Evaluation of contrast-enhanced ultrasonography breast predictive model in optimizing breast lesions BI-RADS classification
10.3760/cma.j.issn.1004-4477.2018.04.011
- VernacularTitle:乳腺超声造影预测模型在优化乳腺病灶BI-RADS分类中的价值
- Author:
Wanyue DENG
1
;
Lina TANG
;
Lichun YANG
;
Zhihong LYU
;
Yinrong CHENG
;
Lijun YUAN
;
Yan CHENG
;
Shengli WANG
;
Qin CHEN
;
Jun LUO
Author Information
1. 563000,遵义医学院
- Keywords:
Contrast-enhanced ultrasound;
Breast neoplasms;
Breast imaging reports and data systems;
Biopsy;
needles
- From:
Chinese Journal of Ultrasonography
2018;27(4):318-322
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the value of contrast-enhanced ultrasonography ( CEUS ) breast predictive model in the optimization of BI-RADS classification of breast lesions . Methods A total of 1049 BI-RADS 4 ,5 breast lesions were obtained from 1039 patients in 8 centers . CEUS examination was performed prior to biopsy or surgery . According to the classification of the model ,class 3 ,4A ,4B and 4C were selected as biopsy thresholds ,and the ROC curve was drawn . The diagnostic sensitivity ,specificity , accuracy ,positive predictive value ,negative predictive value and Jordanian index were calculated for the biopsy threshold . The biopsy rate of breast lesions before and after angiography ,cancer detection rate , follow-up cases of malignant risk were compared . Results There were benign lesions 586 ( 55 .9% ) , malignant lesions 463 (44 .1% ) in the 1049 breast lesions . The area of ROC with thresholds of 3 ,4A ,4B and 4C were 0 .695 ,0 .838 ,0 .847 and 0 .757 ,respectively ( all P < 0 .01) . Ultrasonography had a certain diagnostic effect on benign and malignant breast lesions . The diagnostic sensitivity ,specificity ,accuracy , positive predictive value and negative predictive value with class 4A after CEUS set as the biopsy threshold were 93 .32% ,75 .65% ,82 .75% ,75 .57% and 93 .35% ,respectively ,and the Jordanian index was 0 .690 . When chass 3 after CEUS was set as the biopsy threshold ,the biopsy rate was reduced from 100% to 76 .74% ,the detection rate was increased from 44 .23% to 56 .77% ,and the risk of cancer was only 0 .67% in the follow-up cases . When class 4A was set as the biopsy threshold ,the biopsy rate was reduced from 100% to 55 .58% after CEUS . The detection rate of cancer increased from 44 .23% to 74 .44% . The risk of cancer was 2 .96% . Conclusions The biopsy rate of breast lesions in category 4 and 5 would be reduced and cancer detection rate of them would be increased after CEUS ,however ,the risk of malignancy in the follow -up cases would be controlled as low as category 3 and 4A in previous BI-RADS . Thus ,CEUS has a good prospect of in optimizing BI-RADS and reducing biopsy rate in unnecessary lesions .