The utility of quantifying the orientation of breast masses in ultrasound imaging

Abstract The aim of this study was to quantify the orientation of breast masses and determine whether it can enhance the utility of a not parallel orientation in predicting breast mass malignancy. A total of 15,746 subjects who underwent breast ultrasound examinations were initially enrolled in the...

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Main Authors: Kailiang Chen, Size Wu
Format: Article
Language:English
Published: Nature Portfolio 2024-02-01
Series:Scientific Reports
Subjects:
Online Access:https://doi.org/10.1038/s41598-024-55298-w
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author Kailiang Chen
Size Wu
author_facet Kailiang Chen
Size Wu
author_sort Kailiang Chen
collection DOAJ
description Abstract The aim of this study was to quantify the orientation of breast masses and determine whether it can enhance the utility of a not parallel orientation in predicting breast mass malignancy. A total of 15,746 subjects who underwent breast ultrasound examinations were initially enrolled in the study. Further evaluation was performed on subjects with solid breast masses (≤ 5 cm) intended for surgical resection and/or biopsy. The orientation angle, defined as the acute angle between the align of the maximal longitudinal diameter of the breast mass and the surface of the breast skin, was measured. Receiver operating characteristic (ROC) curve analysis was conducted, and various performance measures including sensitivity, specificity, positive and negative predictive values, accuracy, odds ratio, and the area under the ROC curve (AUC) were calculated. Multivariate analysis was performed to determine if the orientation angle was an independent predictor of breast malignancy. Decision curve analysis (DCA) was also conducted to assess the net benefit of adopting the orientation angle for predicting breast mass malignancy. The final analysis included 83 subjects with breast cancer and 135 subjects with benign masses. The intra-group correlation coefficient for the measurement of the orientation angle of breast masses was 0.986 (P = 0.001), indicating high reproducibility. The orientation angles of malignant and benign breast masses were 36.51 ± 14.90 (range: 10.7–88.6) degrees and 15.28 ± 8.40 (range: 0.0–58.7) degrees, respectively, and there was a significant difference between them (P < 0.001). The cutoff value for the orientation angle was determined to be 22.9°. The sensitivity, specificity, positive and negative predictive values, accuracy, odds ratio, and AUC for the prediction of breast malignancy using the orientation angle were 88.0%, 87.4%, 81.1%, 92.2%, 87.6%, 50.67%, and 0.925%, respectively. Multivariate analysis revealed that the orientation angle (> 22.9°), not circumscribed margin, and calcifications of the breast mass were independent factors predicting breast malignancy. The net benefit of adopting the orientation angle for predicting breast malignancy was 0.303. Based on these findings, it can be concluded that quantifying the orientation angle of breast masses is useful in predicting breast malignancy, as it demonstrates high sensitivity, specificity, AUC, and standardized net benefit. It optimizes the utility of the not parallel orientation in assessing breast mass malignancy.
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spelling doaj.art-3efb61bd03514bc295fbeb296e1ad9b32024-03-05T18:54:47ZengNature PortfolioScientific Reports2045-23222024-02-011411910.1038/s41598-024-55298-wThe utility of quantifying the orientation of breast masses in ultrasound imagingKailiang Chen0Size Wu1Department of Ultrasound, The First Affiliated Hospital of Hainan Medical UniversityDepartment of Ultrasound, The First Affiliated Hospital of Hainan Medical UniversityAbstract The aim of this study was to quantify the orientation of breast masses and determine whether it can enhance the utility of a not parallel orientation in predicting breast mass malignancy. A total of 15,746 subjects who underwent breast ultrasound examinations were initially enrolled in the study. Further evaluation was performed on subjects with solid breast masses (≤ 5 cm) intended for surgical resection and/or biopsy. The orientation angle, defined as the acute angle between the align of the maximal longitudinal diameter of the breast mass and the surface of the breast skin, was measured. Receiver operating characteristic (ROC) curve analysis was conducted, and various performance measures including sensitivity, specificity, positive and negative predictive values, accuracy, odds ratio, and the area under the ROC curve (AUC) were calculated. Multivariate analysis was performed to determine if the orientation angle was an independent predictor of breast malignancy. Decision curve analysis (DCA) was also conducted to assess the net benefit of adopting the orientation angle for predicting breast mass malignancy. The final analysis included 83 subjects with breast cancer and 135 subjects with benign masses. The intra-group correlation coefficient for the measurement of the orientation angle of breast masses was 0.986 (P = 0.001), indicating high reproducibility. The orientation angles of malignant and benign breast masses were 36.51 ± 14.90 (range: 10.7–88.6) degrees and 15.28 ± 8.40 (range: 0.0–58.7) degrees, respectively, and there was a significant difference between them (P < 0.001). The cutoff value for the orientation angle was determined to be 22.9°. The sensitivity, specificity, positive and negative predictive values, accuracy, odds ratio, and AUC for the prediction of breast malignancy using the orientation angle were 88.0%, 87.4%, 81.1%, 92.2%, 87.6%, 50.67%, and 0.925%, respectively. Multivariate analysis revealed that the orientation angle (> 22.9°), not circumscribed margin, and calcifications of the breast mass were independent factors predicting breast malignancy. The net benefit of adopting the orientation angle for predicting breast malignancy was 0.303. Based on these findings, it can be concluded that quantifying the orientation angle of breast masses is useful in predicting breast malignancy, as it demonstrates high sensitivity, specificity, AUC, and standardized net benefit. It optimizes the utility of the not parallel orientation in assessing breast mass malignancy.https://doi.org/10.1038/s41598-024-55298-wBreast massMalignancyBreast imaging-reporting and data system (BI-RADS)OrientationAngle
spellingShingle Kailiang Chen
Size Wu
The utility of quantifying the orientation of breast masses in ultrasound imaging
Scientific Reports
Breast mass
Malignancy
Breast imaging-reporting and data system (BI-RADS)
Orientation
Angle
title The utility of quantifying the orientation of breast masses in ultrasound imaging
title_full The utility of quantifying the orientation of breast masses in ultrasound imaging
title_fullStr The utility of quantifying the orientation of breast masses in ultrasound imaging
title_full_unstemmed The utility of quantifying the orientation of breast masses in ultrasound imaging
title_short The utility of quantifying the orientation of breast masses in ultrasound imaging
title_sort utility of quantifying the orientation of breast masses in ultrasound imaging
topic Breast mass
Malignancy
Breast imaging-reporting and data system (BI-RADS)
Orientation
Angle
url https://doi.org/10.1038/s41598-024-55298-w
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