Combined Use of Shear Wave Elastography, Microvascular Doppler Ultrasound Technique, and BI-RADS for the Differentiation of Benign and Malignant Breast Masses
ObjectiveTo evaluate the value of the combined use of Breast Imaging Reporting and Data System (BI-RADS), qualitative shear wave elastography (SWE), and AngioPLUS microvascular Doppler ultrasound technique (AP) for distinguishing benign and malignant breast masses.Materials and MethodsA total of 210...
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| Format: | Article |
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Frontiers Media S.A.
2022-05-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2022.906501/full |
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| author | Bin Wang Yu-Yuan Chen Si Yang Zhen-Wen Chen Jia Luo Xin-Wu Cui Christoph F. Dietrich Ai-jiao Yi |
| author_facet | Bin Wang Yu-Yuan Chen Si Yang Zhen-Wen Chen Jia Luo Xin-Wu Cui Christoph F. Dietrich Ai-jiao Yi |
| author_sort | Bin Wang |
| collection | DOAJ |
| description | ObjectiveTo evaluate the value of the combined use of Breast Imaging Reporting and Data System (BI-RADS), qualitative shear wave elastography (SWE), and AngioPLUS microvascular Doppler ultrasound technique (AP) for distinguishing benign and malignant breast masses.Materials and MethodsA total of 210 pathologically confirmed breast lesions in 210 patients were reviewed using BI-RADS, qualitative SWE, and AP. The sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), accuracy, and area under the receiver operating characteristic curve (AUC) of BI-RADS and the combination of qualitative SWE and/or AP with BI-RADS were compared, respectively.ResultsCompared with using BI-RADS alone, the use of combined qualitative SWE and/or AP with BI-RADS had higher AUC values (P < 0.001). Besides this, the combination of qualitative SWE and AP with BI-RADS had the best diagnostic performance for differentiating between benign and malignant masses. When AP and SWE were combined with BI-RADS, 49/76 benign masses were downgraded from BI-RADS category 4a into BI-RADS category 3, while no benign masses were upgraded from BI-RADS category 3 into BI-RADS category 4a. Three sub-centimeter malignant masses were downgraded from BI-RADS category 4a into BI-RADS category 3, while three malignant masses remain in BI-RADS category 3 due to a benign manifestation in both AP and qualitative SWE. Moreover, 5/6 of them were sub-centimeter masses, and 4/6 of them were intraductal carcinoma. The sensitivity, specificity, PPV, NPV, accuracy, and AUC were 91.0%, 81.1%, 69.3%, 95.1%, 84.3%, and 0.861 (95% confidence interval, 0.806–0.916; P < 0.001), respectively. Compared with BI-RADS alone, the sensitivity slightly decreased, while the specificity, PPV, NPV, and accuracy were significantly improved.ConclusionCombination of qualitative SWE and AP with BI-RADS improved the diagnostic performance in differentiating benign from malignant breast lesions, which is helpful for avoiding unnecessary biopsies. However, we should be careful about the downgrading of sub-centimeter BI-RADS 4a category lesions. |
| first_indexed | 2024-04-12T17:30:16Z |
| format | Article |
| id | doaj.art-696aca8edd784554acab3f11493e1e37 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-12T17:30:16Z |
| publishDate | 2022-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-696aca8edd784554acab3f11493e1e372022-12-22T03:23:09ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2022-05-011210.3389/fonc.2022.906501906501Combined Use of Shear Wave Elastography, Microvascular Doppler Ultrasound Technique, and BI-RADS for the Differentiation of Benign and Malignant Breast MassesBin Wang0Yu-Yuan Chen1Si Yang2Zhen-Wen Chen3Jia Luo4Xin-Wu Cui5Christoph F. Dietrich6Ai-jiao Yi7Department of Medical Ultrasound, Yueyang Central Hospital, Yueyang, ChinaDepartment of Medical Ultrasound, Yueyang Central Hospital, Yueyang, ChinaDepartment of Medical Ultrasound, Yueyang Central Hospital, Yueyang, ChinaDepartment of Medical Ultrasound, Yueyang Central Hospital, Yueyang, ChinaDepartment of Medical Ultrasound, Yueyang Central Hospital, Yueyang, ChinaDepartment