Effect of Precompression on the Power Doppler Assessment of Breast Lesion Vascularity

Objectives To evaluate the effect of precompression on power Doppler visualization of blood flow in breast masses. Methods This Institutional Review Board–approved and Health Insurance Portability and Accountability Act–compliant study evaluated 30 patients with breast masses (16 benign and 14 malignant) undergoing ultrasound-guided breast biopsy. A computational mathematics program was used to calculate the number of color pixels in a region of interest at various degrees of compression of the breast by the transducer. The amount of precompression was calculated as previously described. The percentage of color pixels compared to minimal compression was plotted against the percentage of precompression. The amount of precompression needed to decrease the number of color pixels by 50% and 100% was calculated. The differences between benign and malignant lesions were compared. Results The mean percentages of precompression ± SD needed to decrease the number of color voxels by 50% in were 15.9% ± 6.43% (range, 8%–30%) for benign lesions and 14.0% ± 4.17% (range, 8%–20%) for malignant lesions (P = .35). The percentages of precompression needed to decrease the number of color pixels by 100% in were 34.7% ± 12.33% (range, 23%–62%) for benign lesions and for malignant lesions 26.7% ± 3.89% (range, 18%–31%), which were statistically significant (P = .027). Conclusions The amount of precompression normally used when obtaining B-mode images can substantially decrease the number of color voxels on power Doppler sonography. When performing quantitative work on Doppler evaluation of breast lesions, precompression needs to be controlled.