Contrast-enhanced ultrasound improved performance of breast imaging reporting and data system evaluation of critical breast lesions

• 作者: Cheng Lan Chi-Hua Wu Guo Zhou Ji-Dong Chen Jing-Qiao Lu Jun Luo Lin-Xian Yue Qing Chen Yi Li
• 来源期刊: 世界放射学杂志：英文版（电子版）
• 学科: 医学
• 关键词: BREAST imaging REPORTING and data system CONTRAST-ENHANCED ULTRASOUND BIOPSY False POSITIVE BIOPSY
• 年，卷（期）: 2016,（6）
• 页码范围: 610-617
• 页数: 8页
• 分类号: R737.9

摘要

AIM: To determine whether contrast-enhanced ultrasound(CEUS) can improve the precision of breast imaging reporting and data system(BI-RADS) categorization. METHODS: A total of 230 patients with 235 solid breast lesions classified as BI-RADS 4 on conventional ultrasound were evaluated. CEUS was performed within one week before core needle biopsy or surgical resection and a revised BI-RADS classification was assigned based on 10 CEUS imaging characteristics. Receiver operating characteristic curve analysis was then conducted to evaluate the diagnostic performance of CEUS-based BI-RADS assignment with pathological examination as reference criteria. RESULTS: The CEUS-based BI-RADS evaluation classified 116/235(49.36%) lesions into category 3, 20(8.51%), 13(5.53%) and 12(5.11%) lesions into categories 4A, 4B and 4C, respectively, and 74(31.49%) into category 5. Selecting CEUS-based BI-RADS category 4A as an appropriate cut-off gave sensitivity and specificity values of 85.4% and 87.8%, respectively, for the diagnosisof malignant disease. The cancer-to-biopsy yield was 73.11% with CEUS-based BI-RADS 4A selected as the biopsy threshold compared with 40.85% otherwise, while the biopsy rate was only 42.13% compared with 100% otherwise. Overall, only 4.68% of invasive cancers were misdiagnosed.CONCLUSION: This pilot study suggests that evaluation of BI-RADS 4 breast lesions with CEUS results in reduced biopsy rates and increased cancer-to-biopsy yields.