Objective:To evaluate the consistency between architectural distortion（AD）observed on coronal images in three-dimensional ultrasonography（3D-US）and full-field digital mammography（FFDM），and to analyze the influencing factors of the presence of AD on 3D-US coronal images.Methods:A retrospective study was conducted on 96 female patients（97 lesions）with AD identified via FFDM that examined at Affiliated Hangzhou First People's Hospital，School of Medicine，Westlake University from January 2019 to December 2021，all of which with corresponding 3D-US results. Kappa analysis was used to assess the consistency between AD on 3D-US and FFDM.The differences of the lesion characteristics on FFDM（glandular density，presence of calcifications，and degree of distortion），3D-US features（number of lesions，presence of mass or non-mass lesions，and skipping sign in coronal images），clinical pathological characteristics（age，location，and pathology）between groups with AD and without AD in 3D-US were compared. Multivariate Logistic regression was used to identify the influencing factors.Results:Among the FFDM-identified AD lesions，62（63.92%，62/97）lesions showed AD on 3D-US coronal images，including 30 malignant lesions（48.39%，30/62）；35（36.08%，35/97）lesions without AD on 3D-US，in which 4（11.43%，4/35）were malignant. The consistency of distortion degree between FFDM and 3D-US was moderate（Kappa=0.455， P<0.001），with no statistically significant difference（ χ2=2.882， P=0.143）. The probability of malignancy was higher in typical AD compared to atypical AD. The comparisons of age，location，number of lesions，presence of skipping sign in 3D-US，breast density，and presence of calcification in the lesion showed no statistically significant differences between the groups with and without AD（all P >0.05）.The pathological results of malignancy，presence of lesions in 3D-US（mass and non-mass lesions），and the degree of distortion in FFDM showed statistically significant differences（all P < 0.05）. The multivariate Logistic regression analysis indicated that there were no independent risk factors for the appearance of AD in 3D-US（all P > 0.05）. Conclusions:In breast FFDM AD lesions，the incidence of 3D-US coronal plane AD was 63.92%，and the consistency between the degree of distortion in FFDM and 3D-US was moderate. The probability of malignancy is higher with typical AD. Pathological malignancy，presence of lesions in 3D-US（both mass and non-mass lesions），and typical AD in FFDM are more likely to correspond with AD in the coronal.

Objective:To evaluate the consistency between architectural distortion（AD）observed on coronal images in three-dimensional ultrasonography（3D-US）and full-field digital mammography（FFDM），and to analyze the influencing factors of the presence of AD on 3D-US coronal images.Methods:A retrospective study was conducted on 96 female patients（97 lesions）with AD identified via FFDM that examined at Affiliated Hangzhou First People's Hospital，School of Medicine，Westlake University from January 2019 to December 2021，all of which with corresponding 3D-US results. Kappa analysis was used to assess the consistency between AD on 3D-US and FFDM.The differences of the lesion characteristics on FFDM（glandular density，presence of calcifications，and degree of distortion），3D-US features（number of lesions，presence of mass or non-mass lesions，and skipping sign in coronal images），clinical pathological characteristics（age，location，and pathology）between groups with AD and without AD in 3D-US were compared. Multivariate Logistic regression was used to identify the influencing factors.Results:Among the FFDM-identified AD lesions，62（63.92%，62/97）lesions showed AD on 3D-US coronal images，including 30 malignant lesions（48.39%，30/62）；35（36.08%，35/97）lesions without AD on 3D-US，in which 4（11.43%，4/35）were malignant. The consistency of distortion degree between FFDM and 3D-US was moderate（Kappa=0.455， P<0.001），with no statistically significant difference（ χ2=2.882， P=0.143）. The probability of malignancy was higher in typical AD compared to atypical AD. The comparisons of age，location，number of lesions，presence of skipping sign in 3D-US，breast density，and presence of calcification in the lesion showed no statistically significant differences between the groups with and without AD（all P >0.05）.The pathological results of malignancy，presence of lesions in 3D-US（mass and non-mass lesions），and the degree of distortion in FFDM showed statistically significant differences（all P < 0.05）. The multivariate Logistic regression analysis indicated that there were no independent risk factors for the appearance of AD in 3D-US（all P > 0.05）. Conclusions:In breast FFDM AD lesions，the incidence of 3D-US coronal plane AD was 63.92%，and the consistency between the degree of distortion in FFDM and 3D-US was moderate. The probability of malignancy is higher with typical AD. Pathological malignancy，presence of lesions in 3D-US（both mass and non-mass lesions），and typical AD in FFDM are more likely to correspond with AD in the coronal.

