The Automated Breast Volume Scanner (ABVS): initial experiences in lesion detection compared with conventional handheld B-mode ultrasound: a pilot study of 50 cases

Abstract

The idea of an automated whole breast ultrasound was developed three decades ago. We present our initial experiences with the latest technical advance in this technique, the automated breast volume scanner (ABVS) ACUSON S2000™. Volume data sets were collected from 50 patients and a database containing 23 women with no detectable lesions in conventional ultrasound (BI-RADS®-US 1), 13 women with clearly benign lesions (BI-RADS®-US 2), and 14 women with known breast cancer (BI-RADS®-US 5) was created. An independent examiner evaluated the ABVS data on a separate workstation without any prior knowledge of the patients’ histories. The diagnostic accuracy for the experimental ABVS was 66.0% (95% confidence interval [CI]: 52.9–79.1). The independent examiner detected all breast cancers in the volume data resulting in a calculated sensitivity of 100% in the described setting (95% CI: 73.2%–100%). After the ABVS examination, there were a high number of requests for second-look ultrasounds in 47% (95% CI: 30.9–63.5) of the healthy women (with either a clearly benign lesion or no breast lesions at all in conventional handheld ultrasound). Therefore, the specificity remained at 52.8% (95% CI: 35.7–69.2). When comparing the concordance of the ABVS with the gold standard (conventional handheld ultrasound), Cohen’s Kappa value as an estimation of the inter-rater reliability was κ = 0.37, indicating fair agreement. In conclusion, the ABVS must still be regarded as an experimental technique for breast ultrasound, which definitely needs to undergo further evaluation studies.

Interpretation of automated breast ultrasound (ABUS) with and without knowledge of mammography: a reader performance study

“…Very good agreement regarding BI-RADS classification of HHUS and ABUS (25) as well as only fair agreement has been reported (26). Agreement between mammography and ABUS was poor due to a high percentage of false positive ultrasound interpretations (27).…”

Comparative Study of Automated Breast 3-D Ultrasound and Handheld B-Mode Ultrasound for Differentiation of Benign and Malignant Breast Masses

“…The authors concluded that automated breast ultrasound is a promising modality in breast imaging. Wojcinski et al (2011) argued to the contrary that the ABVS must be regarded as an experimental technology for breast ultrasound and further studies are required. When used in the assessment of 50 lesions, the ABVS had quite low sensitivity, specificity and accuracy (52.8%, 73.2% and 66.0%, respectively).…”

Automated Breast Volume Scanning Versus Conventional Ultrasound in Breast Cancer Screening

“…Finally, US scanning along the line of the mammary duct is considered to be indispensable because most breast carcinomas originate in the epithelial duct tissue and spread along the ducts (11). Based on these limitations and some reports demonstrating no explicit superiority of ABVS over US (25), ABVS cannot currently displace US for breast screening purposes and still requires further evaluation (26).…”

“…Although it has not yet been established as a routine screening modality, bilateral whole breast US has demonstrated diagnostic advantages over conventional US in screening asymptomatic women (9). In this study, we aimed to comparatively evaluate the latest technical advance in bilateral whole breast US-the Automated Breast Volume Scanner (ABVS) that acquires a series of consecutive B-mode pictures and reconstructs three-dimensional (3D) data sets of the entire breast volume (10)-against conventional breast US.…”