of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment Allgemeine Innere Medizin, Kliniken Hirslanden Beau Site, Salem und Permanence, Bern, SwitzerlandDepartment of Medical Ultrasound, Yueyang Central Hospital, Yueyang, ChinaObjectiveTo evaluate the value of the combined use of Breast Imaging Reporting and Data System (BI-RADS), qualitative shear wave elastography (SWE), and AngioPLUS microvascular Doppler ultrasound technique (AP) for distinguishing benign and malignant breast masses.Materials and MethodsA total of 210 pathologically confirmed breast lesions in 210 patients were reviewed using BI-RADS, qualitative SWE, and AP. The sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), accuracy, and area under the receiver operating characteristic curve (AUC) of BI-RADS and the combination of qualitative SWE and/or AP with BI-RADS were compared, respectively.ResultsCompared with using BI-RADS alone, the use of combined qualitative SWE and/or AP with BI-RADS had higher AUC values (P < 0.001). Besides this, the combination of qualitative SWE and AP with BI-RADS had the best diagnostic performance for differentiating between benign and malignant masses. When AP and SWE were combined with BI-RADS, 49/76 benign masses were downgraded from BI-RADS category 4a into BI-RADS category 3, while no benign masses were upgraded from BI-RADS category 3 into BI-RADS category 4a. Three sub-centimeter malignant masses were downgraded from BI-RADS category 4a into BI-RADS category 3, while three malignant masses remain in BI-RADS category 3 due to a benign manifestation in both AP and qualitative SWE. Moreover, 5/6 of them were sub-centimeter masses, and 4/6 of them were intraductal carcinoma. The sensitivity, specificity, PPV, NPV, accuracy, and AUC were 91.0%, 81.1%, 69.3%, 95.1%, 84.3%, and 0.861 (95% confidence interval, 0.806–0.916; P < 0.001), respectively. Compared with BI-RADS alone, the sensitivity slightly decreased, while the specificity, PPV, NPV, and accuracy were significantly improved.ConclusionCombination of qualitative SWE and AP with BI-RADS improved the diagnostic performance in differentiating benign from malignant breast lesions, which is helpful for avoiding unnecessary biopsies. However, we should be careful about the downgrading of sub-centimeter BI-RADS 4a category lesions.https://www.frontiersin.org/articles/10.3389/fonc.2022.906501/fullbreast massultrasoundshear wave elastographyAngio PLUSBreast Imaging Reporting and Data System |
| spellingShingle | Bin Wang Yu-Yuan Chen Si Yang Zhen-Wen Chen Jia Luo Xin-Wu Cui Christoph F. Dietrich Ai-jiao Yi Combined Use of Shear Wave Elastography, Microvascular Doppler Ultrasound Technique, and BI-RADS for the Differentiation of Benign and Malignant Breast Masses Frontiers in Oncology breast mass ultrasound shear wave elastography Angio PLUS Breast Imaging Reporting and Data System |
| title | Combined Use of Shear Wave Elastography, Microvascular Doppler Ultrasound Technique, and BI-RADS for the Differentiation of Benign and Malignant Breast Masses |
| title_full | Combined Use of Shear Wave Elastography, Microvascular Doppler Ultrasound Technique, and BI-RADS for the Differentiation of Benign and Malignant Breast Masses |
| title_fullStr | Combined Use of Shear Wave Elastography, Microvascular Doppler Ultrasound Technique, and BI-RADS for the Differentiation of Benign and Malignant Breast Masses |
| title_full_unstemmed | Combined Use of Shear Wave Elastography, Microvascular Doppler Ultrasound Technique, and BI-RADS for the Differentiation of Benign and Malignant Breast Masses |
| title_short | Combined Use of Shear Wave Elastography, Microvascular Doppler Ultrasound Technique, and BI-RADS for the Differentiation of Benign and Malignant Breast Masses |
| title_sort | combined use of shear wave elastography microvascular doppler ultrasound technique and bi rads for the differentiation of benign and malignant breast masses |
| topic | breast mass ultrasound shear wave elastography Angio PLUS Breast Imaging Reporting and Data System |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2022.906501/full |
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