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Can Combined Screening of Ultrasound and Elastography Improve Breast Cancer Identification Compared with MRI in Women with Dense Breasts-a Multicenter Prospective Study

Objectives: To assess the performance of elastography (ES) and ultrasound (US) in predicting the malignancy of breast lesions and to compare their combined diagnostic value with that of magnetic resonance imaging (MRI). Materials and Methods: The study prospectively enrolled 242 female patients with...

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Autores principales: Gao, Lu-Ying, Gu, Yang, Xu, Wen, Tian, Jia-Wei, Yin, Li-Xue, Ran, Hai-Tao, Ren, Wei-Dong, Mu, Yu-Ming, Zhang, Jie-Ying, Chang, Cai, Yuan, Jian-Jun, Kang, Chun-Song, Deng, You-Bin, Wang, Hui, Xie, Xiao-Yan, Luo, Bao-Ming, Guo, Sheng-Lan, Zhou, Qi, Xue, En-Sheng, Zhan, Wei-Wei, Jiao, Tong, Zhou, Qing, Li, Jie, Zhou, Ping, Huang, Pin-Tong, Xue, Hong-Yuan, Zhang, Chun-Quan, Chen, Man, Jing, Xiang-Xiang, Gu, Ying, Guo, Jian-Feng, Ding, Hong-Yu, Xu, Jin-Feng, Chen, Wu, Liu, Li, Zhang, Yu-Hong, Wang, Hong-Qiao, Mu, Zhong-Ping, Li, Jian-Chu, Wang, Hong-Yan, Jiang, Yu-Xin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Ivyspring International Publisher 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7171498/
https://www.ncbi.nlm.nih.gov/pubmed/32328194
http://dx.doi.org/10.7150/jca.43326
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author Gao, Lu-Ying
Gu, Yang
Xu, Wen
Tian, Jia-Wei
Yin, Li-Xue
Ran, Hai-Tao
Ren, Wei-Dong
Mu, Yu-Ming
Zhang, Jie-Ying
Chang, Cai
Yuan, Jian-Jun
Kang, Chun-Song
Deng, You-Bin
Wang, Hui
Xie, Xiao-Yan
Luo, Bao-Ming
Guo, Sheng-Lan
Zhou, Qi
Xue, En-Sheng
Zhan, Wei-Wei
Jiao, Tong
Zhou, Qing
Li, Jie
Zhou, Ping
Huang, Pin-Tong
Xue, Hong-Yuan
Zhang, Chun-Quan
Chen, Man
Jing, Xiang-Xiang
Gu, Ying
Guo, Jian-Feng
Ding, Hong-Yu
Xu, Jin-Feng
Chen, Wu
Liu, Li
Zhang, Yu-Hong
Wang, Hong-Qiao
Mu, Zhong-Ping
Li, Jian-Chu
Wang, Hong-Yan
Jiang, Yu-Xin
author_facet Gao, Lu-Ying
Gu, Yang
Xu, Wen
Tian, Jia-Wei
Yin, Li-Xue
Ran, Hai-Tao
Ren, Wei-Dong
Mu, Yu-Ming
Zhang, Jie-Ying
Chang, Cai
Yuan, Jian-Jun
Kang, Chun-Song
Deng, You-Bin
Wang, Hui
Xie, Xiao-Yan
Luo, Bao-Ming
Guo, Sheng-Lan
Zhou, Qi
Xue, En-Sheng
Zhan, Wei-Wei
Jiao, Tong
Zhou, Qing
Li, Jie
Zhou, Ping
Huang, Pin-Tong
Xue, Hong-Yuan
Zhang, Chun-Quan
Chen, Man
Jing, Xiang-Xiang
Gu, Ying
Guo, Jian-Feng
Ding, Hong-Yu
Xu, Jin-Feng
Chen, Wu
Liu, Li
Zhang, Yu-Hong
Wang, Hong-Qiao
Mu, Zhong-Ping
Li, Jian-Chu
Wang, Hong-Yan
Jiang, Yu-Xin
author_sort Gao, Lu-Ying
collection PubMed
description Objectives: To assess the performance of elastography (ES) and ultrasound (US) in predicting the malignancy of breast lesions and to compare their combined diagnostic value with that of magnetic resonance imaging (MRI). Materials and Methods: The study prospectively enrolled 242 female patients with dense breasts treated in 35 heath care facilities in China between November 2018 and October 2019. Based on conventional US and elastography, radiologists classified the degree of suspicion of breast lesions according to the US Breast Imaging Reporting and Data System (BI-RADS) criteria. The diagnostic value was compared between US BI-RADS and MRI BI-RADS, with