Comparative Study of Contrast-Enhanced Ultrasound Qualitative and Quantitative Analysis for Identifying Benign and Malignant Breast Tumor Lumps

BioMed Research International

Wei

et al. 2015

This study was to investigate the correlation between contrast-enhanced ultrasonography (CEUS) characteristics with prognostic factors in breast cancers with different sizes. A retrospective analysis of CEUS characteristics of 104 pathologically proven malignant lesions from 104 women was conducted. Lesions were divided into two groups according to their size measured by US (Group 1: maximum diameter ≤20 mm; Group 2: maximum diameter >20 mm). Features including enhancement degree, order and pattern, enlargement of the enhancement area, and penetrating vessels on CEUS were evaluated. Pathologic prognostic factors, including estrogen and progesterone receptor status, and the expression of c-erb-B2, p53, Ki-67, and VEGF were assessed. Comparison of enhancement pattern parameters between Group 1 and Group 2 showed statistically significant differences (P < 0.0001). A significant correlation was found between enlargement of the enhancement area and ER positivity in Group 1 (P = 0.032). In Group 2 the absence of penetrating vessels was significantly associated with VEGF negativity (P = 0.022) and ER negativity (P = 0.022). Centripetal enhancement reflected VEGF negativity (P = 0.033) in lesions with diameter >20 mm. Thus, breast cancers with different sizes show different CEUS features; small breast cancers show homogeneous enhancement pattern while cancers with diameter >20 mm show homogeneous enhancement pattern. Some CEUS characteristics of differently sized breast cancers could be correlated with prognostic factors, which may be useful in prognosis assessment.

Section: Discussionmentioning

confidence: 99%

Contrast-Enhanced Ultrasonography Features of Breast Malignancies with Different Sizes: Correlation with Prognostic Factors

Zhao

BioMed Research International

Wei

et al. 2015

“…Since angiogenesis is a risk factor for invasion and metastasis of solid tumors, there are generally many proliferative and active cells at the perimeter of malignant tumors, as well as numerous abnormal capillary networks with disordered structures and increased microvessel densities. At the same time, perfusion disruptions can lead to increased microcirculation ow and velocity [19]. In addition, the peripheral regions of malignant breast tumors are often associated with breast hyperplasia and precancerous lesions at different stages.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of contrast-enhanced ultrasonography and shear-wave elastography in conjunction with BI-RADS classification for diagnosis of small breast nodules

Shen

et al. 2020

Preprint

Background: Identification of malignancy in small breast nodules can be difficult using conventional methods, especially in patients with dense breast tissue. Advanced imaging techniques, including contrast-enhanced ultrasound (CEUS) and shear-wave elastography (SWE), could be used in conjunction with Breast Imaging Reporting and Data System (BI-RADS) classification to characterize these nodules more effectively. This study aimed to evaluate the use of CEUS and SWE for the differentiation of benign from malignant small (≤ 2 cm) breast nodules.Methods: This retrospective study reviewed the medical records and imaging data of 302 patients who underwent evaluation for 305 small breast nodules from November 2015 to December 2019. BI-RADS classification of nodules and the results of CEUS and SWE were retrospectively analyzed; the diagnostic efficacy of these techniques was evaluated by comparison with pathology results. Receiver operating characteristic curves were analyzed based on the CEUS patterns and shear-wave velocity values of nodules. The sensitivities, specificities, positive and negative predictive values, and accuracies of BI-RADS, CEUS, SWE, and a combination of all three methods for identifying benign versus malignant small breast nodules were investigated.Results: CEUS was effective at diagnosing malignant nodules when at least two out of nine suspicious features were present. Receiver operating curve analysis revealed that the best cut-off value for SWE was 3.7 m/s. For the diagnosis of benign breast nodules, the BI-RADS classification was reduced by one level when both CEUS and SWE were used, and was unchanged when either CEUS or SWE alone were used; the highest and lowest levels were category 5 and 3, respectively. Furthermore, when using the combined method, 75.8% (91/120) of small breast nodules with a BI-RADS category 4A classification avoided the need for coarse needle biopsies.Conclusion: Both CEUS and SWE can be used as auxiliary methods for clarifying BI-RADS classification of breast nodules, and a combination of these techniques may provide more diagnostic efficacy for identifying malignancy in small breast nodules.

“…As angiogenesis is a risk factor for invasion and metastasis of solid tumors, there are generally many proliferative and active cells at the perimeter of malignant tumors, and numerous abnormal capillary networks with disordered structures and increased microvessel densities. At the same time, perfusion disruptions can lead to increased microcirculation ow and velocity [19]. In addition, the peripheral regions of malignant breast tumors are often associated with breast hyperplasia and precancerous lesions at different stages.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of contrast-enhanced ultrasonography and shear-wave elastography in conjunction with BI-RADS classification for diagnosis of small breast nodules

Shen

et al. 2020

Preprint

Background: Identification of malignancy in small breast nodules can be difficult using conventional methods, especially in patients with dense breast tissue. Advanced imaging techniques, including contrast-enhanced ultrasound (CEUS) and shear-wave elastography (SWE), could be used in conjunction with the Breast Imaging Reporting and Data System (BI-RADS) classification to characterize these nodules more effectively. This retrospective study aimed to evaluate the use of CEUS and SWE for the differentiation of benign from malignant small (≤ 2 cm) breast nodules.Methods: We reviewed the medical records and imaging data of 302 patients who underwent evaluation for 305 small breast nodules from November 2015 to December 2019. The BI-RADS classification values of the nodules and the results of CEUS and SWE were retrospectively analyzed; the diagnostic efficacy of these techniques was evaluated by comparison of the pathology results. Receiver operating characteristic (ROC) curves were analyzed based on the CEUS patterns and shear-wave velocity values of the nodules. The sensitivity, specificity, positive and negative predictive values, accuracies of BI-RADS, CEUS, SWE, and a combination of all three methods for identifying benign and malignant small breast nodules were investigated.Results: CEUS was effective at diagnosing malignant nodules when at least two out of nine suspicious features were present. ROC analysis revealed that the best cut-off value for SWE was at 3.7 m/s. For the diagnosis of benign breast nodules, the BI-RADS classification was reduced by one level when both, CEUS and SWE were used, and remained unchanged when either one, CEUS or SWE was used; the highest and lowest levels were of category 5 and 3, respectively. Furthermore, when using the combined method, 75.8% (91/120) of small breast nodules with a BI-RADS category 4A classification avoided the need for coarse needle biopsies.Conclusions: CEUS and SWE can be used as auxiliary methods for clarifying BI-RADS classification of the breast nodules, and a combination of these techniques may provide more diagnostic efficacy for identifying malignancy in small breast nodules.Trial registration: Retrospectively registered.