A Y Park1, B K Seo2, O H Woo3, K S Jung4, K R Cho5, E K Park1, S H Cha1, J Cha6. 1. Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Gyeonggi-do, Republic of Korea. 2. Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Gyeonggi-do, Republic of Korea. Electronic address: seoboky@korea.ac.kr. 3. Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea. 4. Department of Diagnostic Radiology, Hallym University Sacred Heart Hospital, Anyang, Gyeonggi-do, Republic of Korea. 5. Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea. 6. Medical Science Research Center, Korea University Ansan Hospital, Ansan, Gyeonggi-do, Republic of Korea.
Abstract
AIM: To investigate the utility of superb microvascular imaging (SMI) for evaluating the vascularity of breast masses in comparison with colour or power Doppler ultrasound (US) and the effect on diagnostic performance. MATERIALS AND METHODS: A total of 191 biopsy-proven masses (99 benign and 92 malignant) in 166 women with greyscale, colour Doppler, power Doppler, and SMI images were enrolled in this retrospective study. Three radiologists analysed the vascular images using a three-factor scoring system to evaluate the number, morphology, and distribution of tumour vessels. They assessed the Breast Imaging-Reporting and Data System categories for greyscale US alone and combinations of greyscale US and each type of vascular US. The Kruskal-Wallis test was performed and the area under the receiver-operating characteristic curve (AUC) measured. On SMI, vascular scores were compared between benign and malignant masses and the optimal cut-off value for the overall score was determined. RESULTS: SMI showed higher vascular scores than colour or power Doppler US and malignant masses had higher scores than benign masses (p<0.001). The diagnostic performance of the combination of greyscale US and SMI was higher than those of greyscale US alone and greyscale and colour or power Doppler US (AUC, 0.815 versus 0.774, 0.789, 0.791; p<0.001). The optimal cut-off value of the overall vascular score was 5 with a sensitivity of 82.3% and a specificity of 65.3% (AUC, 0.808). CONCLUSION: SMI is superior to colour or power Doppler US for characterising the vascularity in breast masses and improving diagnostic performance.
AIM: To investigate the utility of superb microvascular imaging (SMI) for evaluating the vascularity of breast masses in comparison with colour or power Doppler ultrasound (US) and the effect on diagnostic performance. MATERIALS AND METHODS: A total of 191 biopsy-proven masses (99 benign and 92 malignant) in 166 women with greyscale, colour Doppler, power Doppler, and SMI images were enrolled in this retrospective study. Three radiologists analysed the vascular images using a three-factor scoring system to evaluate the number, morphology, and distribution of tumour vessels. They assessed the Breast Imaging-Reporting and Data System categories for greyscale US alone and combinations of greyscale US and each type of vascular US. The Kruskal-Wallis test was performed and the area under the receiver-operating characteristic curve (AUC) measured. On SMI, vascular scores were compared between benign and malignant masses and the optimal cut-off value for the overall score was determined. RESULTS: SMI showed higher vascular scores than colour or power Doppler US and malignant masses had higher scores than benign masses (p<0.001). The diagnostic performance of the combination of greyscale US and SMI was higher than those of greyscale US alone and greyscale and colour or power Doppler US (AUC, 0.815 versus 0.774, 0.789, 0.791; p<0.001). The optimal cut-off value of the overall vascular score was 5 with a sensitivity of 82.3% and a specificity of 65.3% (AUC, 0.808). CONCLUSION: SMI is superior to colour or power Doppler US for characterising the vascularity in breast masses and improving diagnostic performance.
Authors: Ah Young Park; Myoungae Kwon; Ok Hee Woo; Kyu Ran Cho; Eun Kyung Park; Sang Hoon Cha; Sung Eun Song; Ju Han Lee; JaeHyung Cha; Gil Soo Son; Bo Kyoung Seo Journal: Korean J Radiol Date: 2019-05 Impact factor: 3.500