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Abstract
The discovery of microbubble harmonic properties has lead to an explosion of technical developments to harness these properties. The use of low mechanical index (MI) imaging techniques, making use of harmonic properties of the microbubble contrast agents, is an ultrasound imaging milestone. Previously, comparisons between MRI, CT and ultrasound have always compared contrast enhanced MRI and CT with non-enhanced ultrasound; not surprisingly coming to the conclusion that the former imaging techniques are superior to ultrasound. This may all change over the next few years (60 New tools, such as contrast-enhanced B-mode imaging method,will open new areas in investigation of intratumoral microvessel perfusion.(62 Various studies show that contrast-enhanced power Doppler US improved characterization of tumor vascularity in breast tumors. (42 Contrast-enhanced power Doppler US is a useful and reliable method to evaluate vascularization in breast tumors. It contributes significantly to differential diagnosis and provides additional information about the contrast bolus. The diagnostic accuracy is higher in power than in color Doppler US studies, thus quantitative assessment of power Doppler US and microbubble contrast agent is still superior to contrastenhanced color Doppler US. Nevertheless, despite an improvement of Doppler US data , differentiation of benign and malignant tumors cannot be achieved with absolute certainty. Biopsy of suspicious or indeterminate breast lesions is still necessary.