Meta-Analysis: Contrast-Enhanced Ultrasound Versus Conventional Ultrasound for Differentiation of Benign and Malignant Breast Lesions

Li, Qian; Hu, Min; Chen, Zhikui; Li, Changtian; Zhang, Xi; Song, Yiqing; Feixiang, Xiang

doi:10.1016/j.ultrasmedbio.2018.01.022

Cited by 46 publications

(36 citation statements)

References 35 publications

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“…For m-US, we found a sensitivity of 88.9% and a specificity of 86.4% which is within the range of previously reported values [18][19][20][21]. A recent meta-analysis [22] published a sensitivity of 87% and specificity of 72%. It is noteworthy that for r-US, we observed an equally high sensitivity, while the specificity was slightly higher than for m-US (89.4% versus 86.4%).…”

Section: Discussionsupporting

confidence: 88%

Comparison of radial and meander-like breast ultrasound with respect to diagnostic accuracy and examination time

Jäggi-Wickes

Brasier-Lutz

Schaedelin

et al. 2020

Arch Gynecol Obstet

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Purpose To prospectively compare the diagnostic accuracy of radial breast ultrasound (r-US) to that of conventional meander-like breast ultrasound (m-US), patients of a consecutive, unselected, mixed collective were examined by both scanning methods. Methods Out of 1948 dual examinations, 150 revealed suspicious lesions resulting in 168 biopsies taken from 148 patients. Histology confirmed breast cancers in 36 cases. Sensitivity, specificity, accuracy, PPV, and NPV were calculated for r-US and m-US. The examination times were recorded. Results For m-US and r-US, sensitivity (both 88.9%), specificity (86.4% versus 89.4%), accuracy (86.9% versus 89.3%), PPV (64.0% versus 69.6%), NPV (both 98.3%), false-negative rate (both 5.6%), and rate of cancer missed by one method (both 5.6%) were similar. The mean examination time for r-US (14.8 min) was significantly (p < 0.01) shorter than for m-US (22.6 min). Conclusion Because the diagnostic accuracy of r-US and m-US are comparable, r-US can be considered an alternative to m-US in routine breast US with the added benefit of a significantly shorter examination time.

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Section: Discussionsupporting

confidence: 88%

Comparison of radial and meander-like breast ultrasound with respect to diagnostic accuracy and examination time

Jäggi-Wickes

Brasier-Lutz

Schaedelin

et al. 2020

Arch Gynecol Obstet

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“…Sensitivity was similar to that reported by a meta-analysis of studies of CEUS, with 86% sensitivity, but the specificity was lower than in the meta-analysis (79%) 22. Similar observation can be made with B-mode ultrasound (87% sensitivity and 72% specificity) 23. This could possibly be due to differences in image analysis and may suggest that our classification method could be improved.…”

Section: Discussionsupporting

confidence: 86%

<p>A multicenter study of a contrast-enhanced ultrasound diagnostic classification of breast lesions</p>

Tang

Chen

et al. 2019

CMAR

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PurposeTo evaluate a classification model of contrast-enhanced ultrasound (CEUS) and examine the characteristics of patients with false-negative diagnosis.Patients and methodsA retrospective secondary analysis of a multicenter trial of CEUS for breast cancer diagnosis (from August 2015 to April 2017) was undertaken. Patients (n=1,023) with Breast Imaging Reporting and Data System 4–5 lesions on B-mode ultrasound underwent CEUS. Pathological diagnoses were available from surgical or biopsy specimens for correlation. Lesion maximum diameter (LMD), distance to the papilla (DtP), distance from the superficial edge of the lesion to the skin (DtS), distance from the deep edge of the lesion to the pectoralis muscle (DtPM), and body mass index (BMI) were evaluated.ResultsMedian age and BMI were 48.0 and 41.2 years and 23.2 and 22.4 kg/m2 for patients with malignant and benign lesions, respectively. Overall sensitivity, specificity, and accuracy of CEUS for malignancy were 89.4%, 65.3%, and 75.8%, respectively. The patients with true-positive and false-negative diagnosis (ie, with malignant lesion) were older than those with false-positive and true-negative diagnosis (ie, with benign lesion). Patients with true-positive and false-positive diagnoses had higher BMI than patients with true-negative and false-negative diagnoses (P=0.004). Patients with true-positive and false-negative diagnoses had larger LMD and DtP, as well as smaller DtS and DtPM.ConclusionOlder age, higher BMI, larger LMD and DtP, and smaller DtS and DtPM were associated with malignant lesions on CEUS. Patients with these characteristics should undergo further imaging.

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“…In a meta‐analysis from 2016 that included 2296 lesions, Ma et al showed that CEUS could potentially be an effective tool in differentiating benign from malignant breast lesions. In a meta‐analysis from 2018 encompassing 2568 breast lesions, Li et al concluded that CEUS alone and CEUS with conventional US had better diagnostic performance than conventional US alone. Both quantitative and qualitative CEUS parameters have been useful in distinguishing benign and malignant masses.…”

Section: Discussionmentioning

confidence: 99%

Contrast‐Enhanced Ultrasound Imaging of Breast Masses: Adjunct Tool to Decrease the Number of False‐Positive Biopsy Results

Lee

Tchelepi

Grant

et al. 2018

J of Ultrasound Medicine

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Objectives-This pilot study evaluated use of contrast-enhanced ultrasound (CEUS) to reduce the number of benign breast masses recommended for biopsy.Methods-This prospective study included 131 consenting women, from October 2016 to June 2017, with American College of Radiology Breast Imaging Reporting and Data System category 4a, 4b, and 4c masses detected by mammography, conventional ultrasound (US), or both. Contrast-enhanced US examinations (using intravenous injection of perflutren lipid microspheres or sulfur hexafluoride lipid-type A microspheres) were performed before biopsy. Qualitative and quantitative CEUS parameters were compared with reference standard histopathologic results from biopsy of 131 masses.Results-There were 109 benign, 6 high-risk, and 16 malignant masses, with a median size of 12 mm (range, 4 to 48 mm) on conventional US imaging. Of 131 masses, 93 (71%) enhanced on CEUS imaging, including 73 of 109 (67%) benign, 6 of 6 (100%) high-risk, and 14 of 16 (87.5%) malignant. Thirty-eight lesions did not enhance, including 36 of 109 (33%) benign and 2 of 16 (12.5%) malignant. Prediction models using recursive petitioning revealed that CEUS may reduce 31% (95% confidence interval, 23%, 40%) of benign biopsies for masses that are: nonenhancing with circumscribed margins or enhancing with an oval shape and homogeneous enhancement. Quantitative parameters indicated that benign masses had the longest time to peak (P = .078), highest time-topeak ratio of mass to background (P = .036), lowest peak intensity (P = .021), and smallest difference in peak intensity between the mass and background (P = .079) compared to high-risk and malignant lesions.Conclusions-Contrast-enhanced US may be a valuable modality that can be used to predict benign pathologic results of breast masses, thereby reducing the number of biopsies.

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Meta-Analysis: Contrast-Enhanced Ultrasound Versus Conventional Ultrasound for Differentiation of Benign and Malignant Breast Lesions

Cited by 46 publications

References 35 publications

Comparison of radial and meander-like breast ultrasound with respect to diagnostic accuracy and examination time

Comparison of radial and meander-like breast ultrasound with respect to diagnostic accuracy and examination time

<p>A multicenter study of a contrast-enhanced ultrasound diagnostic classification of breast lesions</p>

Contrast‐Enhanced Ultrasound Imaging of Breast Masses: Adjunct Tool to Decrease the Number of False‐Positive Biopsy Results

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