Can Combined Screening of Ultrasound and Elastography Improve Breast Cancer Identification Compared with MRI in Women with Dense Breasts-a Multicenter Prospective Study
机构：[1]Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China[2]Department of Ultrasound, the Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China[3]Cardiovascular Ultrasound and Non-invasive Cardiology Department, Key Laboratory of Ultrasound in Cardiac Electrophysiology and Bio-mechanics of Sichuan Province, Sichuan Academy of Medical Sciences & Sichuan Provincial People′s Hospital, Chengdu 610072, China四川省人民医院[4]Department of Ultrasound, the Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China[5]Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang 110004, China中国医科大学附属盛京医院中国医科大学盛京医院[6]Department of Ultrasonography, the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China[7]Department of Radiology, Cancer Institute &Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China[8]Department of Medical Ultrasound, Fudan University Shanghai Cancer Center & Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China[9]Department of Ultrasonography, Henan Provincial People′s Hospital, Zhengzhou 450003, China[10]Department of Ultrasound, Shanxi Academy of Medical Science, Dayi Hospital of Shanxi Medical University, Taiyuan 030032, China[11]Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan 430030, China华中科技大学同济医学院附属同济医院[12]Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun 130033, China吉林大学中日联谊医院[13]Department of Medical Ultrasonics, Division of Interventional Ultrasound, Institute of Diagnostic and Interventional Ultrasound, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China中山大学附属第一医院[14]Department of Ultrasound, the Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China中山大学附属第二医院[15]Department of Ultrasonography, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China[16]Department of Medical Ultrasound, the Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an 710004, China[17]Department of Ultrasound, Union Hospital of Fujian Medical University, Fujian Institute of Ultrasound Medicine, Fuzhou 350001, China[18]Department of Ultrasound, Ruijin Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai 200025, China[19]Department of Ultrasound, Tianjin Union Medicine Hospital, Tianjin 300121, China[20]Department of Ultrasonography, Renmin Hospital of Wuhan University, Wuhan 430060, China[21]Department of Ultrasound, Qilu Hospital, Shandong University, Jinan 250012, China[22]Department of Ultrasound, the Third Xiangya Hospital of Central South University, Changsha 410013, China[23]Department of Ultrasound, the Second Affiliated Hospital of Zhejiang University, Hangzhou 310000, China[24]Department of Ultrasound, Hebei General Hospital, Shijiazhuang 050000, China[25]Department of Ultrasound, the Second Affiliated Hospital of Nanchang University, Nanchang 330006, China[26]Department of Ultrasound Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200336, China[27]Department of Ultrasound, Hainan Provincial People's Hospital, Haikou 570311, China[28]Department of Ultrasonography, the Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China[29]Department of Ultrasound, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou 215001, China[30]Department of Ultrasonography, Qianfoshan Hospital of Shandong University, Jinan 250014, China[31]Department of Ultrasound, Shenzhen People’s Hospital, the Second Clinical Medical College of Jinan University, Shenzhen 518020, China深圳市康宁医院深圳市人民医院深圳医学信息中心[32]Department of Ultrasound, the First Hospital of Shanxi Medical University, Taiyuan 030001, China[33]Department of Ultrasound, Peking University Shenzhen Hospital, Shenzhen 518036, China北京大学深圳医院深圳市康宁医院深圳医学信息中心[34]Department of Ultrasound, the Second Hospital of Dalian Medical University, Dalian 116027, China[35]Department of Ultrasound, the Affiliated Hospital of Qingdao University, Qingdao 266003, China[36]Department of Ultrasound, Maternal and Child Health Care Hospital Affiliated to Medical University of Anhui, Anhui Province Maternal and Child Health Hospital, Hefei 230001, China[37]Chongqing Key Laboratory of Ultrasound Molecular Imaging, Chongqing 400010, China
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.
基金：
National Natural Science Foundation of ChinaNational Natural Science Foundation of China [81601517]; Natural Science Foundation of BeijingBeijing Natural Science Foundation [7202156]; Foundation of ihecc [2018C0032-2]; Peking Union Medical College Reform in Education Project [10023201900113]
第一作者机构：[1]Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
通讯作者：
通讯机构：[1]Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China[*1]Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Shuai Fu Yuan, Dong Cheng District, Beijing 100730, China
推荐引用方式(GB/T 7714)：
Lu-Ying Gao,Yang Gu,Wen Xu,et al.Can Combined Screening of Ultrasound and Elastography Improve Breast Cancer Identification Compared with MRI in Women with Dense Breasts-a Multicenter Prospective Study[J].JOURNAL OF CANCER.2020,11(13):3903-3909.doi:10.7150/jca.43326.
APA：
Lu-Ying Gao,Yang Gu,Wen Xu,Jia-Wei Tian,Li-Xue Yin...&Yu-XinJiang.(2020).Can Combined Screening of Ultrasound and Elastography Improve Breast Cancer Identification Compared with MRI in Women with Dense Breasts-a Multicenter Prospective Study.JOURNAL OF CANCER,11,(13)
MLA：
Lu-Ying Gao,et al."Can Combined Screening of Ultrasound and Elastography Improve Breast Cancer Identification Compared with MRI in Women with Dense Breasts-a Multicenter Prospective Study".JOURNAL OF CANCER 11..13(2020):3903-3909
