The role of contrast-enhanced ultrasound in the diagnosis of malignant non-mass breast lesions and exploration of diagnostic criteria

2021 ◽  
Vol 94 (1120) ◽  
pp. 20200880
Author(s):  
Fan Zhang ◽  
Lifang Jin ◽  
Gang Li ◽  
Chao Jia ◽  
Qiusheng Shi ◽  
...  
Keyword(s):  
Diagnostic Criteria ◽  
Sensitivity And Specificity ◽  
Breast Imaging ◽  
Diagnostic Value ◽  
Binary Logistic Regression Analysis ◽  
Lower Sensitivity ◽  
Breast Lesions ◽  
Contrast Enhanced Ultrasound ◽  
Contrast Enhanced ◽  
Histopathological Results

Objectives: To assess the value of contrast-enhanced ultrasound (CEUS) for diagnosing malignant non-mass breast lesions (NMLs) and to explore the CEUS diagnostic criteria. Methods: A total of 116 patients with 119 NMLs detected by conventional US were enrolled. Histopathological results were used as the reference standard. The enhancement characteristics of NMLs in CEUS were compared between malignant and benign NMLs. The CEUS diagnostic criteria for malignant NMLs were established using independent diagnostic indicators identified by binary logistic regression analysis. The diagnostic performance of Breast Imaging Reporting and Data System-US (BI-RADS-US), CEUS, and BI-RADS-US combined with CEUS was evaluated and compared. Results: Histopathological results showed 63 and 56 benign and malignant NMLs. Enhancement degree (OR = 5.75, p = 0.003), enhancement area (OR = 4.25, p = 0.005), and radial or penetrating vessels (OR = 7.54, p = 0.003) were independent diagnostic indicators included to establish the CEUS diagnostic criteria. The sensitivity and specificity of BI-RADS-US, CEUS, and BI-RADS-US combined with CEUS were 100 and 30.2%, 80.4 and 74.6%, and 94.6 and 77.8%, respectively; the corresponding areas under the receiver operating characteristic curve (AUC) were 0.819, 0.775, and 0.885, respectively. Conclusions: CEUS has a high specificity in malignant NML diagnosis based on the diagnostic criteria including enhancement degree, enhancement area, and radial or penetrating vessels, but with lower sensitivity than BI-RADS-US. The combination of CEUS and BI-RADS-US is an effective diagnostic tool with both high sensitivity and specificity for the diagnosis of malignant NMLs. Advances in knowledge: In this study, we assessed the diagnostic value of CEUS for malignant NMLs and constructed a feasible diagnostic criterion. We further revealed that the combination of CEUS and BI-RADS-US has a high diagnostic value for malignant NMLs.

scholarly journals Does contrast-enhanced ultrasound (CEUS) play a better role in diagnosis of breast lesions with calcification? A comparison with MRI

2020 ◽  
Vol 93 (1112) ◽  
pp. 20200195
Author(s):  
Jiamin Pan ◽  
Wenjuan Tong ◽  
Jia Luo ◽  
Jinyu Liang ◽  
Fushun Pan ◽  
...  
Keyword(s):  
Breast Imaging ◽  
Breast Lesions ◽  
Diagnostic Efficiency ◽  
Contrast Enhanced Ultrasound ◽  
Roc Curve Analysis ◽  
Diagnostic Efficacy ◽  
Score System ◽  
Contrast Enhanced ◽  
Significant Difference

Objective: To compare the efficacy of contrast-enhanced ultrasound enabled reclassification of Breast Imaging Reporting and Data System (CEUS-BI-RADS) with MRI in the diagnosis of breast lesions with calcification. Methods: A total of 52 breast lesions with calcification from 51 patients were detected by ultrasound as hyperechoic foci and categorized as BI-RADS 3–5. The 51 patients further underwent CEUS scan and MRI. The ultrasound-BI-RADS combined with CEUS 5-point score system redefined the classification of BI-RADS which was called CEUS-BI-RADS. The diagnostic efficacy of three methods was assessed by receiver operating characteristic (ROC) curve analysis. Histopathological assessment used as the gold-standard. Results: The sensitivities of Ultrasound-BI-RADS, MRI classification of BI-RADS (MRI-BI-RADS) and CEUS-BI-RADS were 85%, 90% and 95% without significant difference among the three modalities (p > 0.05). The diagnostic specificities of ultrasound-BI-RADS, MRI-BI-RADS and CEUS-BI-RADS were 78.1%, 78.1% and 96.8%, respectively (p < 0.05); and the accuracy were 80.7%, 82.6% and 96.1% for ultrasound-BI-RADS, MRI-BI-RADS and CEUS-BI-RADS, respectively (p < 0.05). The area under ROC (AUROC) in differentiation of breast lesions with calcification was 0.945 for CEUS-BI-RADS, 0.907 for MRI-BI-RADS and 0.853 for ultrasound-BI-RADS, with no significant difference among the three modalities (p > 0.05). Conclusion: The CEUS-BI-RADS has a better diagnostic efficiency than MRI-BI-RADS in the differentiation of the breast lesions with calcification. Advances in knowledge: •CEUS is a better method in differentiation of breast lesions with calcification. •CEUS-BI-RADS increases the efficiency of diagnosis compared to MRI.

