B-Mode Ultrasound Combined with Color Doppler and Strain Elastography in the Diagnosis of Non-mass Breast Lesions: A Prospective Study

Li, Lujing; Zhou, Xiaolin; Zhao, Xinbao; Hao, Shaoyun; Jiang, Yao; Zhong, Wei; Zhi, Hui

doi:10.1016/j.ultrasmedbio.2017.07.014

Cited by 36 publications

(24 citation statements)

References 17 publications

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“…On the basis of the above mentioned criteria the calculated sensitivity, specificity, accuracy, PPV, NPV of DS were 93.3%, 81.5%, 87.7%, 84.8% and 91.7% respectively (Tables 9 and 10). When comparing between Bmode US and DS most studies have reported better specificity for DS and higher sensitivity for B-mode US (Table 10) which is similar to this study results [7,8,15,16]. The lower specificity of B-mode US compared to DS in this study was due to a total of 12 (44.4%) false positive cases ( Table 8).…”

Section: Discussionsupporting

confidence: 84%

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Role of Duplex Ultrasound for the Assessment of Malignancy in Breast Tumors

Paul¹,

Nasreen²,

Sultana³

2019

CRJ

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Background: Breast cancer is the commonest form of cancer in females which may be curable if detected early. Breast ultrasound (US) is a non invasive, primary screening tool which can evaluate breast tumors in women even with dense breast. By adding color Doppler signal with B-mode US namely Duplex ultrasound better characterization of breast tumors is possible especially for the indeterminate tumors (BIRADS category 3 and 4) on B-Mode US. Objective: The purpose of this study is to assess the efficacy of Duplex Sonography (DS) for assessment of malignancy in breast tumors compared to histopathology. Materials and methods: This cross-sectional study was carried out at National Institute of Nuclear Medicine & Allied Science (NINMAS) from July 2017 to June 2018. A total of 57 female patients having breast tumors (age mean 42.09 years with SD ± 15.85) were included in this study. After clinical assessment, all study patients underwent Duplex Ultrasound and was then subjected to the excisional biopsy and histopathology for confirmation of the diagnosis. Diagnostic performance test of DS was done for diagnosis of breast malignancy compared to histopathology. Receiver-operator characteristic (ROC) curve was also constructed to determine the optimal cutoff point for each spectral Doppler indices. Results: On Color Doppler Sonography (CDS), hypervascularity was more common in malignant tumors than benign lesions (86.7%Vs 18.5%; p=0.001). Spectral Doppler indices including resistive index (RI) and pulsatility index (PI) were significantly higher in malignant tumors (p=0.001). All of these indices had high diagnostic accuracy for differentiating malignant from benign tumors with area under the curve (AUC) which is equals to 0.90, 0.92 for RI and PI respectively. The optimal cutoff points to differentiate benign and malignant tumors from ROC curve for RI was 0.75 (sensitivity: 89.0%, specificity: 85.0%) and that of PI was 1.2 (sensitivity: 96.6%, specificity: 80.0%). All obtained results of sensitivity, specificity and over all accuracy of DS (considering the vessel number on CDS & BIRADS criteria on B-mode US) were 93.3%, 81.5% and 87.7% respectively. Conversely, conventional B-Mode US alone had a sensitivity, specificity and over all accuracy of 100%, 55.6%, and 78.9% respectively. Addition of CDS to B-mode US in the same session increased specificity from 55.6% to 81.5% and accuracy from 78.9% to 87.7%. Conclusion: Duplex ultrasound has a significant role in the evaluation of breast tumors and adds value to B-mode US for distinguishing malignant tumors from benign lesions.

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Section: Discussionsupporting

confidence: 84%

“…So for those BIRADS 5 tumors the Duplex ultrasound did not give false negative result. By applying Doppler signal with B-mode US, higher specificity and diagnostic accuracy can be achieved as also suggested by previous study [14][15][16].…”

Section: Discussionmentioning

confidence: 57%

Role of Duplex Ultrasound for the Assessment of Malignancy in Breast Tumors

Paul¹,

Nasreen²,

Sultana³

2019

CRJ

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“…Similar findings have been reported in previous studies. [15][16][17][18] Hao et al found an increased AUC of B-mode US from 0.73 to 0.87 after the addition of SE. 18 In the study of Yeo et al, the AUC for combined SE with sonography was 0.86, which was higher than the sonography with color Doppler (0.57) or sonography alone (0.65).…”

