Diagnostic and prognostic values of contrast‑enhanced ultrasound combined with diffusion‑weighted magnetic resonance imaging in different subtypes of breast cancer

Correlation analysis between rim enhancement features of contrast-enhanced ultrasound and lymph node metastasis in breast cancer

OBJECTIVE

To explore the correlation between rim enhancement features of contrast-enhanced ultrasound and lymphatic metastasis, and to provide theoretical support for clinical treatment of breast cancer.

METHODS

387 breast cancer patients (748 axillary lymph nodes in total) treated in our hospital from January 2017 to January 2020 were selected and analyzed by contrast-enhanced ultrasound. Pathological examination showed that 540 axillary lymph nodes showed metastasis whereas 208 axillary lymph nodes did not show metastasis. Univariate analysis and Logistic stepwise regression were used to analyze the correlation between rim enhancement features of contrast-enhanced ultrasound and axillary lymph node metastasis of breast cancer.

RESULTS

Peripheral halo, peripheral convergence, rim enhancement, enhancement mode, enhancement amplitude, enhancement sequence, expansion after enhancement, peak intensity, time to peak, area under curve, thrombolysis in myocardial infarction, perfusion sequence, aspect ratio, and maximum cortical thickness were all related to lymph node metastasis of breast cancer by univariate analysis, and the difference was statistically significant (P < 0.05). Multivariate analysis showed that enhancement mode, enhancement amplitude, extension after enhancement, maximum cortical thickness, peak intensity and time to peak were all related to lymph node metastasis of breast cancer.

CONCLUSION

Rim enhancement features of contrast-enhanced ultrasound of breast cancer are related to lymph node metastasis, which will provide a guidance for clinical treatment of breast cancer.

Factors influencing the performance of a diagnostic model including contrast-enhanced ultrasound in 1023 breast lesions: comparison with histopathology

Background

We aimed to investigate the influence of patient and lesion characteristics on our diagnostic model for contrast-enhanced ultrasound (CEUS) of the breast, comparing its accuracy with that of histopathology.

Methods

Conducting a study with eight medical centers, we compared 1,023 breast lesions categorized as BI-RADS 4 or 5 with the score from our newly-established CEUS-based diagnostic model, comparing the results with pathological outcomes. Univariate and multivariate logistic regression analyses were conducted to determine the influence of clinicopathological characteristics on the performance of this CEUS model.

Results

Logistic regression analysis showed that patients' age, maximum lesion diameter, and distance from the lesion's deep edge to the pectoralis major were significant independent influencing factors. The model's diagnostic accuracy was greater for patients >35 y (P=0.005), for maximum lesion diameter >20 mm, and for distance from the lesion's deep edge to the pectoralis major ≤3.05 mm. There was no significant difference in accuracy between lesions with maximum lesion diameter 10-20 and <10 mm (P=0.393).

Conclusions

The diagnostic performance of the proposed CEUS model for breast lesions is influenced by patients' age, maximum lesion diameter, and distance from the lesion's deep edge to the pectoralis major. Consideration of influencing factors is required to optimize clinical use of the CEUS model.