Value of contrast-enhanced malignancy imaging features in secondary grade diagnosis of BI-RADS-US type 4 breast lesions

2020 ◽  
pp. 030089162096571
Author(s):  
Junxi Gao ◽  
Wei Han ◽  
Di Li Mu La Ti Ai Si Mu Tu La ◽  
Xueqin Hou ◽  
Zhi Ming Li ◽  
...  
Keyword(s):  
Breast Imaging ◽  
Benign Lesion ◽  
Breast Lesions ◽  
Imaging Features ◽  
Contrast Enhanced Ultrasound ◽  
Contrast Enhanced ◽  
Peripheral Ring ◽  
Malignant Lesions ◽  
Type 3

Purpose: To explore the value of contrast-enhanced malignancy imaging features in secondary grade diagnosis of Breast Imaging Reporting and Data System for Ultrasonography (BI-RADS-US) type 4 breast lesions. Methods: After initial diagnosis by ultrasound, 124 BI-RADS-US type 4 patients with 130 lesions were examined by contrast-enhanced ultrasound (CEUS) and were classified again before surgery according to five contrast-enhanced malignancy imaging features: inhomogeneous enhancement, peripheral ring-like enhancement, expansive enhancement, internal filling defects, and surrounding radioactive convergence. Lesions with no contrast-enhanced features of malignancy were categorized as type 3; lesions with one, two, or three features of malignancy were categorized as type 4A, 4B, or 4C, respectively; and lesions with four or more indices of malignancy were categorized as type 5. The value of contrasted imaging features of malignancy in diagnosing BI-RADS-US type 4 breast lesions was analyzed. Results: The accuracy of CEUS diagnosis for type 3 lesions was 93.8% (46/49), 76.9% (10/13) for type 4A, 71.4% (5/7) for type 4B, 75.0% (9/12) for type 4C, and 93.8% (46/49) for type 5 lesions. The sensitivity of CEUS in diagnosing malignant lesions was 90.4%, specificity was 83.6%, and accuracy was 86.9%. CEUS decreased the benign lesion biopsy ratio to 68.5% (46/67) and increased the diagnosis ratio of malignant lesions to 73.0% (46/63). Conclusions: CEUS can further optimize the classification of BI-RADS-US type 4 breast lesions and may provide a better reference basis for clinical diagnosis and treatment of those breast lesions.

scholarly journals Contrast-enhanced ultrasound of breast fibromatosis: a case report

2021 ◽  
Vol 49 (5) ◽  
pp. 030006052110106
Author(s):  
Shanhong Lin ◽  
Yong Cao ◽  
Libin Chen ◽  
Mei Chen ◽  
Shengmin Zhang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Rare Case ◽  
Common Type ◽  
Breast Lesions ◽  
Contrast Enhanced Ultrasound ◽  
High Similarity ◽  
Potential Value ◽  
Contrast Enhanced ◽  
Malignant Breast ◽  
Contrast Enhanced Ultrasonography

We herein present a rare case of breast fibromatosis, the contrast-enhanced ultrasonography (CEUS) findings of which we believe have never been described. The high similarity between the clinical and imaging manifestations of breast cancer makes its differential diagnosis difficult. In this report, we describe the CEUS findings of a less common type of fibromatosis, discuss the potential value of CEUS to differentiate it from malignant breast lesions, and briefly review the literature.

scholarly journals Diagnostic Value of Contrast-Enhanced Ultrasound Evaluation of Malignant and Benign Solitary Thyroid Nodules

2016 ◽  
Vol 70 (1) ◽  
pp. 1-6 ◽  
Author(s):  
Pēteris Priedītis ◽  
Maija Radziņa ◽  
Ilze Štrumfa ◽  
Zenons Narbuts ◽  
Arturs Ozoliņs ◽  
...  
Keyword(s):  
Contrast Enhancement ◽  
Thyroid Nodules ◽  
Fine Needle Biopsy ◽  
Diagnostic Value ◽  
Contrast Enhanced Ultrasound ◽  
Clinical Value ◽  
Additional Tool ◽  
Ultrasound Evaluation ◽  
Contrast Enhanced ◽  
Benign Nodules

Abstract The aim of the study was to investigate the diagnostic value of contrast-enhanced ultrasound (CEUS) in differentiating benign and malignant thyroid nodules. Thirty-five patients with morphologically proved thyroid nodules (17 malignant; 18 benign), underwent CEUS examination. Five enhancement patterns were evaluated: vascularisation, homogeneity, presence of peripheral rim type enhancement, wash-out rate of the contrast medium, and enhancement using microvascular imaging application. Time-intensity curves (TIC) were analysed in post-processing and defined as three types: slow versus rapid and stable versus rapid biphasic wash-out. Diagnostic value of the listed CEUS parameters was calculated. The results showed medium strength correlation between morphology (benign versus malignant nodule) and type of TIC curve rs = 0.38 (p = 0.021), as well as between mode of contrast enhancement rs = 0.39 (p = 0.022) and wash-out pattern rs =0.39 (p = 0.024). The overall pooled sensitivity of selected diagnostic parameters was 82%, specificity 57%, and accuracy 70%. Malignant nodules were characterised by iso- or hypovascular contrast enhancement and slow wash-out, while benign nodules showed hypervascular enhancement with rapid wash-out TIC curve and rim-like pattern. The CEUS patterns significantly differed between malignant and benign thyroid nodules with high diagnostic accuracy. Thus, CEUS has important clinical value as an additional tool to ultrasound and fine needle biopsy.

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