J 2020

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

JANŮ, Eva, Lucie KŘIKAVOVÁ, Jiřina LITTLE, Karel DVOŘÁK, Dagmar BRANČÍKOVÁ et. al.

Basic information

Original name

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

Authors

JANŮ, Eva (203 Czech Republic, belonging to the institution), Lucie KŘIKAVOVÁ (203 Czech Republic), Jiřina LITTLE (203 Czech Republic), Karel DVOŘÁK (203 Czech Republic), Dagmar BRANČÍKOVÁ (203 Czech Republic), Eva JANDÁKOVÁ (203 Czech Republic), Tomáš PAVLÍK (203 Czech Republic, belonging to the institution), Petra KOVALČÍKOVÁ (203 Czech Republic, belonging to the institution), Tomáš KAZDA (203 Czech Republic, guarantor, belonging to the institution) and Vlastimil VÁLEK (203 Czech Republic)

Edition

BMC MEDICAL IMAGING, LONDON, BMC, 2020, 1471-2342

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30224 Radiology, nuclear medicine and medical imaging

Country of publisher

United Kingdom of Great Britain and Northern Ireland

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

Impact factor

Impact factor: 1.930

RIV identification code

RIV/00216224:14110/20:00116002

Organization unit

Faculty of Medicine

DOI

UT WoS

000542736400001

Keywords in English

Contrast ultrasonography; CEUS; Breast cancer; TI curve; Ultrasound

Tags

Tags

International impact, Reviewed
Změněno: 16/7/2020 09:05, Mgr. Tereza Miškechová

Abstract

V originále

Background To determine the benefit of contrast-enhanced ultrasound (CEUS) in the assessment of breast lesions. 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. Conclusions 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.