Section: Findings In Relation To Other Studies and Possible Mechanismmentioning

confidence: 99%

<p>Diagnostic Value of Elastography, Strain Ratio, and Elasticity to B-Mode Ratio and Color Doppler Ultrasonography in Breast Lesions</p>

Ranjkesh

Hajibonabi

Seifar

et al. 2020

IJGM

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The aim of this study was to investigate the sensitivity, specificity, and diagnostic accuracy of sonoelastography (SE), strain ratio (SR), elasticity to B-mode (E/B) ratio, and color Doppler ultrasonography (US) in suspected breast lesions. Materials and Methods: This prospective study was conducted on women referred to Alzahra university hospital of Tabriz for annual screening of breast cancer between May 2017 and December 2018. B-mode US, SE, and color Doppler imaging were conducted in females with suspected mammography reports. The lesions in B-mode were classified according to the Breast Imaging Reporting and Data System (B-RADS). The results of SE imaging were graded based on five-grade SE score. SR and E/B ratio of each lesion were also analyzed in SE images. Color Doppler findings were categorized from 0 (no visible vessel) to 2 (> two vessels) based on the vascularity of the tumor. Pathology results were used as the gold standard to measure the area under the receiver operating characteristic curve (AUC), sensitivity, specificity, and diagnostic accuracy of each modality. Results: One-hundred and ten breast lesions of 104 women aged 42.05±10.33 years were included in the study. Seventy-seven of the lesions were benign and 3 were malignant. Sensitivity and specificity of 97.0% and 77.9% for B-mode US, 93.9% and 87.0% for SE score, 81.8% and 66.2% for color Doppler US, 72.7% and 77.6% for E/B ratio (cutoff: 1.05), and 77.3% and 79.6% for SR (cutoff: 1.90) were obtained, respectively. Addition of SE score to B-mode US increased the sensitivity to 93.9%, specificity to 93.5%, and AUC from 0.95 to 0.97. Cumulative color Doppler US with B-mode US did not enhance the diagnostic accuracy of B-mode US. Conclusion: SE was more effective than color Doppler US for distinguishing malignant from benign breast lesion. Among the three different SE features, five-grade SE score was superior to E/B ratio and SR.

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“…Neoangiogenesis in breast lesions is also associated with increased speed of tumor growth and metastasis [ 14 ]. Although the assessment of vascularity can therefore improve breast cancer diagnosis using ultrasound [ 5 , 15 , 16 , 17 , 18 , 19 ], Doppler imaging is still underused in clinical applications. Since BI-RAD US grading does take Doppler images into account, there is scope for formalizing and quantifying Doppler assessment for improving breast mass diagnosis with radiomics.…”

Section: Introductionmentioning

confidence: 99%

Color Doppler Ultrasound Improves Machine Learning Diagnosis of Breast Cancer

et al. 2020

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Color Doppler is used in the clinic for visually assessing the vascularity of breast masses on ultrasound, to aid in determining the likelihood of malignancy. In this study, quantitative color Doppler radiomics features were algorithmically extracted from breast sonograms for machine learning, producing a diagnostic model for breast cancer with higher performance than models based on grayscale and clinical category from the Breast Imaging Reporting and Data System for ultrasound (BI-RADSUS). Ultrasound images of 159 solid masses were analyzed. Algorithms extracted nine grayscale features and two color Doppler features. These features, along with patient age and BI-RADSUS category, were used to train an AdaBoost ensemble classifier. Though training on computer-extracted grayscale features and color Doppler features each significantly increased performance over that of models trained on clinical features, as measured by the area under the receiver operating characteristic (ROC) curve, training on both color Doppler and grayscale further increased the ROC area, from 0.925 ± 0.022 to 0.958 ± 0.013. Pruning low-confidence cases at 20% improved this to 0.986 ± 0.007 with 100% sensitivity, whereas 64% of the cases had to be pruned to reach this performance without color Doppler. Fewer borderline diagnoses and higher ROC performance were both achieved for diagnostic models of breast cancer on ultrasound by machine learning on color Doppler features.

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B-Mode Ultrasound Combined with Color Doppler and Strain Elastography in the Diagnosis of Non-mass Breast Lesions: A Prospective Study

Cited by 36 publications

References 17 publications

Role of Duplex Ultrasound for the Assessment of Malignancy in Breast Tumors

Role of Duplex Ultrasound for the Assessment of Malignancy in Breast Tumors

<p>Diagnostic Value of Elastography, Strain Ratio, and Elasticity to B-Mode Ratio and Color Doppler Ultrasonography in Breast Lesions</p>

Color Doppler Ultrasound Improves Machine Learning Diagnosis of Breast Cancer

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