Accuracy of Cyst Versus Solid Diagnosis in the Breast Using Quantitative Transmission (QT) Ultrasound.
Accuracy of Cyst Versus Solid Diagnosis in the Breast Using Quantitative Transmission (QT) Ultrasound.
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DOI：
10.1016/j.acra.2017.03.024
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发表时间：
2017-09
影响因子：
4.8
通讯作者：
Klock JC
中科院分区：
文献类型：
--
作者：
Iuanow E;Smith K;Obuchowski NA;Bullen J;Klock JC
本研究的目的是评估使用透射超声乳腺成像的诊断效用。我们提出了读者的准确性，以确定是否乳腺病变是一个囊肿与固体使用传输超声作为辅助乳房摄影。这项回顾性多读片者、多病例受试者操作特征研究包括37处乳腺X线摄影和透射超声检查发现的病变。囊肿病例通过其在手持式超声上的外观被确认为囊肿。实性病例经病理结果证实为实性。14名阅片师使用乳房X线摄影+定量透射扫描图像进行盲法随机阅片，分配置信度评分（0-100）和囊肿或实性的二元分类。计算阅片者的平均受试者工作特征面积、灵敏度和特异性的95%百分位数bootstrap置信区间（CI）。采用阅片者对囊肿或实性病变的二分类，平均敏感性和特异性分别为0.933 [95%CI：0.837，0.995]和0.858 [95%CI：0.701，0.985]。当使用阅片者的置信度评分区分囊肿与实性时，平均受试者工作特征面积为0.920 [95% CI：0.827，0.985]。透射超声可以提供一个准确的评估囊肿与固体病变的乳房。前瞻性临床试验将进一步阐明透射超声作为乳腺X线摄影辅助手段的作用，以提高乳腺评估的特异性。
This study aims to evaluate the diagnostic utility of breast imaging using transmission ultrasound. We present readers’ accuracy in determining whether a breast lesion is a cyst versus a solid using transmission ultrasound as an adjunct to mammography. This retrospective multi-reader, multi-case receiver operating characteristic study included 37 lesions seen on mammography and transmission ultrasound. Cyst cases were confirmed as cysts using their appearance on handheld ultrasound. Solid cases were confirmed as solids with pathology results. Fourteen readers performed blinded, randomized reads with mammog-raphy + quantitative transmission scan images, assigning both a confidence score (0–100) and a binary classification of cyst or solid. A 95% percentile bootstrap confidence interval (CI) was computed for the readers’ mean receiver operating characteristic area, sensitivity, and specificity. Using the readers’ binary classification of cyst or solid lesions, the mean sensitivity and specificity were 0.933 [95% CI: 0.837, 0.995] and 0.858 [95% CI: 0.701, 0.985], respectively. When the readers’ confidence scores were used to distinguish a cyst versus solid, the mean receiver operating characteristic area was 0.920 [95% CI: 0.827, 0.985]. Transmission ultrasound can provide an accurate assessment of a cyst versus a solid lesion in the breast. Prospective clinical trials will further delineate the role of transmission ultrasound as an adjunct to mammography to increase specificity in breast evaluation.
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