<p>Vascular index measured by smart 3-D superb microvascular imaging can help to differentiate malignant and benign breast lesion</p>

Abstract

Purpose: The purpose of our study was to prospectively evaluate the diagnostic performance of the vascular index (VI, defined as the ratio of Doppler signal pixels to pixels in the total lesion) measured via Smart 3-D superb microvascular imaging (SMI) for breast lesions. Patients and methods: Two hundred and thirty-two consecutive patients with 236 breast lesions referred for biopsy at Peking Union Medical College Hospital were enrolled in the study from December 2016 to November 2017. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of VI were calculated with histopathologic results as the reference standard. Results: Of the 236 breast lesions, 121 were malignant and 115 were benign. The mean VI was significantly higher in malignant lesions (9.7±8.2) than that in benign ones (3.4±3.3) ( P <0.0001). Sensitivity, specificity, PPV, NPV and accuracy of VI (4.0 as the threshold) were respectively: 76.0%, 66.1%, 70.2%, 72.4% and 71.2% ( P <0.05). Conclusion: Smart three-dimensional (3-D) SMI is a noninvasive tool using two-dimensional (2-D) scanning to generate 3-D vascular architecture with a high-resolution image of micro-vessels. This can be used as a qualitative guide to identify the optimal 2-D SMI plane with the most abundant vasculature to guide VI quantitative measurements of breast lesions. Smart 3-D SMI may potentially serve as a noninvasive tool to accurately characterize benign versus malignant breast lesions.

<p>The Vascular Index of Superb Microvascular Imaging Can Improve the Diagnostic Accuracy for Breast Imaging Reporting and Data System Category 4 Breast Lesions</p>

“…For BI-RADS, lesions are considered malignant when classified as above BI-RADS 3 and considered benign when classified as category 3. In a previous study, the sensitivity, specificity, PPV, NPV and accuracy of the VI (with 4.0 as the threshold) were 76.0%, 66.1%, 70.2%, 72.4% and 71.2% (P<0.05) respectively, showing good diagnostic efficacy, 15 In our study, VI ≤4.0 was the standard for downgrading masses. BI-RADS 4 masses were downgraded one level (4A-3, 4B-A, 4C-4B) to an integral BI-RADS grade, while the others maintained the conventional grade.…”

Diagnostic accuracy of ultrasound superb microvascular imaging for breast tumor: a meta-analysis

“…We reviewed the titles and abstracts of all articles and excluded 21 articles; full texts and data integrity were also reviewed and 11 were further excluded. Finally, 15 studies that met all inclusion criteria were included in this meta-analysis [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25]. Figure 1 showed the selection process of eligible articles.…”

Quantitative Musculoskeletal Ultrasound

“…The clinical value of the vascular index was recently studied in the diagnosis of Hashimoto's thyroiditis 79 and breast lesions. 80 Durmaz et al 79 selected the image with the highest amount of vascular signal in a 5-s video of a US scan in patients affected by Hashimoto's thyroiditis. Zhang et al 80 used a tool recently equipped in a Canon US machine (Smart 3D SMI app, Canon Medical System, Tokyo, Japan) that can obtain a three-dimensional vascular image from a 2D image scan with a linear array probe.…”

“…80 Durmaz et al 79 selected the image with the highest amount of vascular signal in a 5-s video of a US scan in patients affected by Hashimoto's thyroiditis. Zhang et al 80 used a tool recently equipped in a Canon US machine (Smart 3D SMI app, Canon Medical System, Tokyo, Japan) that can obtain a three-dimensional vascular image from a 2D image scan with a linear array probe. Once they selected the 2D images with the highest vascular signal amount, they calculated the vascular index.…”