Non-mass Breast Lesions: Could Multimodal Ultrasound Imaging Be Helpful for Their Diagnosis?
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patients
2.2. Ultrasound Examination
2.3. Image Analysis
2.4. Statistical Analysis
3. Results
3.1. Histopathologic Diagnosis
3.2. Single Factor Analysis of the Indicators for Malignant NMLs
3.3. Developing the Prediction Model
3.4. Comparison of Diagnostic Performance of Different Methods
3.5. False-Positive and False-Negative Diagnoses with the Multimodal Method
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Histopathological Diagnosis | No. of Lesions (n = 104) |
---|---|
Benign lesions | 50 |
Adenosis | 18 |
Intraductal papilloma | 14 |
Granulomatous mastitis | 8 |
Mammary duct ectasia | 5 |
Fibroadenoma | 3 |
Sclerosing adenosis | 2 |
Malignant lesions | 51 |
Ductal carcinoma in situ | 17 |
Invasive ductal carcinoma | 16 |
Invasive ductal carcinoma + ductal carcinoma in situ | 9 |
intraductal papillary carcinoma | 4 |
Solid papillary carcinoma | 2 |
Mucinous breast carcinoma | 1 |
Lobular carcinoma in situ | 1 |
Paget’s disease+ ductal carcinoma in situ | 1 |
Characteristics | Benign n (%) | Malignant n (%) | p |
---|---|---|---|
Patients | |||
Age (years) | <0.001 | ||
<45 | 23(46.0) | 7(13.7) | |
≥45 | 27(54.0) | 44(86.3) | |
Menstrual history | 0.051 | ||
Menstrual | 35(70.0) | 26(51.0) | |
Menopause | 15(30.0) | 25(49.0) | |
Conventional US | |||
Lesion size (mm) | 0.037 | ||
<20 | 30(60.0) | 20(39.2) | |
≥20 | 20(40.0) | 31(60.8) | |
Intralesional echo | 0.060 | ||
Other echoes | 6(12.0) | 1(2.0) | |
Hypo-echo | 44(88.0) | 50(98.0) | |
Posterior echo | 0.092 | ||
Other echoes | 48(96.0) | 43(90.1) | |
Attenuation | 2(4.0) | 8(9.9) | |
Orientation | 0.362 | ||
Parallel | 49(98.0) | 47(92.2) | |
Non-parallel | 1(2.0) | 4(7.8) | |
Microcalcification | <0.001 | ||
Absent | 45(90.0) | 22(43.1) | |
Present | 5(10.0) | 29(56.9) | |
Architectural distortion | 0.001 | ||
Absent | 50(100) | 40(78.4) | |
Present | 0(0) | 11(21.6) | |
Ductal changes | 0.145 | ||
Absent | 35(70.0) | 42(82.4) | |
Present | 15(30.0) | 9(17.6) | |
Vascularity | 0.002 | ||
Scarce | 44(88.0) | 31(60.8) | |
Abundant | 6(12.0) | 20(39.2) | |
SE | |||
Elasticity score | <0.001 | ||
≤3 | 42(84.0) | 16(31.4) | |
>3 | 8(16.0) | 35(68.6) | |
CEUS | |||
Enhancement time | <0.001 | ||
Synchronous or later | 36(72.0) | 5(9.8) | |
Earlier | 14(28.0) | 46(90.2) | |
Enhancement intensity | <0.001 | ||
Iso-/hypo-enhancement | 37(74.0) | 3(5.9) | |
Hyper-enhancement | 13(26.0) | 48(94.1) | |
Enhancement sharpness | <0.001 | ||
Regular | 23(46.0) | 0(0) | |
Irregular | 27(54.0) | 51(100) | |
Enhancement margin | 0.034 | ||
Clear | 10(20.0) | 3(5.9) | |
Unclear | 40(80.0) | 48(94.1) | |
Enhancement distribution | 0.373 | ||
Homogenous | 25(50.0) | 21(41.2) | |
Heterogeneous | 25(50.0) | 30(58.8) | |
Enhancement area | <0.001 | ||
Non-enlarged | 40(80.0) | 12(23.5) | |
Enlarged | 10(20.0) | 39(76.5) | |
Radial or penetrating vessels | 0.013 | ||
Absent | 47(94.0) | 39(76.5) | |
Present | 3(6.0) | 12(23.5) |
Sensitivity (%) | Specificity (%) | PPV (%) | NPV (%) | Accuracy (%) | AUC (95% Confidence Interval) | |
---|---|---|---|---|---|---|
US | 84.3 | 76 | 78.2 | 82.6 | 80.2 | 0.802 |
(43/51) | (38/50) | (43/55) | (38/46) | (81/101) | (0.711–0.892) | |
US + SE | 92.2 | 74 | 78.3 | 90.2 | 83.2 | 0.831 |
(47/51) | (37/50) | (47/60) | (37/41) | (84/101) | (0.746–0.916) | |
US + CEUS | 92.2 | 90 | 90.4 | 91.8 | 91.1 | 0.911 |
(47/51) | (75/50) | (47/52) | (45/49) | (92/101) | (0.846–0.975) | |
US + SE + CEUS | 98 | 94 | 94.3 | 97.9 | 96 | 0.96 |
(50/51) | (47/50) | (50/53) | (47/48) | (97/101) | (0.916–1.000) |
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Guo, W.; Wang, T.; Li, F.; Jia, C.; Zheng, S.; Zhang, X.; Bai, M. Non-mass Breast Lesions: Could Multimodal Ultrasound Imaging Be Helpful for Their Diagnosis? Diagnostics 2022, 12, 2923. https://doi.org/10.3390/diagnostics12122923
Guo W, Wang T, Li F, Jia C, Zheng S, Zhang X, Bai M. Non-mass Breast Lesions: Could Multimodal Ultrasound Imaging Be Helpful for Their Diagnosis? Diagnostics. 2022; 12(12):2923. https://doi.org/10.3390/diagnostics12122923
Chicago/Turabian StyleGuo, Wenjuan, Tong Wang, Fan Li, Chao Jia, Siqi Zheng, Xuemei Zhang, and Min Bai. 2022. "Non-mass Breast Lesions: Could Multimodal Ultrasound Imaging Be Helpful for Their Diagnosis?" Diagnostics 12, no. 12: 2923. https://doi.org/10.3390/diagnostics12122923