Liu BaoXian, Zheng YanLing, Shan QuanYuan, Lu Ying, Lin ManXia, Tian WenShuo, Xie XiaoYan
Division of Interventional Ultrasound, Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-sen University, Sun Yat-Sen University, 58 Zhong Shan Road 2, Guangzhou, 510080, China.
J Med Ultrason (2001). 2016 Jan;43(1):47-55. doi: 10.1007/s10396-015-0658-9. Epub 2015 Oct 28.
To perform a meta-analysis assessing the ability of elastography by acoustic radiation force impulse (ARFI) technology to differentiate benign and malignant breast lesions.
PubMed, the Cochrane Library, and the Web of Knowledge before September 24, 2014 were searched. Published studies that evaluated the diagnostic performance of ARFI for characterization of focal breast lesions were included.
A total of fifteen studies, including 1720 patients with 1873 breast lesions (743 cancers, 1130 benign lesions), was analyzed. Among the included studies, virtual touch tissue imaging (VTI) was used in six studies, virtual touch tissue quantification (VTQ) in eight, combined VTI and VTQ in four, and virtual touch tissue imaging quantification (VTIQ) in three. Summary sensitivity and summary specificity for distinguishing malignant from benign breast lesions were 0.913 [95% confidence interval (CI), 0.779-0.969] and 0.871 (95% CI 0.773-0.930) for VTI, 0.849 (95% CI 0.805-0.884) and 0.889 (95% CI 0.771-0.950) for VTQ, and 0.935 (95% CI 0.892-0.961) and 0.881 (95% CI 0.818-0.924) for combined VTI and VTQ, respectively. The area under summary receiver operating characteristic (sROC) curve of VTI, VTQ, and combined VTI and VTQ were 0.95, 0.88, and 0.96, respectively. Significant publication bias was found only in the VTQ assessment (p = 0.025). The obtained sensitivity of VTIQ ranged from 80.4 to 90.3%, while the specificity ranged from 73.0 to 93.0%. The summary diagnostic value of VTIQ could not be evaluated due to insufficient data.
Elastography by ARFI technology could be used as a good identification tool for differentiating benign and malignant breast lesions.
进行一项荟萃分析，评估基于声辐射力脉冲（ARFI）技术的弹性成像鉴别乳腺良恶性病变的能力。
检索截至2014年9月24日的PubMed、Cochrane图书馆和Web of Knowledge。纳入评估ARFI对乳腺局灶性病变特征诊断性能的已发表研究。
共分析了15项研究，包括1720例患者的1873个乳腺病变（743个癌症，1130个良性病变）。在所纳入的研究中，6项研究使用了虚拟触诊组织成像（VTI），8项使用了虚拟触诊组织定量（VTQ），4项同时使用了VTI和VTQ，3项使用了虚拟触诊组织成像定量（VTIQ）。VTI鉴别乳腺良恶性病变的汇总敏感性和汇总特异性分别为0.913 [95%置信区间（CI），0.779 - 0.969]和0.871（95% CI 0.773 - 0.930），VTQ分别为0.849（95% CI 0.805 - 0.884）和0.889（95% CI 0.771 - 0.950），VTI和VTQ联合应用分别为0.935（95% CI 0.892 - 0.961）和0.881（95% CI 0.818 - 0.924）。VTI、VTQ以及VTI和VTQ联合应用的汇总受试者工作特征（sROC）曲线下面积分别为0.95、0.88和0.96。仅在VTQ评估中发现显著的发表偏倚（p = 0.025）。VTIQ获得的敏感性范围为80.4%至90.3%，特异性范围为73.0%至93.0%。由于数据不足，无法评估VTIQ的汇总诊断价值。
基于ARFI技术的弹性成像可作为鉴别乳腺良恶性病变的良好识别工具。
