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Brasier-Lutz P, Jäggi-Wickes C, Schaedelin S, Burian R, Schoenenberger CA, Zanetti-Dällenbach R. Agreement in breast lesion assessment and final BI-RADS classification between radial and meander-like breast ultrasound. BMC Med Imaging 2021; 21:104. [PMID: 34157997 PMCID: PMC8220682 DOI: 10.1186/s12880-021-00632-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 06/04/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study prospectively investigates the agreement between radial (r-US) and meander-like (m-US) breast ultrasound with regard to lesion location, lesion size, morphological characteristics and final BI-RADS classification of individual breast lesions. METHODS Each patient of a consecutive, unselected, mixed collective received a dual ultrasound examination. RESULTS The agreement between r-US and m-US for lesion location ranged from good (lesion to mammilla distance ICC 0.64; lesion to skin distance ICC 0.72) to substantial (clock-face localization κ 0.70). For lesion size the agreement was good (diameter ICC 0.72; volume ICC 0.69), for lesion margin and architectural distortion it was substantial (κ 0.68 and 0.70, respectively). Most importantly, there was a substantial agreement (κ 0.76) in the final BI-RADS classification between r-US and m-US. CONCLUSIONS Our recent comparison of radial and meander-like breast US revealed that the diagnostic accuracy of the two scanning methods was comparable. In this study, we observe a high degree of agreement between m-US and r-US for the lesion description (location, size, morphology) and final BI-RADS classification. These findings corroborate that r-US is a suitable alternative to m-US in daily clinical practice. Trial registration NCT02358837. Registered January 2015, retrospectively registered https://clinicaltrials.gov/ct2/results?cond=&term=NCT02358837&cntry=&state=&city=&dist =.
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Affiliation(s)
- Pascale Brasier-Lutz
- Department of Obstetrics and Gynecology, University Hospital Basel, Spitalstrasse 21, 4056, Basel, Switzerland
| | - Claudia Jäggi-Wickes
- Department of Obstetrics and Gynecology, University Hospital Basel, Spitalstrasse 21, 4056, Basel, Switzerland
| | - Sabine Schaedelin
- Department of Clinical Research, Statistics and Data Management, University Basel, Schanzenstrasse 55, 4031, Basel, Switzerland
| | - Rosemarie Burian
- Department of Obstetrics and Gynecology, University Hospital Basel, Spitalstrasse 21, 4056, Basel, Switzerland
| | - Cora-Ann Schoenenberger
- Department of Chemistry, University Basel, BioPark 1096, Mattenstrasse 24a, 4058, Basel, Switzerland.,Gynecology/Gynecologic Oncology, St. Claraspital Basel, Kleinriehenstrasse 30, 4085, Basel, Switzerland
| | - Rosanna Zanetti-Dällenbach
- Gynecology/Gynecologic Oncology, St. Claraspital Basel, Kleinriehenstrasse 30, 4085, Basel, Switzerland.
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The contribution and histopathological correlation of MRI in BI-RADS category 4 solid lesions detected by ultrasonography. JOURNAL OF SURGERY AND MEDICINE 2021. [DOI: 10.28982/josam.865402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Pekarev OG, Brega ES, Gus AI, Lunkov SS, Dikke GB, Kochev DM, Sukhikh GT. Sonoelastography for the comparative assessment of cervical maturation after different approaches to cervical preparation ahead of labor induction. J Matern Fetal Neonatal Med 2020; 35:1865-1871. [PMID: 32460594 DOI: 10.1080/14767058.2020.1770220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Aim: To compare the efficacy of different approaches to cervical preparation to labor induction using the ultrasound cervical elastography.Materials and methods: This prospective open-label study included 200 pregnant women aged between 23 and 38 years eligible for labor pre-induction. Patients were divided into four groups (n = 50 per group). In Group I, four osmotic Dilapan-S cervical dilators combined with two doses of oral mifepristone (200 mg each) 24 h apart were used. The dilators were inserted for up to 12 h. In Group II, only the Dipalan-S dilators were used. In Group III, a Foley catheter was positioned intracervically for 12 h. In Group IV, we used two doses of intracervical prostaglandin E2 gel (0.5 mg each) 6 h apart. Cervical maturation was assessed using the Bishop scoring system and the ultrasound cervicometry with the color mapping and calculation of SR ratio. At baseline, all participants were also divided into three subgroups depending on the Bishop score before the pre-induction. Subgroup А (n = 66) included patients with the Bishop score between 0‒2 points, subgroup B (n = 69) between 3-4 points, and subgroup С (n = 65) between 4-6 points.Results: Our study showed that the efficacy of Dilapan-S combined with mifepristone for cervical preparation to labor induction was higher than Dilapan-S, Foley catheter and intracervical prostaglandin E2 gel. In this group, the Bishop score after the pre-induction was the highest (11.4 (0.21) points versus 10.2 (0.2), 9.4 (0.3) и 9.67 (0.25) in Groups II, III and IV respectively (p < .05 for all). The lowest SR values were also observed among the patients receiving the combination of Dilapan-S and mifepristone: 1.23 (0.04) versus 1.63 (0.07), 1.7 (0.08) and 1.83 (0.1) in Groups II, III and IV respectively (p < .05 for all). The sonoelastographic SR values in subgroups B and C were statistically lower compared with subgroup A across all groups studied. Ultrasound elastography of the cervix allowed to perform a more objective assessment of cervical maturation compared with the Bishop scoring.Conclusion: Dilapan-S combined with mifepristone had higher efficacy for cervical preparation to labor induction compared with other approaches investigated.
