Computer-Aided Diagnosis of Solid Breast Lesions With Ultrasound: Factors Associated With False-negative and False-positive Results
Computer-Aided Diagnosis of Solid Breast Lesions With Ultrasound: Factors Associated With False-negative and False-positive Results
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超声计算机辅助诊断乳腺实体病变：与假阴性和假阳性结果相关的因素
DOI：
10.1002/jum.15020
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发表时间：
2019-12-01
影响因子：
2.3
通讯作者：
Luo, Bao-ming
中科院分区：
文献类型：
--
作者：
Wu, Jia-yi;Zhao, Zi-zhuo;Luo, Bao-ming
目的探讨计算机辅助诊断系统（S-Detect; Samsung Medison Co，Ltd，首尔，韩国）用于实性乳腺病变超声（US）检查时可能导致假阳性或假阴性结果的因素。方法本前瞻性研究经中山纪念医院伦理委员会批准。所有患者在活检或手术前签署并提供书面知情同意书。从2017年9月至2018年5月，纳入了269名连续女性，共338处实体乳腺病变。所有病变均在活检或手术切除前进行超声和S-检测。由放射科医生和S-Detect进行的最终US评估与病理结果相匹配。比较“真”和“假”S-Detect组中的患者和病变因素，并使用多变量logistic回归分析来确定与假S-Detect结果相关的因素。结果患者的平均年龄± SD为42.6 ± 12.9岁（范围：18-77岁）。良性病变209例（61.8%），恶性病变129例（38.2%）。较大的病变、B型超声检测到的病变钙化以及Adler等人（Ultrasound Med Biol 1990; 16：553-559）的2级和3级与假阳性S-检测结果显著相关（比值比[OR]，1.071; P = .006; OR，5.851; P = .001; OR，1.726; P = .009）。在恶性实体性乳腺病变中，B型超声检测到的较小病变和无钙化与假阴性S-Detect结果显著相关（OR，1.141; P = 0.015; OR，7.434; P = 0.016）。结论：较大的良性病变、病变钙化的存在和高度的血管分布可能显示假阳性的S-Detect结果。较小的恶性病变和没有钙化可能显示假阴性S-Detect结果。
Objectives To investigate factors that may lead to false-positive or false-negative results in a computer-aided diagnostic system (S-Detect; Samsung Medison Co, Ltd, Seoul, Korea) for ultrasound (US) examinations of solid breast lesions. Methods This prospective study was approved by the Institutional Review Board of Sun Yat-sen Memorial Hospital. All patients signed and provided written informed consent before biopsy or surgery. From September 2017 to May 2018, 269 consecutive women with 338 solid breast lesions were included. All lesions were examined with US and S-Detect before biopsy or surgical excision. The final US assessments made by radiologists and S-Detect were matched to the pathologic results. Patient and lesion factors in the "true" and "false" S-Detect groups were compared, and multivariate logistic regression analyses were used to identify the factors associated with false S-Detect results. Results The mean age of the patients +/- SD was 42.6 +/- 12.9 years (range, 18-77 years). Of the 338 lesions, 209 (61.8%) were benign, and 129 (38.2%) were malignant. Larger lesions, the presence of lesion calcifications detected by B-mode US, and grades of 2 and 3 according to Adler et al (Ultrasound Med Biol 1990; 16:553-559) were significantly associated with false-positive S-Detect results (odds ratio [OR], 1.071; P = .006; OR, 5.851; P = .001; OR, 1.726; P = .009, respectively). Smaller lesions and the absence of calcifications detected by B-mode US in malignant solid breast lesions were significantly associated with false-negative S-Detect results (OR, 1.141; P = .015; OR, 7.434; P = .016). Conclusions Larger benign lesions, the presence of lesion calcifications, and high degrees of vascularity are likely to show false-positive S-Detect results. Smaller malignant lesions and the absence of calcifications are likely to show false-negative S-Detect results.