Differentiating benign from malignant solid breast masses with US strain imaging
Differentiating benign from malignant solid breast masses with US strain imaging
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DOI：
10.1148/radiol.2452061805
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发表时间：
2007-11-01
期刊：
影响因子：
19.7
通讯作者：
Hangiandreou, Nicholas J.
中科院分区：
文献类型：
--
作者：
Burnside, Elizabeth S.;Hall, Timothy J.;Hangiandreou, Nicholas J.
目的：为了前瞻性地评估超声（US）应变成像的敏感性和特异性，区分良性和恶性乳腺实性肿块，活检结果作为参考standard.Materials和方法：这项研究是机构审查委员会批准和健康保险及责任法案兼容。获得所有参与患者的知情同意书。对403例乳腺肿块进行了超声应变成像。选择质量最高的50个恶性病变和48个良性病变（患者年龄为19 - 83岁;平均年龄为49岁+/- 17岁[标准差]）进行阅片人研究。三名对病理结果不知情的观察者首先使用美国乳腺成像报告和数据系统描述符描述了B模式图像结果，并推导出恶性肿瘤的概率。然后，他们通过评估应变图像来更新概率。使用这些概率构建受试者工作特征（ROC）曲线。计算并比较ROC曲线下面积、敏感性和特异性。观察者间的变异性和自动和主观图像质量assessment.Results之间的相关性进行了分析：ROC曲线下的平均面积为所有三个读者后，美国应变成像（0.903）大于后，B-模式美国（0.876，P = 0.014）。使用2%的恶性阈值概率，应变成像-与单独的B模式超声相比-具有改善的平均特异性（0.257 vs 0.132，P 0.99）。观察者间差异显著（P
Purpose: To prospectively evaluate the sensitivity and specificity of ultrasonographic ( US) strain imaging for distinguishing between benign and malignant solid breast masses, with biopsy results as the reference standard.Materials and Methods: The study was institutional review board approved and HIPAA compliant. Informed consent was obtained from all participating patients. US strain imaging of 403 breast masses was performed. The 50 malignant and 48 benign lesions ( in patients aged 19 - 83 years; mean age, 49 years +/- 17 [ standard deviation]) with the highest quality were selected for the reader study. Three observers blinded to the pathologic outcomes first described the B- mode image findings by using US Breast Imaging Reporting and Data System descriptors and derived a probability of malignancy. They then updated the probability by assessing strain images. Receiver operating characteristic ( ROC) curves were constructed by using these probabilities. Areas under the ROC curve, sensitivities, and specificities were calculated and compared. Interobserver variability and the correlation between automated and subjective image quality assessment were analyzed.Results: The average area under the ROC curve for all three readers after US strain imaging ( 0.903) was greater than that after B- mode US alone ( 0.876, P =.014). With use of a 2% probability of malignancy threshold, strain imaging - as compared with B- mode US alone - had improved average specificity ( 0.257 vs 0.132, P .99). Significant interobserver variability was observed ( P