Farrokh André, Erdönmez Harika, Schäfer Fritz, Maass Nicolai
Universitätsklinik Schleswig-Holstein, Campus Kiel, Klinik für Gynäkologie und Geburtshilfe, Kiel, Germany.
Klinikum Bremerhaven-Reinkenheide, Frauenklinik, Bremerhaven, Germany.
Geburtshilfe Frauenheilkd. 2018 May;78(5):499-505. doi: 10.1055/a-0600-2279. Epub 2018 Jun 4.
Most of the currently available automated breast ultrasound systems require patients to be in the supine position. Previous data, however, show a high recall rate with this method due to artifacts. The novel automated breast ultrasound scanner SOFIA scans the breast with the patient in a prone position, resulting in even compression of breast tissue. We present our initial results with this examination method.
63 patients were analyzed using a handheld B-mode ultrasound. In cases of BI-RADS 1, 2 or 5, a SOFIA scan was performed. Sensitivity, specificity and accuracy were calculated. Interobserver agreement was evaluated using Cohen's kappa. The duration of the scan was measured for both methods.
No BI-RADS 5 lesion was missed with SOFIA. The SOFIA had an additional recall rate of 16.67% compared to B-mode ultrasound. The sensitivity, specificity and accuracy of SOFIA was 100, 83.33 and 88.89%, respectively. Cohen's kappa showed substantial agreement (κ = 0.769) between examiner 1 (B-mode) and examiner 2 (SOFIA). The mean scan duration for the B-mode system and the SOFIA system was 24.21 minutes and 12.94 minutes, respectively. In four cases, D-cup breasts were not scanned in their entirety.
No cancer was missed when SOFIA was used in this preselected study population. The scanning time was approximately half of that required for B-mode ultrasound. The additional unnecessary recall rate was 16.67%. Larger D cup-size breasts were difficult to position and resulted in an incomplete image in four cases.
目前市面上大多数自动乳腺超声系统都要求患者处于仰卧位。然而，既往数据显示，由于伪像，这种方法的召回率很高。新型自动乳腺超声扫描仪SOFIA在患者俯卧位时对乳房进行扫描，从而实现乳腺组织的均匀压迫。我们展示了这种检查方法的初步结果。
使用手持式B超对63例患者进行分析。对于BI-RADS 1、2或5类病例，进行SOFIA扫描。计算敏感性、特异性和准确性。使用Cohen's kappa评估观察者间一致性。测量两种方法的扫描持续时间。
SOFIA未漏诊任何BI-RADS 5类病变。与B超相比，SOFIA的额外召回率为16.67%。SOFIA的敏感性、特异性和准确性分别为100%、83.33%和88.89%。Cohen's kappa显示检查者1（B超）和检查者2（SOFIA）之间有高度一致性（κ = 0.769）。B超系统和SOFIA系统的平均扫描持续时间分别为24.21分钟和12.94分钟。在4例病例中，D罩杯乳房未被完整扫描。
在这个预先选择的研究人群中使用SOFIA时未漏诊任何癌症。扫描时间约为B超所需时间的一半。额外的不必要召回率为16.67%。较大的D罩杯乳房难以定位，4例出现图像不完整的情况。