Objective To investigate the value of the automated breast volume scanning (ABVS) combined with virtual touch tissue imaging quantification (VTIQ) in the differential diagnosis of benign and malignant breast lesion.Methods Five hundred and seven patients with a total of 675 breast nodules were detected using ABVS and VTIQ technique.Of them,coronal plane imaging,SWVmax,SWVmin,and SWVmean (in m/s) for each nodule was acquired three days before operation or core needle biopsy.According to pathological results,the receiver operating characteristic (ROC) curve analysis was performed to evaluate the utility of the ABVS alone (retraction phenomenon on coronal plane),VTIQ alone and their combination in the diagnosis of breast lesions.Results Among all nodules,504 lesions were benign,and 171 were malignant.The rate of retraction phenomenon on coronal plane in malignant lesions was significantly higher than that in benign lesions (x2=279.89,P ＜ 0.001).The value of SWVmax,SWVmin,SWVmean (6.79± 1.71 m/s,5.03 ± 1.24 m/s,5.74± 1.36 m/s) in malignant nodules were higher than that of benign nodules [(3.41 ±1.51) m/s,(2.46± 0.87) m/s,(2.65 ± 1.23) m/s],the differences were statistically significant (t=32.43,33.85,26.77,all P ＜ 0.001).The AUC of malignant nodules for SWV (maximum,minimum,and average) were 0.922,0.934 and 0.937,respectively.With cut-off value of 4.045 m/s,SWVmean showed the best diagnostic performance.The sensitivity,specificity and accuracy of the retraction phenomenon on coronal plane,SWVmean and their combination in diagnosing malignant breast lesion were (39.65％,94.39％,95.78％),(97.50％,94.39％,95.53％) and (82.84％,93.51％,94.25％),respectively.And the SWVmean showed significant higher sensitivity than that of retraction phenomenon.The diagnostic capacity significantly improved when the two approaches were combined.Conclusion Both the retraction phenomenon on coronal plane and VTIQ had high diagnostic value,combining the two methods can improve the differential diagnosis ability for breast lesions.

Objective To evaluate the value of automated breast volume scanner (ABVS) and conventional ultrasound in differentiation of benign and malignant breast imaging reporting and data system (BI-RADS) 4 breast lesions. Methods Totally 239 breast lesions from 217 patients, with diagnosing of BI-RADS 4 by conventional ultrasound and automatically breast volume imaging, were analyzed retrospectively, using postoperative pathology as golden standard. The sensitivity, specificity, accuracy and area under the curve of ABVS and conventional ultrasound were calculated separately. Results There were 154 benign breast lesions, 83 malignant lesions and 2 borderline lesions. The statistical analysis results of ABVS and conventional ultrasound were 96.10% and 91.80% in sensitivity, 84.30% and 80.20% in specificity,89.30% and 84.10% in accuracy, and 0.952 and 0.833 in area under the curve. Therefore, ABVS was superior to the conventional ultrasound. Conclusion Compared with conventional ultrasound, ABVS could improve the diagnostic efficacy for BI-RADS 4 breast lesions in the aspects of sensitivity, specificity, accuracy, which was useful in detection of small and atypical breast cancer and could be used as a noninvasive and reliable complement for conventional ultrasound.

ObjectiveTo investigate the value of the automated breast volume scanner (ABVS) in the diagnosis of ductal carcinomain situ(DCIS).MethodsSixty-seven patients who were diagnosed as DCIS by histopathology from December, 2010 to December, 2012 were retrospectively analyzed. Their image results and detection rates of mammography, conventional ultrasound and ABVS were analyzed and compared by Nonparametric Cochran'sQ test, and the further comparison were performed between groups by McNemar test.ResultsThe cases diagnosed as mass (with or without microcalcifications) by mammography, conventional ultrasound and ABVS were 13 (19%), 22 (33%) and 25 (37%), respectively. The detection rates of conventional ultrasound and ABVS were higher than mammography, and the differences were statistically significant (χ2=7.11, 10.08, bothP<0.05). However, the detection rate of mass between conventional ultrasound and ABVS were not statistically different (P>0.05). The cases diagnosed as simple microcalcification or associated with microcalcification by mammography, conventional ultrasound and ABVS were 42 (63%), 30 (45%) and 39 (58%), respectively. The detection rates of simple microcalcification or associated with microcalcifications by mammography and ABVS were higher than conventional ultrasound, and the differences were statistically significant (χ2=8.64, 5.82, bothP<0.05). However, the detection rate of simple microcalcification or associated with microcalcifications between conventional ultrasound and ABVS were not statistically different (P>0.05). The detection rates of DCIS by mammography, conventional ultrasound and ABVS were 84%, 70% and 91%. The detection rates of DCIS by mammography and ABVS were higher than conventional ultrasound, and the differences were statistically significant. But the rate between mammography and ABVS showed no statistical significance.ConclusionsABVS can improve the ultronic detection rate of breast DCIS. Its detection rate is similar with mammography performance.

