School of Public Health, Dalian Medical University, Dalian, Liaoning, China.
Department of Ultrasound, The First Hospital Affiliated to Dalian Medical University, Dalian, Liaoning, China.
Indian J Med Res. 2021 Aug;154(2):347-354. doi: 10.4103/ijmr.IJMR_836_19.
BACKGROUND & OBJECTIVES: Breast cancer being one of the most common malignant tumours among women, diagnostic modalities for early detection of the same become of paramount importance. In this context, the hand-held ultrasound (HHUS) and automated breast volume scanner (ABVS) could provide valuable information for clinicians to diagnose breast diseases. This study aimed to compare and evaluate the diagnostic performance of combined use of HHUS and ABVS for the differentiation of benign and malignant breast lesions.
A total of 361 female patients, who underwent both HHUS and ABVS examinations were included in this study. ABVS and HHUS images were interpreted using the American College of Radiology Breast Imaging-Reporting and Data System (BI-RADS). The distributions of the BI-RADS categories and pathology results were shown as specific numbers. Kappa coefficients test (κ) was calculated to compare the diagnostic results amongst the ABVS, HHUS and ABVS combined with HHUS. The sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of the three diagnostic methods were calculated and their respective diagnostic performance was analyzed by receiver operator characteristic curve.
Of a total of 431 lesions, 153 (35.5%) were malignant and 278 (64.5%) were benign. With respect to the pathology results, the value of κ was 0.713 (P<0.001) for HHUS, κ=0.765 (P<0.001) for ABVS and κ=0.815 (P<0.001) for HHUS+ABVS. The sensitivity, specificity, accuracy, PPV and NPV for HHUS combined with ABVS were 96.08 (147/153), 88.49 (246/278), 91.18 (393/431), 82.12 (147/179) and 97.62 per cent (246/252) respectively. For HHUS, these were 90.20 (138/153), 84.17 (234/278), 86.31 (372/431), 75.82 (138/182) and 93.98 per cent (234/249) respectively; and for ABVS these were 92.16 (141/153), 87.05 (242/278), 88.86 (383/431), 79.66 (141/177) and 95.28 per cent (242/254), respectively. There was no significant difference amongst these three methods, but the diagnostic performance of HHUS combined with ABVS was better than, or at least equal to, that of HHUS or ABVS alone.
INTERPRETATION & CONCLUSIONS: The results of this study suggest that ABVS is a promising and advantageous modality for breast cancer detection. Furthermore, the combination of HHUS and ABVS showed a more comparable diagnostic performance than HHUS or ABVS alone for distinguishing between benign and malignant breast lesions.
乳腺癌是女性中最常见的恶性肿瘤之一，因此对于早期发现乳腺癌的诊断方法显得尤为重要。在这种情况下，手持式超声（HHUS）和自动乳腺容积扫描仪（ABVS）可为临床医生诊断乳腺疾病提供有价值的信息。本研究旨在比较和评估 HHUS 和 ABVS 联合使用对鉴别良恶性乳腺病变的诊断性能。
共纳入 361 例女性患者，这些患者均接受了 HHUS 和 ABVS 检查。ABVS 和 HHUS 图像使用美国放射学院乳腺成像报告和数据系统（BI-RADS）进行解读。BI-RADS 类别和病理结果的分布以具体数字表示。采用 Kappa 系数检验（κ）比较 ABVS、HHUS 和 ABVS 联合 HHUS 的诊断结果。计算三种诊断方法的敏感性、特异性、准确性、阳性预测值（PPV）和阴性预测值（NPV），并通过受试者工作特征曲线分析各自的诊断性能。
431 个病灶中，153 个（35.5%）为恶性，278 个（64.5%）为良性。根据病理结果，HHUS 的κ值为 0.713（P<0.001），ABVS 的κ值为 0.765（P<0.001），HHUS+ABVS 的κ值为 0.815（P<0.001）。HHUS+ABVS 的敏感性、特异性、准确性、PPV 和 NPV 分别为 96.08%（147/153）、88.49%（246/278）、91.18%（393/431）、82.12%（147/179）和 97.62%（246/252）。HHUS 的敏感性、特异性、准确性、PPV 和 NPV 分别为 90.20%（138/153）、84.17%（234/278）、86.31%（372/431）、75.82%（138/182）和 93.98%（234/249）。ABVS 的敏感性、特异性、准确性、PPV 和 NPV 分别为 92.16%（141/153）、87.05%（242/278）、88.86%（383/431）、79.66%（141/177）和 95.28%（242/254）。这三种方法之间无显著差异，但 HHUS+ABVS 的诊断性能优于或至少等同于 HHUS 或 ABVS 单独使用。
本研究结果表明，ABVS 是一种很有前途和优势的乳腺癌检测方法。此外，HHUS 和 ABVS 的联合使用在鉴别良恶性乳腺病变方面比 HHUS 或 ABVS 单独使用具有更好的诊断性能。
