder than fat, fibroadenoma are 10 times harder than fat, and carcinomas are 20 times harder than fat. With elastography, we are seeing things with an elastic contrast as low as 2:1. Elastography has had some promising cases. I refer anyone interested in elastography to the article by B. S. Garra, MD, in Radiology, Jan, 1997 issue.

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