Abstract
Purpose
Our aim was to investigate the diagnostic potential of automated breast volume scanning (ABVS) and compare it with manual ultrasound (US) and mammography.
Patients and methods
One hundred and fifty-five patients with a total of 165 breast lesions had mammograms, manual US and an ABVS. Multiplanar reconstructions in coronal, transverse and sagittal views were reconstructed from the automated data set. After biopsy or surgery, all lesions were confirmed histologically. Data were evaluated according to the Breast Imaging Reporting and Data System (BI-RADS) classification. Detection rate, diagnostic accuracy, sensitivity, specificity and positive (PPV) and negative (NPV) predictive value of each method were analysed.
Results
Detection rate, diagnostic accuracy and mammography sensitivity were significantly lower than those of each US method (p<0.05). There were no significant differences between manual US and ABVS. When combining ABVS, US and mammography, diagnostic accuracy, sensitivity and specificity reached 96.4%, 97.1% and 95.2%, respectively. A spiculated and stellate margin in the coronal plane has a high specificity in diagnosing malignant lesions.
Conclusions
ABVS can provide additional information in the differential diagnosis of a lesion. It has significantly higher sensitivity than mammography, but it is similar to manual US and cannot be preferred to a manual US examination.
Riassunto
Obiettivo
Valutare le potenzialità diagnostiche della scansione automatica del volume del seno (ABVS) nei confronti dell’ecografia convenzionale (US) e della mammografia.
Pazienti e metodi
155 pazienti con un totale di 165 lesioni mammarie sono state studiate con mammografia, ecografia convenzionale e scansione automatica del volume mammario (ABVS). Dal volume dei dati acquisiti in modo automatico sono state realizzate ricostruzioni multiplanari nei piani coronale, assiale e sagittale. Tutte le lesioni sono state confermate istologicamente. I dati sono stati valutati secondo la classificazione BI-RADS (Breast Imaging Reporting e Data System). Per ciascuna modalità sono stati analizzati il tasso di rilevamento, l’accuratezza diagnostica, la sensibilità, la specificità, il valore predittivo positivo (VPP) ed il valore predittivo negativo (VPN).
Risultati
Il tasso di rilevamento, l’accuratezza diagnostica e la sensibilità della mammografia erano significativamente inferiori a quelli di ciascun metodo ecografico (p<0,05). Non si sono evidenziate differenze statisticamente significative tra l’ecografia convenzionale e l’ABVS. Quando si combinano l’ABVS, l’ecografia convenzionale e la mammografia, l’accuratezza diagnostica, la sensibilità e la specificità raggiungono il 96,4%, il 97,1% e il 95,2%, rispettivamente. I margini spiculati e stellati nel piano coronale hanno una elevata specificità nella diagnosi di lesioni maligne.
Conclusioni
L’ABVS può fornire ulteriori informazioni nella diagnosi differenziale di una lesione. Esso ha una sensibilità significativamente maggiore della mammografia, ma è simile all’ecografia convenzionale e non può essere preferibile ad un esame ecografico convenzionale.
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Wang, Z.L., Xw, J.H., Li, J.L. et al. Comparison of automated breast volume scanning to hand-held ultrasound and mammography. Radiol med 117, 1287–1293 (2012). https://doi.org/10.1007/s11547-012-0836-4
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DOI: https://doi.org/10.1007/s11547-012-0836-4