Diagnostic criteria for contrast-enhanced ultrasound in the differentiation of focal breast lesions

Choonpa Igaku ◽  
2020 ◽  
Vol 47 (2) ◽  
pp. 53-59
Author(s):  
Toshikazu ITO
Keyword(s):  
Diagnostic Criteria ◽  
Breast Lesions ◽  
Contrast Enhanced Ultrasound ◽  
Contrast Enhanced

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 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 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.

scholarly journals Prospective evaluation of contrast-enhanced ultrasound of breast BI-RADS 3-5 lesions

2020 ◽  
Author(s):  
Janu Eva ◽  
Krikavova Lucie ◽  
Little Jirina ◽  
Dvorak Karel ◽  
Brancikova Dagmar ◽  
...  
Keyword(s):  
Quantitative Analysis ◽  
Qualitative Analysis ◽  
Malignant Tumors ◽  
Blood Perfusion ◽  
Benign Tumors ◽  
Breast Lesions ◽  
Contrast Enhanced Ultrasound ◽  
Benign Lesions ◽  
Time To Peak ◽  
Contrast Enhanced

Abstract Purpose: To determine the benefit of contrast-enhanced ultrasound (CEUS) in the assessment of breast lesions. Materials and Methods: A standardized contrast-enhanced ultrasound was performed in 230 breast lesions classified as BI-RADS category 3 to 5. All lesions were subjected to qualitative and quantitative analysis. MVI (MicroVascular Imaging) technique was used to derive qualitative analysis parameters; blood perfusion of the lesions was assessed (perfusion homogeneity, type of vascularization, enhancement degree). Quantitative analysis was conducted to estimate perfusion changes in the lesions within drawn regions of interest (ROI); parameters TTP (time to peak), PI (peak intensity), WIS (wash in slope), AUC (area under curve) were obtained from time intensity (TI) curves. Acquired data were statistically analyzed to assess the ability of each parameter to differentiate between malignant and benign lesions. The combination of parameters was also evaluated for the possibility of increasing the overall diagnostic accuracy. Biological nature of the lesions was verified by a pathologist. Benign lesions without histopathological verification (BI-RADS 3) were followed up for at least 24 months. Results: Out of 230 lesions, 146 (64%) were benign, 67 (29%) were malignant, 17 (7%) lesions were eliminated. Malignant tumors showed statistically significantly lower TTP parameters (sensitivity 77.6%, specificity 52.7%) and higher WIS values (sensitivity 74.6%, specificity 66.4%) than benign tumors. Enhancement degree also proved to be statistically well discriminating as 55.2% of malignant lesions had a rich vascularity (sensitivity 89.6% and specificity 48.6%). The combination of quantitative analysis parameters (TTP, WIS) with enhancement degree did not result in higher accuracy in distinguishing between malignant and benign breast lesions. Conclusion: We have demonstrated that contrast-enhanced breast ultrasound has the potential to distinguish between malignant and benign lesions. In particular, this method could help to differentiate lesions BI-RADS category 3 and 4 and thus reduce the number of core-cut biopsies performed in benign lesions. Qualitative analysis, despite its subjective element, appeared to be more beneficial. A combination of quantitative and qualitative analysis did not increase the predictive capability of CEUS.

Meta-analysis of contrast-enhanced ultrasound for the differentiation of benign and malignant breast lesions

2015 ◽  
Vol 56 (1) ◽  
pp. 25-33 ◽  
Author(s):  
Qiao Hu ◽  
Xiao Yan Wang ◽  
Shang Yong Zhu ◽  
Li Ke Kang ◽  
Yan Ju Xiao ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Breast Lesions ◽  
Contrast Enhanced Ultrasound ◽  
Contrast Enhanced ◽  
Malignant Breast
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