pathological results used as the reference standard. Results: The results demonstrated that irregular tumor shape, a nonparallel growth orientation, indistinct margins, angular contours, microcalcifications, color Doppler flow and ES score on US imaging were significantly related to breast cancer in dense breasts (P=0.001; P=0.001; P=0.008; P<0.001; P=0.019; P=0.008; P=0.002, respectively). The sensitivity, specificity, PPV, NPV, accuracy and AUC of US BI-RADS category were 94.7%, 90.7%, 95.8%, 88.0%, 93.4% and 0.93 (95%CI, 0.88-0.97), respectively, while those of MRI BI-RADS category were 98.2%, 57.5%, 84.3%, 83.3%, 86.0% and 0.78 (95%CI, 0.71-0.85), respectively. MRI BI-RADS showed a significantly higher sensitivity than US BI-RADS (98.2% vs 94.7%, P=0.043), whereas US BI-RADS showed significantly higher specificity (90.7% vs 57.5%, P<0.001). US BI-RADS showed better diagnostic efficiency in differentiating nodules in dense breasts than MRI BI-RADS (AUC 0.93 vs 0.78, P<0.001). Conclusion: By combining the use of ES and conventional US, US BI-RADS had better diagnostic efficiency in differentiating nodules in dense breasts than MRI. For the diagnosis of malignant tumors in patients with dense breasts, MRI and US BI-RADS can be used as supplemental diagnostic tools to detect lesions, with US BI-RADS considered the preferred adjunctive resource.
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spelling pubmed-71714982020-04-23 Can Combined Screening of Ultrasound and Elastography Improve Breast Cancer Identification Compared with MRI in Women with Dense Breasts-a Multicenter Prospective Study Gao, Lu-Ying Gu, Yang Xu, Wen Tian, Jia-Wei Yin, Li-Xue Ran, Hai-Tao Ren, Wei-Dong Mu, Yu-Ming Zhang, Jie-Ying Chang, Cai Yuan, Jian-Jun Kang, Chun-Song Deng, You-Bin Wang, Hui Xie, Xiao-Yan Luo, Bao-Ming Guo, Sheng-Lan Zhou, Qi Xue, En-Sheng Zhan, Wei-Wei Jiao, Tong Zhou, Qing Li, Jie Zhou, Ping Huang, Pin-Tong Xue, Hong-Yuan Zhang, Chun-Quan Chen, Man Jing, Xiang-Xiang Gu, Ying Guo, Jian-Feng Ding, Hong-Yu Xu, Jin-Feng Chen, Wu Liu, Li Zhang, Yu-Hong Wang, Hong-Qiao Mu, Zhong-Ping Li, Jian-Chu Wang, Hong-Yan Jiang, Yu-Xin J Cancer Research Paper Objectives: To assess the performance of elastography (ES) and ultrasound (US) in predicting the malignancy of breast lesions and to compare their combined diagnostic value with that of magnetic resonance imaging (MRI). Materials and Methods: The study prospectively enrolled 242 female patients with dense breasts treated in 35 heath care facilities in China between November 2018 and October 2019. Based on conventional US and elastography, radiologists classified the degree of suspicion of breast lesions according to the US Breast Imaging Reporting and Data System (BI-RADS) criteria. The diagnostic value was compared between US BI-RADS and MRI BI-RADS, with pathological results used as the reference standard. Results: The results demonstrated that irregular tumor shape, a nonparallel growth orientation, indistinct margins, angular contours, microcalcifications, color Doppler flow and ES score on US imaging were significantly related to breast cancer in dense breasts (P=0.001; P=0.001; P=0.008; P<0.001; P=0.019; P=0.008; P=0.002, respectively). The