Ultrasound Viscosity Imaging in Breast Lesions: A Multicenter Prospective Study

RATIONALE AND OBJECTIVES

To explore and validate the clinical value of ultrasound (US) viscosity imaging in differentiating breast lesions by combining with BI-RADS, and then comparing the diagnostic performances with BI-RADS alone.

MATERIALS AND METHODS

This multicenter, prospective study enrolled participants with breast lesions from June 2021 to November 2022. A development cohort (DC) and validation cohort (VC) were established. Using histological results as reference standard, the viscosity-related parameter with the highest area under the receiver operating curve (AUC) was selected as the optimal one. Then the original BI-RADS would upgrade or not based on the value of this parameter. Finally, the results were validated in the VC and total cohorts. In the DC, VC and total cohorts, all breast lesions were divided into the large lesion, small lesion and overall groups respectively.

RESULTS

A total of 639 participants (mean age, 46 years ± 14) with 639 breast lesions (372 benign and 267 malignant lesions) were finally enrolled in this study including 392 participants in the DC and 247 in the VC. In the DC, the optimal viscosity-related parameter in differentiating breast lesions was calculated to be A'-S2-Vmax, with the AUC of 0.88 (95% CI: 0.84, 0.91). Using > 9.97 Pa.s as the cutoff value, the BI-RADS was then modified. The AUC of modified BI-RADS significantly increased from 0.85 (95% CI: 0.81, 0.88) to 0.91 (95% CI: 0.87, 0.93), 0.85 (95% CI: 0.80, 0.89) to 0.90 (95% CI: 0.85, 0.93) and 0.85 (95% CI: 0.82, 0.87) to 0.90 (95% CI: 0.88, 0.92) in the DC, VC and total cohorts respectively (P < .05 for all).

CONCLUSION

The quantitative viscous parameters evaluated by US viscosity imaging contribute to breast cancer diagnosis when combined with BI-RADS.

The accuracy of sonoelastography in fatty degeneration of the supraspinatus: a comparison of magnetic resonance imaging and conventional ultrasonography

OBJECTIVE

Sonolastography (SE) technique is one of the new functional ultrasonic imaging techniques, which was developed in the past few years and can obtain the distributions of elasticity in tissues. Using magnetic resonance imaging (MRI) as the standard of reference, the purpose of this study was to evaluate the ability of SE to assess the fatty degeneration of suprasupinatus (SSP) and to compare it to the MRI and the conventional ultrasonography (US) findings.

MATERIALS AND METHODS

The institutional review board approved the study, and a retrospective analysis between January 2013 and September 2013 was performed on 101 shoulders of 98 consecutive patients using MRI, US, and SE for the evaluation of shoulder lesion. Oblique sagittal images of SSP were obtained using SE. The SE images were evaluated by reviewers using an experimentally proven color grading system.

RESULTS

When comparing SE to standard MRI findings, the mean sensitivity of SE was 95.6 %, the specificity 87.5 %, and the accuracy 91.1 %. The interobserver reliability of the SE findings was "almost perfect agreement" with a weighted kappa coefficient of 0.81. On comparing MRI with the SE findings, the grades of MRI and SE have a positive correlation (r = 0.855, P = <0.001). Furthermore, the grades of US and SE also have a positive correlation (r = 0.793, P = <0.001).

CONCLUSION

SE is valuable in the quantitative assessment of the severity of the fatty atrophy of the supraspinatus and has an excellent accuracy, an excellent correlation with MRI and the conventional US, and an excellent interobserver reliability.