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Affiliation(s)
- O G Pekarev
- "National Medical Research Centre of Obstetrics, Gynaecology and Perinatology named after academician V.I. Kulakov", Ministry of Healthcare of the Russian Ministry of Health, Moscow, Russia
| | - E S Brega
- "National Medical Research Centre of Obstetrics, Gynaecology and Perinatology named after academician V.I. Kulakov", Ministry of Healthcare of the Russian Ministry of Health, Moscow, Russia
| | - A I Gus
- "National Medical Research Centre of Obstetrics, Gynaecology and Perinatology named after academician V.I. Kulakov", Ministry of Healthcare of the Russian Ministry of Health, Moscow, Russia
| | - S S Lunkov
- "National Medical Research Centre of Obstetrics, Gynaecology and Perinatology named after academician V.I. Kulakov", Ministry of Healthcare of the Russian Ministry of Health, Moscow, Russia
| | - G B Dikke
- Medical Education Academy named after I.F. Inozemtsev, Saint Petersburg, Russia
| | | | - G T Sukhikh
- "National Medical Research Centre of Obstetrics, Gynaecology and Perinatology named after academician V.I. Kulakov", Ministry of Healthcare of the Russian Ministry of Health, Moscow, Russia
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Comparison of radial and meander-like breast ultrasound with respect to diagnostic accuracy and examination time. Arch Gynecol Obstet 2020; 301:1533-1541. [PMID: 32363545 PMCID: PMC7246244 DOI: 10.1007/s00404-020-05554-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 04/20/2020] [Indexed: 12/03/2022]
Abstract
Purpose To prospectively compare the diagnostic accuracy of radial breast ultrasound (r-US) to that of conventional meander-like breast ultrasound (m-US), patients of a consecutive, unselected, mixed collective were examined by both scanning methods. Methods Out of 1948 dual examinations, 150 revealed suspicious lesions resulting in 168 biopsies taken from 148 patients. Histology confirmed breast cancers in 36 cases. Sensitivity, specificity, accuracy, PPV, and NPV were calculated for r-US and m-US. The examination times were recorded. Results For m-US and r-US, sensitivity (both 88.9%), specificity (86.4% versus 89.4%), accuracy (86.9% versus 89.3%), PPV (64.0% versus 69.6%), NPV (both 98.3%), false-negative rate (both 5.6%), and rate of cancer missed by one method (both 5.6%) were similar. The mean examination time for r-US (14.8 min) was significantly (p < 0.01) shorter than for m-US (22.6 min). Conclusion Because the diagnostic accuracy of r-US and m-US are comparable, r-US can be considered an alternative to m-US in routine breast US with the added benefit of a significantly shorter examination time.
