Value of contrast-enhanced ultrasound in the diagnosis of breast US-BI-RADS 3 and 4 lesions with calcifications. Issue 12 (December 2020)

• Record Type: Journal Article
• Authors: Cheng, M.; Tong, W.; Luo, J.; Li, M.; Liang, J.; Pan, F.; Pan, J.; Zheng, Y.; Xie, X.
• Is Part Of: Clinical radiology. Volume 75:Issue 12(2020)
• Page Start: 934
• Page End: 941
• Publication Date: 2020-12
• Subjects: Medical radiology -- Periodicals; Radiotherapy -- Periodicals; Radiotherapy -- Periodicals; Radiology -- Periodicals; Societies, Medical -- Periodicals; Medical radiology; Radiotherapy; Electronic journals; Periodicals; 616.0757
• DOI: 10.1016/j.crad.2020.07.017
• Languages: English
• ISSNs: 0009-9260

Abstract

Abstract : Aim: To evaluate the diagnostic performance of contrast-enhanced ultrasound (CEUS) for Breast Imaging-Reporting and Data System for Ultrasound (US-BI-RADS) 3 and 4 lesions with calcifications. Materials and methods: A retrospective study of 168 breast lesions with calcifications detected on both mammography and conventional ultrasonography (US) in 152 patients were categorised as US-BI-RADS 3–4 at US between June 2009 and June 2018. CEUS scores were obtained based on a CEUS five-point scoring system. The combination of US-BI-RADS and CEUS scores created the Rerated BI-RADS (referred to as CEUS-BI-RADS). All results were compared with the histological findings. The diagnostic performances of US and CEUS-BI-RADS were compared. Results: The diagnostic sensitivity, specificity, and accuracy of US were 81.8% (95% confidence interval [CI]: 71.6%, 92%), 85% (95% CI: 78.4%, 91.5%), and 83.9% (95% CI: 78.4%, 89.5%), respectively, while those for CEUS-BI-RADS were 98.2% (95% CI: 94.7%, 100%), 90.3% (95% CI: 84.8%, 95.7%), and 92.9% (95% CI: 89%, 96.8%), respectively. The diagnostic sensitivity and accuracy values of CEUS-BI-RADS greatly improved compared with those of US ( p =0.003 and p =0.004, respectively). The areas under the receiver operating characteristic (ROC) curves for US and CEUS-BI-RADS were 0.888 (95% CI: 0.840, 0.936) and 0.963 (95% CI: 0.936, 0.989), respectively. The diagnostic efficacy of CEUS-BI-RADS was significantly higher than that of US alone ( p =0.004). Conclusion: CEUS-BI-RADS significantly improves the diagnostic accuracy for breast US-BI-RADS 3 and 4 lesions with calcifications compared with US. Highlights: Classifying suspicious lesions with calcifications remains a dilemma on US. CEUS is a valuable tool in the evaluation of breast lesions with calcifications. CEUS-BI-RADS showed better results than US on breast lesions with calcifications. CEUS was effective in the diagnosis of isolated microcalcifications without mass.