Schmachtenberg Constanze, Fischer Thomas, Hamm Bernd, Bick Ulrich
Department of Radiology, Charité Universitätsmedizin Berlin, Charitéplatz 1, Berlin 10117, Germany.
Department of Radiology, Charité Universitätsmedizin Berlin, Charitéplatz 1, Berlin 10117, Germany.
Acad Radiol. 2017 Aug;24(8):954-961. doi: 10.1016/j.acra.2017.01.021. Epub 2017 Mar 20.
This study aimed to compare the diagnostic value of automated breast volume scanning (ABVS) to that of handheld ultrasonography (HHUS) using breast magnetic resonance imaging (MRI) as the gold standard.
Twenty-eight patients with 39 examined breasts with at least one lesion visible in breast MRI underwent HHUS and ABVS. Detection rate, localization, maximum diameter, and Breast Imaging Reporting and Data System classification were compared. Sensitivity, specificity, diagnostic accuracy, positive predictive value, and negative predictive value were calculated for HHUS and ABVS. Lesion localization and maximum diameters based on HHUS and ABVS were compared to size measurement in MRI. Breast Imaging Reporting and Data System categories based on each method were compared to the MRI diagnosis (malignant or benign) or, if available (21 cases), with the histologic diagnosis.
MRI detected 72 lesions, ABVS 59 lesions, and HHUS 54 lesions. Malignancy was proven histopathologically in 15 cases. There was no significant difference between ABVS and HHUS in terms of sensitivity (93.3% vs. 100%), specificity (83.3% vs. 83.3%), diagnostic accuracy (87.2% vs. 89.7%), positive predictive value (77.8% vs. 78.9%), and negative predictive value (95.2% vs. 100%). Agreement regarding lesion localization (same quadrant) was 94.3% for ABVS and MRI and 91.2% for HHUS and MRI. Lesion size compared to MRI lesion size was assessed correctly (+/- 3 mm) in 79.4% (HHUS) and 80% (ABVS). The correlation of size measurement was slightly higher for ABVS-MRI (r = 0.89) than for HHUS-MRI (r = 0.82) with P < .001.
ABVS can be used as an alternative to HHUS. ABVS has the advantage of operator independence and better reproducibility although it is limited in evaluating axillary lymph nodes and lacks Doppler or elastrography capabilities, which sometimes provide important supplementary information in HHUS.
本研究旨在以乳腺磁共振成像（MRI）作为金标准，比较自动乳腺容积扫描（ABVS）与手持超声检查（HHUS）的诊断价值。
28例患者共39个乳房在乳腺MRI上至少可见1个病灶，均接受了HHUS和ABVS检查。比较了检测率、定位、最大直径及乳腺影像报告和数据系统（BI-RADS）分类。计算了HHUS和ABVS的灵敏度、特异度、诊断准确性、阳性预测值和阴性预测值。将基于HHUS和ABVS的病灶定位及最大直径与MRI中的大小测量结果进行比较。将基于每种方法的BI-RADS类别与MRI诊断结果（恶性或良性）进行比较，若可行（21例），则与组织学诊断结果进行比较。
MRI检测到72个病灶，ABVS检测到59个病灶，HHUS检测到54个病灶。15例经组织病理学证实为恶性。ABVS和HHUS在灵敏度（93.3%对100%）、特异度（83.3%对83.3%）、诊断准确性（87.2%对89.7%）、阳性预测值（77.8%对78.9%）和阴性预测值（95.2%对100%）方面无显著差异。ABVS与MRI在病灶定位（同一象限）方面的一致性为94.3%，HHUS与MRI为91.2%。与MRI病灶大小相比，HHUS对病灶大小的评估正确（±3mm）率为79.4%，ABVS为80%。ABVS与MRI的大小测量相关性（r = 0.89）略高于HHUS与MRI（r = 0.82），P <.001。
ABVS可作为HHUS的替代方法。ABVS具有独立于操作者且重复性更好的优点，尽管其在评估腋窝淋巴结方面存在局限性，且缺乏多普勒或弹性成像功能，而这些功能有时在HHUS中可提供重要的补充信息。
