声学结构定量分析能否用于描述乳腺病变周围区域的超声回声特征？

Can acoustic structural quantification be used to characterize the ultrasound echotexture of the peripheral zone of breast lesions?

机构信息

Department of Radiology, University Berlin, Charité, Berlin, Germany.

Department of Nephrology, University Berlin, Charité, Berlin, Germany.

出版信息

Clin Hemorheol Microcirc. 2019;72(2):189-200. doi: 10.3233/CH-180484.

DOI:10.3233/CH-180484

PMID:30714952

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6700716/

Abstract

BACKGROUND

Besides mammography, breast ultrasound is the most important imaging modality for women with suspected breast cancer. New software tools bear high potential for improved detectability and specification of malignant breast lesions.

OBJECTIVE

To compare the halo depicted around malignant breast lesions by ultrasound using Acoustic Structure Quantification (ASQ) of raw image data with the echogenic rim seen in B-mode ultrasound.

METHODS

This retrospective study included 37 women for whom conventional B-mode ultrasound of the breast and ASQ were available as well as histopathology findings for comparison. Software tools were used to measure the halo area or echogenic rim and tumor area and calculate halo-to-lesion ratios for the two ultrasound modes. Six inexperienced readers characterized the breast lesions based on this information. Specificity, sensitivity, positive predictive value (PPV), and negative predictive value (NPV) were determined. ANOVA, the Wilcoxon test, and ROC curve analysis were performed.

RESULTS

There was a linear relationship between ASQ-based and B-mode-based halo-to-lesion ratios; however, a systematic error was also noted. ASQ-derived ratios tended to be higher for breast lesions with lymphangioinvasion (p = 0.051, n.s.) and higher N-stages (p > 0.925, n.s.), while there was no correlation with other markers. Because of the significantly greater conspicuity of peritumoral halos in the ASQ mode, inexperienced readers achieved greater sensitivity (78% vs. 74%) and specificity (75% vs. 71%) and higher NPVs (75% vs. 71%) and PPVs (78% vs. 74%) compared with B-mode images. Greater halo conspicuity affected the identification of malignant lesions with both modes; ASQ was found to be particularly well suited (FBimage (1,100) = 19.253, p < 0.001; FASQ (1,100) = 52.338, p < 0.001). The inexperienced readers were significantly more confident about their diagnosis using the ASQ maps (z = -3.023, p = 0.003).

CONCLUSIONS

We conclude that the halo in ASQ and the echogenic rim in B-mode ultrasound are attributable to different morphologic correlates. ASQ improves diagnostic accuracy and confidence of inexperienced examiners because of improved halo visibility.

摘要

背景

除了乳房 X 光摄影术，乳腺超声是疑似乳腺癌女性最重要的影像学检查方法。新的软件工具具有提高恶性乳腺病变检测能力和特异性的巨大潜力。

目的

比较超声声触诊组织量化（ASQ）原始图像数据中恶性乳腺病变周围晕环与 B 型超声中见到的强回声边缘。

方法

本回顾性研究纳入了 37 名女性，这些女性均接受了常规乳腺 B 型超声和 ASQ 检查，且有组织病理学检查结果可供比较。软件工具用于测量晕环面积或强回声边缘和肿瘤面积，并计算两种超声模式下的晕环与病变比值。6 名无经验的读者根据这些信息对乳腺病变进行特征描述。确定了特异性、敏感性、阳性预测值（PPV）和阴性预测值（NPV）。进行了方差分析、Wilcoxon 检验和 ROC 曲线分析。

结果

ASQ 与 B 型超声的基于比值存在线性关系，但也存在系统误差。有淋巴管侵犯（p=0.051，无统计学意义）和更高 N 分期（p>0.925，无统计学意义）的乳腺病变，ASQ 得出的比值较高，而与其他标志物无相关性。由于在 ASQ 模式下肿瘤周围晕环的显著性更高，无经验的读者获得了更高的敏感性（78%比 74%）和特异性（75%比 71%），以及更高的 NPV（75%比 71%）和 PPV（78%比 74%）。与 B 型图像相比，更大的晕环显著性影响了两种模式下恶性病变的识别；发现 ASQ 特别适合（FBimage（1,100）=19.253，p<0.001；FASQ（1,100）=52.338，p<0.001）。无经验的读者在使用 ASQ 图谱时对诊断更有信心（z=-3.023，p=0.003）。