Sino-Dutch Biomedical and Information Engineering School, Northeastern University, Shenyang, Liaoning, China.
Department of Radiology, Shengjing hospital of China Medical University, Shenyang, Liaoning, China.
J Xray Sci Technol. 2018;26(5):805-813. doi: 10.3233/XST-18388.
Various imaging modalities have been used to diagnose suspicious breast lesions. Purpose of this study is to compare the diagnostic accuracy for breast cancer using mammography, ultrasonography and magnetic resonance imaging (MRI).
Total 107 patients aged from 19 to 62 years are included in this retrospective study. Mammography, ultrasonography and MRI scans were performed for each patient detected with suspected breast tumor within a month. In addition, the tumor diversity (10 types of benign and 5 types of malignant) was confirmed by pathological findings of tumor biopsy. To compare the diagnosis performance of the three imaging modalities, the overall fraction correct (accuracy), positive predict value (PPV), negative predict value (NPV), sensitivity and specificity were calculated. Meanwhile, the receiver operating characteristic (ROC) analysis was also performed.
The diagnostic accuracy ranged from 78.5% to 86.9% among three imaging modalities. All modalities yielded a PPV lower than 77.8% and a NPV higher than 90.0% in identifying the presence of malignant tumors. MRI presented a diagnostic accuracy of 86.9%, as well as a sensitivity of 95.5% and an area under curve (AUC) of 0.948, which are higher than mammography and ultrasonography.
By using a diverse dataset and comparing the diagnostic accuracy of three imaging modalities commonly used in breast cancer detection and diagnosis, this study also demonstrated that mammography, ultrasonography and MRI had different diagnostic performance in breast tumor identification. Among them, MRI yielded the highest performance even though the unexpected specificity may lead to over-diagnosis, and ultrosonography is slightly better than mammography.
各种影像学方法已被用于诊断可疑的乳腺病变。本研究旨在比较乳腺摄影、超声和磁共振成像（MRI）诊断乳腺癌的准确性。
本回顾性研究共纳入 107 例年龄在 19 岁至 62 岁之间的患者。在一个月内对每位疑似患有乳腺肿瘤的患者进行乳腺摄影、超声和 MRI 扫描。此外，通过肿瘤活检的病理发现证实了肿瘤的多样性（10 种良性和 5 种恶性）。为了比较三种影像学方法的诊断性能，计算了总分数正确（准确性）、阳性预测值（PPV）、阴性预测值（NPV）、敏感性和特异性。同时，还进行了受试者工作特征（ROC）分析。
三种影像学方法的诊断准确率在 78.5%至 86.9%之间。所有方法在识别恶性肿瘤的存在时，PPV 均低于 77.8%，NPV 均高于 90.0%。MRI 的诊断准确率为 86.9%，敏感性为 95.5%，曲线下面积（AUC）为 0.948，均高于乳腺摄影和超声。
通过使用多样化的数据集并比较三种常用于乳腺癌检测和诊断的影像学方法的诊断准确性，本研究还表明，乳腺摄影、超声和 MRI 在乳腺肿瘤识别方面具有不同的诊断性能。其中，MRI 的性能最高，尽管特异性出乎意料可能导致过度诊断，而超声略优于乳腺摄影。