Objective To analyze sonographic characteristics of the automated breast volume scanner (ABVS) in non-mass-like breast carcinoma.Methods 49 patients with non-mass-like breast carcinoma were confirmed by pathology after operation.All of the patients underwent ABVS,the sonographic characteristics of internal echo and microcalcifications in the lesions,the retraction phenomenon in coronal plane and surrounding change were analyzed.All the lesions were assessed by breast imaging reporting and data system (BI-RADS).Results In 49 patients with non-mass-like breast carcinoma,27(55.10％) cases were ductal carcinoma in situ,21 (42.86％) cases were infitrating ductal carcinoma,and 1 (2.04％) case were infitrating lobular carcinoma.The findings of ABVS:43 (87.76 ％) lesions appeared as segmental hypoechoic areas,41 (83.67％) lesions appeared as scattered or clustered microcalcifications,6(12.24％) lesions appeared as the retraction phenomenon in coronal plane,and 1 (2.04％) lesion appeared as pachyderma and subcutaneous dropsy.Microcalcifications in ductal carcinoma in situ appeared more than that in infitrating ductal carcinoma (85.19 ％ vs 80.95 ％,P =0.715) ;the retraction phenomenon in coronal plane of infitrating ductal carcinoma were higher than that of ductal carcinoma in situ(19.05％ vs 7.41％,P =0.383),but there were no significant difference in those between ductal carcinoma in situ with infitrating ductal carcinoma(P ＞0.05).All the cases were assessed according to BI-RADS,including 4a-5 category 44 cases,0-2 category 5 cases.The coincidence rate in diagnosis of ABVS were 89.80％.Conclusions The ABVS features of non-mass-like breast carcinoma are characteristic.Segmental hypoechoic areas,microcalcifications and the retraction phenomenon in coronal plane are important for the diagnosis of non-mass-like breast carcinoma,ABVS can improve the detect ability and decrease the missed diagnosis of non-mass-like breast carcinoma.

Objective To compare the values of automated breast volume scanner(ABVS) and conventional ultrasound(US) in the diagnosis of breast microcalcifications.Methods Sixty-eight cases of patients with breast microcalcifications 71 lesions were found by mammography,which were also examined by ABVS and US.The detection rate of microcalcifications under different background which have masses or not by the two methods were compared respectively,and the detection rate in the different pathological types of breast were also compared.All the cases were confirmed with histopathology.Results Sixty-five cases with breast microcalcifications were detected by ABVS and 55 cases detected by US,respectively.The detection rate of ABVS was significantly higher than that of US (91.5％ vs 77.5％,x2 =5.379,P =0.020).Forty-four cases of microcalcifications were found within the masses,but the other 27 cases without mass.The detection rate of microcalcifications within the masses had no siginificant difference between ABVS and US (97.7％ vs 93.2％,x2 =0.262,P =0.609),but ABVS was significantly higher than US (81.5％ vs 51.9％,x2 =5.333,P =0.021) in the detection rate of microcalcifications without the masses.The detection rate of ABVS in microcalcifications for those patients with invasive ductal carcinoma,were found the same as US (both 100％).However,the detection rate of microcalcifications by ABVS was much higher than US (94.1 ％ vs 58.8％,P =0.039) in patients with ductal carcinoma in situ.Conclusions ABVS can improve the detection rate of microcalcifications,especially without mass.The microcalcifications distribution can be observed in the coronal plane of ABVS,which increases the detection rate of ultrasound in the diagnosis of ductal carcinoma in situ.