Quantitative Multiparametric Breast Ultrasound: Application of Contrast-Enhanced Ultrasound and Elastography Leads to an Improved Differentiation of Benign and Malignant Lesions.
View / Open Files
Authors
Kapetas, Panagiotis
Clauser, Paola
Wengert, Georg J
Lazar, Mathias
Pinker, Katja
Helbich, Thomas H
Baltzer, Pascal AT
Publication Date
2019-05Journal Title
Investigative Radiology
ISSN
0020-9996
Publisher
Wolters Kluwer Health
Volume
54
Issue
5
Pages
257-264
Language
eng
Type
Article
This Version
AM
Metadata
Show full item recordCitation
Kapetas, P., Clauser, P., Woitek, R., Wengert, G. J., Lazar, M., Pinker, K., Helbich, T. H., & et al. (2019). Quantitative Multiparametric Breast Ultrasound: Application of Contrast-Enhanced Ultrasound and Elastography Leads to an Improved Differentiation of Benign and Malignant Lesions.. Investigative Radiology, 54 (5), 257-264. https://doi.org/10.1097/RLI.0000000000000543
Abstract
OBJECTIVES: The aim of this study was to evaluate breast multiparametric ultrasound (mpUS) and its potential to reduce unnecessary breast biopsies with 1, 2, or 3 additional quantitative parameters (Doppler, elastography, and contrast-enhanced ultrasound [CEUS]) to B-mode and investigate possible variations with different reader experience. MATERIALS AND METHODS: This prospective study included 124 women (age range, 18-82 years; mean, 52 years), each with 1 new breast lesion, scheduled for ultrasound-guided biopsy between October 2015 and September 2016. Each lesion was examined with B-mode, elastography (Virtual Touch IQ [VTIQ]), Doppler, and CEUS, and different quantitative parameters were recorded for each modality. Four readers (2 experienced breast radiologists and 2 in-training) independently evaluated B-mode images of each lesion and assigned a BI-RADS (Breast Imaging Reporting and Data System) score. Using the area under the receiver operating characteristic curve (AUC), the most accurate quantitative parameter for each modality was chosen. These were then combined with the BI-RADS scores of all readers. Descriptive statistics and AUC were used to evaluate the diagnostic performance of mpUS. RESULTS: Sixty-five lesions were malignant. MpUS with B-mode and 2 additional quantitative parameters (VTIQ and CEUS or Doppler) showed the highest diagnostic performance for all readers (averaged AUCs, 0.812-0.789 respectively vs 0.683 for B-mode, P = 0.0001). Both combinations significantly reduced the number of false-positive findings up to 46.9% (P < 0.0001). CONCLUSIONS: Quantitative mpUS with 2 different triple assessment modalities (B-mode, VTIQ elastography, CEUS, or Doppler) shows the best diagnostic performance for breast cancer diagnosis and leads to a significant reduction of false-positive biopsy recommendations, for both experienced and inexperienced readers.
Identifiers
External DOI: https://doi.org/10.1097/RLI.0000000000000543
This record's URL: https://www.repository.cam.ac.uk/handle/1810/296750
Rights
All rights reserved