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Zanetti-Dällenbach R, Plodinec M, Oertle P, Redling K, Obermann EC, Lim RYH, Schoenenberger CA. Length Scale Matters: Real-Time Elastography versus Nanomechanical Profiling by Atomic Force Microscopy for the Diagnosis of Breast Lesions. BIOMED RESEARCH INTERNATIONAL 2018; 2018:3840597. [PMID: 30410929 PMCID: PMC6206582 DOI: 10.1155/2018/3840597] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 09/17/2018] [Indexed: 12/21/2022]
Abstract
Real-time elastography (RTE) is a noninvasive imaging modality where tumor-associated changes in tissue architecture are recognized as increased stiffness of the lesion compared to surrounding normal tissue. In contrast to this macroscopic appraisal, quantifying stiffness properties at the subcellular level by atomic force microscopy (AFM) reveals aggressive cancer cells to be soft. We compared RTE and AFM profiling of the same breast lesion to explore the diagnostic potential of tissue elasticity at different length scales. Patients were recruited from women who were scheduled for a biopsy in the outpatient breast clinic of the University Hospital Basel, Switzerland. RTE was performed as part of a standard breast work-up. Individual elastograms were characterized based on the Tsukuba elasticity score. Additionally, lesion elasticity was semiquantitatively assessed by the strain ratio. Core biopsies were obtained for histologic diagnosis and nanomechanical profiling by AFM under near-physiological conditions. Bulk stiffness evaluation by RTE does not always allow for a clear distinction between benign and malignant lesions and may result in the false assessment of breast lesions. AFM on the other hand enables quantitative stiffness measurements at higher spatial, i.e., subcellular, and force resolution. Consequently, lesions that were false positive or false negative by RTE were correctly identified by their nanomechanical AFM profiles as confirmed by histological diagnosis. Nanomechanical measurements can be used as unique markers of benign and cancerous breast lesions by providing relevant information at the molecular level. This is of particular significance considering the heterogeneity of tumors and may improve diagnostic accuracy compared to RTE.
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Affiliation(s)
| | - Marija Plodinec
- Biozentrum and Swiss Nanoscience Institute, University of Basel, Switzerland
| | - Philipp Oertle
- Biozentrum and Swiss Nanoscience Institute, University of Basel, Switzerland
| | - Katharina Redling
- Gynecology and Obstetrics, University Hospital Basel, 4031 Basel, Switzerland
| | | | - Roderick Y. H. Lim
- Biozentrum and Swiss Nanoscience Institute, University of Basel, Switzerland
| | - Cora-Ann Schoenenberger
- Gynecology and Gynecologic Oncology, Claraspital, 4016 Basel, Switzerland
- Department of Chemistry, University of Basel, Switzerland
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Kim SM, Kim Y, Jeong K, Jeong H, Kim J. Logistic LASSO regression for the diagnosis of breast cancer using clinical demographic data and the BI-RADS lexicon for ultrasonography. Ultrasonography 2017; 37:36-42. [PMID: 28618771 PMCID: PMC5769953 DOI: 10.14366/usg.16045] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 04/14/2017] [Accepted: 04/14/2017] [Indexed: 02/03/2023] Open
Abstract
Purpose The aim of this study was to compare the performance of image analysis for predicting breast cancer using two distinct regression models and to evaluate the usefulness of incorporating clinical and demographic data (CDD) into the image analysis in order to improve the diagnosis of breast cancer. Methods This study included 139 solid masses from 139 patients who underwent a ultrasonography-guided core biopsy and had available CDD between June 2009 and April 2010. Three breast radiologists retrospectively reviewed 139 breast masses and described each lesion using the Breast Imaging Reporting and Data System (BI-RADS) lexicon. We applied and compared two regression methods-stepwise logistic (SL) regression and logistic least absolute shrinkage and selection operator (LASSO) regression-in which the BI-RADS descriptors and CDD were used as covariates. We investigated the performances of these regression methods and the agreement of radiologists in terms of test misclassification error and the area under the curve (AUC) of the tests. Results Logistic LASSO regression was superior (P<0.05) to SL regression, regardless of whether CDD was included in the covariates, in terms of test misclassification errors (0.234 vs. 0.253, without CDD; 0.196 vs. 0.258, with CDD) and AUC (0.785 vs. 0.759, without CDD; 0.873 vs. 0.735, with CDD). However, it was inferior (P<0.05) to the agreement of three radiologists in terms of test misclassification errors (0.234 vs. 0.168, without CDD; 0.196 vs. 0.088, with CDD) and the AUC without CDD (0.785 vs. 0.844, P<0.001), but was comparable to the AUC with CDD (0.873 vs. 0.880, P=0.141). Conclusion Logistic LASSO regression based on BI-RADS descriptors and CDD showed better performance than SL in predicting the presence of breast cancer. The use of CDD as a supplement to the BI-RADS descriptors significantly improved the prediction of breast cancer using logistic LASSO regression.
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Affiliation(s)
- Sun Mi Kim
- Department of Radiology, Seoul National University Bundang Hospital, Seoul National University, Seongnam, Korea
| | - Yongdai Kim
- Department of Statistics, Seoul National University, Seoul, Korea
| | - Kuhwan Jeong
- Department of Statistics, Seoul National University, Seoul, Korea
| | - Heeyeong Jeong
- Department of Health Promotion, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jiyoung Kim
- Department of Radiology, Seoul National University Bundang Hospital, Seoul National University, Seongnam, Korea
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