Screening of breast lesions: a comparative study between mammography, B-mode ultrasonography, sonoelastography and histological results

Objective To compare the capacity of mammography, sonoelastography, B-mode ultrasonography and histological analysis to differentiate benign from malignant breast lesions. Materials and Methods A total of 12 histopathologically confirmed breast lesions were documented. The lesions were assessed by means of mammography, B-mode ultrasonography and sonoelastography, and histopathological analysis was utilized as a gold standard. Sensitivity and specificity were calculated. A receiver operating characteristic (ROC) curve was constructed to evaluate the diagnostic performance of the mentioned techniques. Results Sensitivity and specificity in the differentiation between benign and malignant lesions were respectively 100% and 50% for mammography, 100% and 71% for B-mode ultrasonography, and 67% and 83% for sonoelastography. The area under the ROC curve was calculated for the three imaging modalities and corresponded to 0.792 for mammography, 0.847 for B-mode ultrasonography, and 0.806 for sonoelastography. Conclusion Sonoelastography demonstrated higher specificity and lower sensitivity as compared with mammography and B-mode ultrasonography. On the other hand, B-mode ultrasonography had the largest area under the ROC curve. Sonoelastography has demonstrated to be a promising technique to detect and evaluate breast lesions, and could potentially reduce the number of unnecessary biopsies.

研究目的：对比乳腺钼靶摄影（mammography）、超声弹性成像（sonoelastography）、B型超声（B-mode ultrasonography）及组织学分析（histological analysis）鉴别乳腺良恶性病变的效能。材料与方法：本研究共纳入经组织病理学确诊的乳腺病变12例，所有病变均接受乳腺钼靶摄影、B型超声及超声弹性成像检查，并以组织病理学分析作为金标准。计算各检查方法的灵敏度与特异度，绘制受试者工作特征（Receiver Operating Characteristic, ROC）曲线以评估上述技术的诊断性能。结果：乳腺钼靶摄影鉴别乳腺良恶性病变的灵敏度与特异度分别为100%和50%，B型超声为100%和71%，超声弹性成像为67%和83%。三种影像检查模式的受试者工作特征曲线下面积分别为：乳腺钼靶摄影0.792，B型超声0.847，超声弹性成像0.806。结论：与乳腺钼靶摄影及B型超声相比，超声弹性成像的特异度更高、灵敏度更低；而B型超声的受试者工作特征曲线下面积最大。超声弹性成像已被证实为一种极具前景的乳腺病变检测与评估技术，有望减少不必要的活检操作。