Title:Diagnosis of Benign and Malignant BI-RADS 4 Breast Masses by Contrastenhanced
Ultrasound Combined with Shear Wave Elastography
Volume: 20
Author(s): Lifeng Weng*Mengxia Yu
Affiliation:
- Department of Ultrasound Medicine, Changzhou Second People's Hospital, Changzhou, Jiangsu 213004, China
Keywords:
Contrast-enhanced ultrasound (CEUS), Shear wave elastography (SWE), Breast imaging reporting and data system (BI-RADS) 4, Breast, Diagnostic value, Treatment.
Abstract:
Background:
Breast cancer, one of the most prevalent malignant tumors in females, usually occurs in the breast epithelial tissues.
Objective:
The study aimed to explore the diagnostic value of contrast-enhanced ultrasound (CEUS) combined with shear wave elastography (SWE) in the
diagnosis of benign and malignant breast masses in BI-RADS (Breast Imaging Reporting and Data System) 4.
Methods:
Examination outcomes and clinical information of 83 patients with BI-RADS 4 breast masses were analyzed retrospectively. These included
patients who received CEUS, SWE, and pathological examinations. The difference of CEUS in determining the classification of BI-RADS 4 breast
masses was evaluated using histopathological outcomes of breast masses as a reference standard. The diagnostic value of CEUS, SWE, and CEUS
combined with SWE in the diagnosis of benign and malignant breast masses in BI-RADS 4 was also explored.
Results:
Pathological biopsy results revealed 63 malignant masses and 20 benign masses among 83 BI-RADS 4 breast masses, with a 75.9% incidence of
malignant masses. After the diagnosis of BI-RADS 4 breast masses with CEUS, SWE, and CEUS+SWE, the incidence of malignancy was 56.6%,
78.3%, and 73.5%, respectively. CEUS+SWE showed higher sensitivity (93.7% vs. 81% and 68.3%), specificity (90% vs. 30% and 80%), positive
predictive value (96.7% vs. 78.5% and 91.5%), negative predictive value (81.8% vs. 33.3% and 44.4%), and diagnostic coincidence rate (92.8% vs.
68.7% and 71.1%) than SWE and CEUS alone in diagnosing pathological type of breast masses. Moreover, CEUS combined with SWE exhibited a
larger area under the receiver operating characteristic (ROC) curve (0.918) than SWE (0.741, p = 0.028) and CEUS (0.555, p < 0.001) alone in the
diagnosis of BI-RADS 4 breast masses.
Conclusion:
Overall, the diagnostic value of CEUS+SWE for the pathological type of BI-RADS is preferred over CEUS and SWE alone. CEUS+SWE showed
higher values than CEUS and SWE alone in diagnosing BI-RADS 4 breast masses. Specifically, CEUS+SWE can correctly identify benign and
malignant masses, reduce unnecessary trauma, and avoid misdiagnosis. In summary, CEUS combined with SWE can serve as an effective
diagnostic method and avoid delaying the best treatment opportunity for some malignant lesions.