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乳腺癌筛查中自动乳腺容积扫描与传统超声的比较

Automated breast volume scanning versus conventional ultrasound in breast cancer screening.

作者信息

Xiao Yuanming, Zhou Qichang, Chen Zhiheng

机构信息

Health Management Center, Third Xiangya Hospital of Central South University, Changsha, 410013, China.

Department of Ultrasonography, Second Xiangya Hospital of Central South University, Changsha, China.

出版信息

Acad Radiol. 2015 Mar;22(3):387-99. doi: 10.1016/j.acra.2014.08.013. Epub 2015 Jan 22.

Abstract

RATIONALE AND OBJECTIVES

To assess the diagnostic value of automated breast volume scanning (ABVS) versus conventional ultrasound (US) in breast cancer screening.

MATERIALS AND METHODS

This study retrospectively analyzed the ABVS and US images from 200 women who underwent breast examination and were recommended for biopsy in our health management centers between July 22, 2011, and October 20, 2013. We retrospectively assessed whether breast lesions from 200 women, which were detected and classified by US, could be detected and classified by an independent examiner using only ABVS findings. The sensitivity and specificity of ABVS versus US in determining lesion malignancy were calculated using biopsy as the gold standard.

RESULTS

In the 200 cases, 273 and 194 individual lesions were detected by ABVS and US, respectively. All 194 US-detected lesions were detected by ABVS. Pathologic examination determined that, of the 273 total lesions, 251 lesions were benign and 22 lesions were malignant. US detected 21 of the 22 malignant lesions and ABVS detected all 22 malignant lesions. The sensitivity and specificity of ABVS relative to biopsy (gold standard) were 28.95% and 100%, whereas the sensitivity and specificity of US relative to biopsy were 43.06% and 98.36%.

CONCLUSIONS

US displays superior sensitivity to ABVS across all Breast Imaging Reporting and Data System (BI-RADS) density categories while displaying equivalent specificity with the exception of BI-RADS density category 1, in which ABVS displayed a slightly superior specificity. As ABVS possesses several advantages and limitations with respect to US, ABVS may serve as an effective, adjunct, screening tool to mammography and conventional sonography.

摘要

原理与目的

评估自动乳腺容积扫描(ABVS)与传统超声(US)在乳腺癌筛查中的诊断价值。

材料与方法

本研究回顾性分析了2011年7月22日至2013年10月20日期间在我们健康管理中心接受乳腺检查并被建议进行活检的200名女性的ABVS和US图像。我们回顾性评估了仅根据ABVS检查结果,一名独立检查者能否检测并分类由US检测出的这200名女性的乳腺病变。以活检作为金标准,计算ABVS与US在确定病变恶性程度方面的敏感性和特异性。

结果

在这200例病例中,ABVS和US分别检测出273个和194个独立病变。US检测出的所有194个病变均被ABVS检测到。病理检查确定,在总共273个病变中,251个病变为良性,22个病变为恶性。US检测出22个恶性病变中的21个,ABVS检测出所有22个恶性病变。ABVS相对于活检(金标准)的敏感性和特异性分别为28.95%和100%,而US相对于活检的敏感性和特异性分别为43.06%和98.36%。

结论

在所有乳腺影像报告和数据系统(BI-RADS)密度类别中,US对ABVS显示出更高的敏感性,同时除BI-RADS密度类别1外显示出相当的特异性,其中ABVS显示出略高的特异性。由于ABVS相对于US既有优势也有局限性,ABVS可作为乳腺X线摄影和传统超声检查的一种有效的辅助筛查工具。

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