Fuchsjaeger Michael H, Flöry Daniel, Reiner Cäcilia S, Rudas Margarete, Riedl Christopher C, Helbich Thomas H
Department of Radiology, Medical University of Vienna, Vienna, Austria.
Invest Radiol. 2005 Jul;40(7):478-85. doi: 10.1097/01.rli.0000167425.34577.d1.
We sought to prospectively assess the value of electrical impedance scanning (EIS) in discriminating benign from malignant lesions classified as BI-RADS category IV in mammography in comparison with ultrasound (US), with a special focus on negative prediction.
EIS was performed on 128 BI-RADS category IV lesions in 121 women (mean, 51.8 years). The newly developed EIS software 2.67 calculates a BI-RADS-like level of suspicion (LOS) on a 5-grade scale. LOS 1, 2, and 3 were considered negative; LOS 4 and 5 were considered positive. Histopathologic results were obtained in all lesions.
Histology proved 37 lesions malignant, 91 benign. Sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) of EIS compared with US were 94.6%, 74.7%, 80.5%, 60.3%, 97.1% versus 90.5%, 33.8%, 47.2%, 29.7%, 92.0%, respectively. In 43 lesions sized < or = 10 mm, EIS demonstrated better sensitivity, specificity, accuracy, PPV, and NPV of 100%, 83.3%, 90.7%, 82.6%, and 100%, respectively. Although NPV was also high, US showed no sufficient results in 39 (30.5%) lesions because of microcalcifications. Receiver operating curve analysis revealed best results for a combined use of US and EIS.
With a NPV of 97.1% of EIS in BI-RADS category IV breast lesions, a negative result in these lesions could be firm indication to manage them as BI-RADS-category III and refer patients for a 6-month short-interval follow-up rather than performing a biopsy. The best adjunctive diagnostic performance can be achieved by a combination of US and EIS. Costs and patient morbidity could be minimized.
我们旨在前瞻性评估电阻抗扫描（EIS）在鉴别乳腺钼靶检查中分类为BI-RADS 4类的良性与恶性病变方面的价值，并与超声（US）进行比较，特别关注阴性预测。
对121名女性（平均年龄51.8岁）的128个BI-RADS 4类病变进行了电阻抗扫描。新开发的EIS软件2.67以5级量表计算类似BI-RADS的可疑程度（LOS）。LOS 1、2和3被视为阴性；LOS 4和5被视为阳性。所有病变均获得了组织病理学结果。
组织学证实37个病变为恶性，91个为良性。与超声相比，EIS的敏感性、特异性、准确性、阳性预测值（PPV）和阴性预测值（NPV）分别为94.6%、74.7%、80.5%、60.3%、97.1%，而超声分别为90.5%、33.8%、47.2%、29.7%、92.0%。在43个大小≤10 mm的病变中，EIS的敏感性、特异性、准确性、PPV和NPV分别表现更好，为100%、83.3%、90.7%、82.6%和100%。尽管NPV也很高，但由于微钙化，超声在39个（30.5%）病变中显示结果不充分。受试者操作特征曲线分析显示，超声和EIS联合使用效果最佳。
对于BI-RADS 4类乳腺病变，EIS的NPV为97.1%，这些病变的阴性结果可能是将其作为BI-RADS 3类处理并建议患者进行6个月短期随访而非活检的有力指征。超声和EIS联合使用可实现最佳的辅助诊断性能。成本和患者发病率可降至最低。
