Contrast-enhanced ultrasound improved performance of breast imaging reporting and data system evaluation of critical breast lesions

Figure 1 Hypothetical biopsy thresholds depending on breast imaging reporting and data system after contrast-enhanced ultrasound: Malignant risk assessment, resultant biopsy rates, cancer-to-biopsy yields. CEUS: Contrast-enhanced ultrasound; BI-RADS: Breast imaging reporting and data system.

Figure 2 Enhancement patterns of triple-negative Iinvasive ductal carcinoma. A: Color Doppler flow imaging with hypo-vascular; B and C: Homogeneous hyper-enhancement with rapid wash-in, irregular shape, clear margin and equal size, without perfusion defect, penetrating vessel and crab claw-like pattern; D: Mammography shows an adenoma or benign phyllodes tumor- like appearance with sharp clear margin and regular shape.

Figure 3 Enhancement patterns of inflammatory lesion. A: Color Doppler flow imaging with hyper-vascular; B: Heterogeneous hyper-enhancement with rapid wash-in, enlarged size compared with 2 dimensional image, with perfusion defect, irregular shape and unclear margin, without penetrating vessel and crab claw-like pattern.