Barr Richard G, DeVita Robert, Destounis Stamatia, Manzoni Federica, De Silvestri Annalisa, Tinelli Carmine
Northeast Ohio Medical University, Rootstown, Ohio, USA.
Southwoods Imaging, Youngstown, Ohio, USA.
J Ultrasound Med. 2017 Oct;36(10):2087-2092. doi: 10.1002/jum.14248. Epub 2017 Jun 1.
To compare the agreement and interobserver variability of diagnostic handheld ultrasound (US) and a single volume on an automated breast volume scanner (ABVS) and to determine whether there was a significant difference if the ABVS was used by a sonographer or mammographic technologist.
Ninety patients scheduled for diagnostic US examinations were randomized to either handheld US or the ABVS first. The AVBS was randomized between a sonographer and a mammographic technologist performing the study. The studies were blinded, randomized, and read by 2 radiologists. The lesion with the highest Breast Imaging Reporting and Data System (BI-RADS) score was used in the analysis. Final diagnoses were made by core biopsy or follow-up for 2 years. Lesions included 9 malignant and 81 benign.
The 90 patients had a mean age ± SD of 53.1 ± 16.3 years. The κ value for agreement between the ABVS and handheld US was 0.831 (95% confidence interval, 0.744-0.925), whereas the global agreement for a 7-point BI-RADS score was 0.488 (0.372-0.560). The agreement between the ABVS and handheld US was nearly the same when the ABVS was used by a mammographic technologist (κ = 0.858 [0.723-0.963]) or sonographer (κ = 0.803 [0.596-1.000]; P = .47). The areas under the receiver operating characteristic curves for characterization by the ABVS were 0.91 (0.84-0.96) for reader 1 and 0.91 (0.83-0.96) for reader 2; those for handheld US were 0.91 (0.84-0.96) for reader 1 and 0.83 (0.74-0.90) for reader 2, with no statistical difference. The agreement based on pathologic images was κ = 0.831 (0.718-0.944); for handheld US, κ = 0.795 (0.623-0.967); and for the AVBS, κ = 0.869 (0.725-1.000).
Performing a single-view diagnostic ABVS examination has good agreement with a handheld diagnostic US workup. There is no difference if the ABVS is used by a sonographer or mammographic technologist.
比较诊断性手持超声（US）与自动乳腺容积扫描仪（ABVS）单容积成像的一致性及观察者间的变异性，并确定由超声医师或乳腺摄影技师操作ABVS时是否存在显著差异。
90例计划进行诊断性超声检查的患者被随机分为先接受手持超声检查或先接受ABVS检查。ABVS检查由超声医师和乳腺摄影技师随机操作。研究采用双盲、随机分组，由2名放射科医生阅片。分析中采用乳腺影像报告和数据系统（BI-RADS）评分最高的病变。最终诊断通过核心活检或2年随访确定。病变包括9例恶性和81例良性。
90例患者的平均年龄±标准差为53.1±16.3岁。ABVS与手持超声之间的κ值为0.831（95%置信区间，0.744 - 0.925），而对于7分的BI-RADS评分，总体一致性为0.488（0.372 - 0.560）。当由乳腺摄影技师操作ABVS时（κ = 0.858 [0.723 - 0.963]）或超声医师操作时（κ = 0.803 [0.596 - 1.000]；P = 0.47），ABVS与手持超声之间的一致性几乎相同。ABVS用于特征性诊断时，阅片者1的受试者操作特征曲线下面积为0.91（0.84 - 0.96），阅片者2为0.91（0.83 - 0.96）；手持超声用于特征性诊断时，阅片者1为0.91（0.84 - 0.96），阅片者2为0.83（0.74 - 0.90），无统计学差异。基于病理图像的一致性，κ = 0.831（0.718 - 0.944）；手持超声为κ = 0.795（0.623 - 0.967）；ABVS为κ = 0.869（0.725 - 1.000）。
进行单视角诊断性ABVS检查与手持诊断性超声检查具有良好的一致性。由超声医师或乳腺摄影技师操作ABVS无差异。
