Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-gil, Songpa-gu, Seoul 138-736, Korea.
AJR Am J Roentgenol. 2011 Sep;197(3):732-9. doi: 10.2214/AJR.10.5102.
The objective of our study was to prospectively evaluate the diagnostic accuracy of optical diffusion breast imaging in patients who underwent conventional ultrasound followed by surgery or biopsy.
We performed optical diffusion breast imaging after conventional ultrasound of 193 patients (mean age, 47 years) with 217 lesions. All patients underwent ultrasound-guided core needle biopsy or surgery. One of six radiologists reviewed conventional ultrasound features, assessed a BI-RADS category, and reviewed optical diffusion imaging results for each lesion. Surgery and biopsy results were used as reference standards. We compared the diagnostic accuracy including the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of conventional ultrasound alone and of conventional ultrasound followed by optical diffusion imaging. In addition, we prospectively investigated if total hemoglobin level or oxygen saturation level is the most reliable indicator in optical diffusion imaging.
Of the 217 breast lesions, 108 were malignant and 109 were benign. For differentiation of malignant from benign lesions, conventional ultrasound was associated with a sensitivity of 100%, specificity of 27.5%, PPV of 57.8%, NPV of 100%, and accuracy of 63.6%. The supplemental use of optical diffusion imaging after conventional ultrasound was associated with a sensitivity of 98.1%, specificity of 41.3%, PPV of 62.4%, NPV of 95.7%, and accuracy of 69.7%. The area under the receiver operating characteristic curve was 0.738 for total hemoglobin level and 0.502 for oxygen saturation level. The cutoff value was 0.195 mmol/L for total hemoglobin, with 68.4% sensitivity and 69.7% specificity.
Optical diffusion imaging might be a good supplemental tool to increase the diagnostic accuracy of conventional ultrasound in differentiating malignant from benign breast lesions.
本研究旨在前瞻性评估光学扩散乳腺成像在接受常规超声检查后行手术或活检的患者中的诊断准确性。
我们对 193 例（平均年龄 47 岁）217 个病灶的患者进行了常规超声检查后，进行了光学扩散乳腺成像。所有患者均接受了超声引导下的核心针活检或手术。六名放射科医生中的一名对常规超声特征进行了回顾，评估了 BI-RADS 类别，并对每个病灶的光学扩散成像结果进行了评估。手术和活检结果被用作参考标准。我们比较了常规超声单独和常规超声后结合光学扩散成像的诊断准确性，包括敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）。此外，我们前瞻性地研究了总血红蛋白水平或氧饱和度水平是否是光学扩散成像中最可靠的指标。
在 217 个乳腺病变中，108 个为恶性，109 个为良性。对于恶性与良性病变的鉴别，常规超声的敏感性为 100%，特异性为 27.5%，PPV 为 57.8%，NPV 为 100%，准确性为 63.6%。常规超声后联合使用光学扩散成像的敏感性为 98.1%，特异性为 41.3%，PPV 为 62.4%，NPV 为 95.7%，准确性为 69.7%。总血红蛋白水平的受试者工作特征曲线下面积为 0.738，氧饱和度水平的为 0.502。总血红蛋白的截断值为 0.195mmol/L，敏感性为 68.4%，特异性为 69.7%。
光学扩散成像可能是一种很好的辅助工具，可以提高常规超声在鉴别良恶性乳腺病变中的诊断准确性。