sensitivity, specificity, PPV, NPV, accuracy and AUC of US BI-RADS category were 94.7%, 90.7%, 95.8%, 88.0%, 93.4% and 0.93 (95%CI, 0.88-0.97), respectively, while those of MRI BI-RADS category were 98.2%, 57.5%, 84.3%, 83.3%, 86.0% and 0.78 (95%CI, 0.71-0.85), respectively. MRI BI-RADS showed a significantly higher sensitivity than US BI-RADS (98.2% vs 94.7%, P=0.043), whereas US BI-RADS showed significantly higher specificity (90.7% vs 57.5%, P<0.001). US BI-RADS showed better diagnostic efficiency in differentiating nodules in dense breasts than MRI BI-RADS (AUC 0.93 vs 0.78, P<0.001). Conclusion: By combining the use of ES and conventional US, US BI-RADS had better diagnostic efficiency in differentiating nodules in dense breasts than MRI. For the diagnosis of malignant tumors in patients with dense breasts, MRI and US BI-RADS can be used as supplemental diagnostic tools to detect lesions, with US BI-RADS considered the preferred adjunctive resource. Ivyspring International Publisher 2020-04-06 /pmc/articles/PMC7171498/ /pubmed/32328194 http://dx.doi.org/10.7150/jca.43326 Text en © The author(s) This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/). See http://ivyspring.com/terms for full terms and conditions.
spellingShingle Research Paper
Gao, Lu-Ying
Gu, Yang
Xu, Wen
Tian, Jia-Wei
Yin, Li-Xue
Ran, Hai-Tao
Ren, Wei-Dong
Mu, Yu-Ming
Zhang, Jie-Ying
Chang, Cai
Yuan, Jian-Jun
Kang, Chun-Song
Deng, You-Bin
Wang, Hui
Xie, Xiao-Yan
Luo, Bao-Ming
Guo, Sheng-Lan
Zhou, Qi
Xue, En-Sheng
Zhan, Wei-Wei
Jiao, Tong
Zhou, Qing
Li, Jie
Zhou, Ping
Huang, Pin-Tong
Xue, Hong-Yuan
Zhang, Chun-Quan
Chen, Man
Jing, Xiang-Xiang
Gu, Ying
Guo, Jian-Feng
Ding, Hong-Yu
Xu, Jin-Feng
Chen, Wu
Liu, Li
Zhang, Yu-Hong
Wang, Hong-Qiao
Mu, Zhong-Ping
Li, Jian-Chu
Wang, Hong-Yan
Jiang, Yu-Xin
Can Combined Screening of Ultrasound and Elastography Improve Breast Cancer Identification Compared with MRI in Women with Dense Breasts-a Multicenter Prospective Study
title Can Combined Screening of Ultrasound and Elastography Improve Breast Cancer Identification Compared with MRI in Women with Dense Breasts-a Multicenter Prospective Study
title_full Can Combined Screening of Ultrasound and Elastography Improve Breast Cancer Identification Compared with MRI in Women with Dense Breasts-a Multicenter Prospective Study
title_fullStr Can Combined Screening of Ultrasound and Elastography Improve Breast Cancer Identification Compared with MRI in Women with Dense Breasts-a Multicenter Prospective Study
title_full_unstemmed Can Combined Screening of Ultrasound and Elastography Improve Breast Cancer Identification Compared with MRI in Women with Dense Breasts-a Multicenter Prospective Study
title_short Can Combined Screening of Ultrasound and Elastography Improve Breast Cancer Identification Compared with MRI in Women with Dense Breasts-a Multicenter Prospective Study
title_sort can combined screening of ultrasound and elastography improve breast cancer identification compared with mri in women with dense breasts-a multicenter prospective study
topic Research Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7171498/
https://www.ncbi.nlm.nih.gov/pubmed/32328194
http://dx.doi.org/10.7150/jca.43326
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