TY - JOUR
T1 - 3D Harmonic and Subharmonic Imaging for Characterizing Breast Lesions
T2 - A Multi-Center Clinical Trial
AU - Forsberg, Flemming
AU - Piccoli, Catherine W.
AU - Sridharan, Anush
AU - Wilkes, Annina
AU - Sevrukov, Alexander
AU - Ojeda-Fournier, Haydee
AU - Mattrey, Robert F.
AU - Machado, Priscilla
AU - Stanczak, Maria
AU - Merton, Daniel A.
AU - Wallace, Kirk
AU - Eisenbrey, John R.
N1 - Publisher Copyright:
© 2021 American Institute of Ultrasound in Medicine.
PY - 2022/7
Y1 - 2022/7
N2 - Objective: Breast cancer is the most frequent type of cancer among women. This multi-center study assessed the ability of 3D contrast-enhanced ultrasound to characterize suspicious breast lesions using clinical assessments and quantitative parameters. Methods: Women with suspicious breast lesions scheduled for biopsy were enrolled in this prospective, study. Following 2D grayscale ultrasound and power Doppler imaging (PDI), a contrast agent (Definity; Lantheus) was administrated. Contrast-enhanced 3D harmonic imaging (HI; transmitting/receiving at 5.0/10.0 MHz), as well as 3D subharmonic imaging (SHI; transmitting/receiving at 5.8/2.9 MHz), were performed using a modified Logiq 9 scanner (GE Healthcare). Five radiologists independently scored the imaging modes (including standard-of-care imaging) using a 7-point BIRADS scale as well as lesion vascularity and diagnostic confidence. Parametric volumes were constructed from time-intensity curves for vascular heterogeneity, perfusion, and area under the curve. Diagnostic accuracy was determined relative to pathology using receiver operating characteristic (ROC) and reverse, step-wise logistical regression analyses. The κ-statistic was calculated for inter-reader agreement. Results: Data were successfully acquired in 219 cases and biopsies indicated 164 (75%) benign and 55 (25%) malignant lesions. SHI depicted more anastomoses and vascularity than HI (P <.021), but there were no differences by pathology (P >.27). Ultrasound achieved accuracies of 82 to 85%, which was significantly better than standard-of-care imaging (72%; P <.03). SHI increased diagnostic confidence by 3 to 6% (P <.05), but inter-reader agreements were medium to low (κ < 0.52). The best regression model achieved 97% accuracy by combining clinical reads and parametric SHI. Conclusions: Combining quantitative 3D SHI parameters and clinical assessments improves the characterization of suspicious breast lesions.
AB - Objective: Breast cancer is the most frequent type of cancer among women. This multi-center study assessed the ability of 3D contrast-enhanced ultrasound to characterize suspicious breast lesions using clinical assessments and quantitative parameters. Methods: Women with suspicious breast lesions scheduled for biopsy were enrolled in this prospective, study. Following 2D grayscale ultrasound and power Doppler imaging (PDI), a contrast agent (Definity; Lantheus) was administrated. Contrast-enhanced 3D harmonic imaging (HI; transmitting/receiving at 5.0/10.0 MHz), as well as 3D subharmonic imaging (SHI; transmitting/receiving at 5.8/2.9 MHz), were performed using a modified Logiq 9 scanner (GE Healthcare). Five radiologists independently scored the imaging modes (including standard-of-care imaging) using a 7-point BIRADS scale as well as lesion vascularity and diagnostic confidence. Parametric volumes were constructed from time-intensity curves for vascular heterogeneity, perfusion, and area under the curve. Diagnostic accuracy was determined relative to pathology using receiver operating characteristic (ROC) and reverse, step-wise logistical regression analyses. The κ-statistic was calculated for inter-reader agreement. Results: Data were successfully acquired in 219 cases and biopsies indicated 164 (75%) benign and 55 (25%) malignant lesions. SHI depicted more anastomoses and vascularity than HI (P <.021), but there were no differences by pathology (P >.27). Ultrasound achieved accuracies of 82 to 85%, which was significantly better than standard-of-care imaging (72%; P <.03). SHI increased diagnostic confidence by 3 to 6% (P <.05), but inter-reader agreements were medium to low (κ < 0.52). The best regression model achieved 97% accuracy by combining clinical reads and parametric SHI. Conclusions: Combining quantitative 3D SHI parameters and clinical assessments improves the characterization of suspicious breast lesions.
KW - 3D ultrasound imaging
KW - breast cancer
KW - contrast-enhanced ultrasound
KW - harmonic imaging
KW - subharmonic imaging
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U2 - 10.1002/jum.15848
DO - 10.1002/jum.15848
M3 - Article
C2 - 34694019
AN - SCOPUS:85117843661
SN - 0278-4297
VL - 41
SP - 1667
EP - 1675
JO - Journal of Ultrasound in Medicine
JF - Journal of Ultrasound in Medicine
IS - 7
ER -