The Diagnostic Significance of the BI‐RADS Classification Combined With Automated Breast Volume Scanner and Shear Wave Elastography for Breast Lesions

Abstract

Objective We herein compared the diagnostic accuracy of the BI‐RADS, ABVS, SWE, and combined techniques for the classification of breast lesions. Methods Breast lesions were appraised using the BI‐RADS classification system as well as the combinations of BI‐RADS plus ABVS (BI‐RADS + ABVS) and BI‐RADS plus SWE (BI‐RADS + SWE), and both methods (BI‐RADS + ABVS + SWE) by two specialties Medical Ultrasound physician. The Fisher's exact and χ2 tests were performed to compare the degree of malignancy for the various methods with a pathology ground truth. Receiver operating characteristic curves (ROC) were generated and the corresponding area under the curve (AUC) values were determined to test the diagnostic efficacy of the various methods and identify the optimal SWE cut‐off indicative of malignancy. Results The incidence of the retraction phenomenon on ABVS images of the malignant group was significantly higher (P < .001) than that of the benign group. The specificity, sensitivity, and positive and negative predictive values of the BI‐RADS classification were 88.72, 79.38, 83.70, and 85.50%, respectively. BI‐RADS plus SWE‐Max exhibited enhanced specificity, sensitivity, and positive and negative predictive values of 88.72, 92.78, 85.70, and 94.40%, respectively. Similarly, when BI‐RADS + ABVS was utilized, the sensitivity and negative predictive value increased to 95.88 and 96.40%, respectively. BI‐RADS + ABVS + SWE possessed the highest overall sensitivity (96.91%), specificity (94.74%), and positive (93.10%) and negative (97.70%) predictive values from all four indices. Conclusion ABVS and SWE can reduce the subjectivity of BI‐RADS. As a result, BI‐RADS + ABVS + SWE resulted in the best diagnostic accuracy.

Intra‐ and Interobserver Reliability of Shear Wave Elastography in Breast Cancer Diagnosis

“…ABVS enables automatic assessment of the entire breast volume and provides reconstructed images that can be evaluated independently of time and place. [30][31][32] Still, large prospective data are lacking and ABVS is only rarely used in clinical routine. Another approach to improving diagnostic performance of ultrasound in breast cancer diagnostics by SWE is to adapt not only the performance of SWE through standardization but its interpretation.…”

“…This method is examiner‐independent and could therefore overcome the limitations of hand‐held ultrasound. ABVS enables automatic assessment of the entire breast volume and provides reconstructed images that can be evaluated independently of time and place 30–32 . Still, large prospective data are lacking and ABVS is only rarely used in clinical routine.…”