Contrast-Enhanced Ultrasonography in the Diagnosis and Treatment Modulation of Breast Cancer

Boca, Ioana; Dudea, Sorin M; Ciurea, Andreea

doi:10.3390/jpm11020081

Cited by 26 publications

(13 citation statements)

References 69 publications

(48 reference statements)

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“…The value of CEUS in the diagnosis and evaluation of the curative effect of breast cancer has been recognized ( 23 , 24 ). Our research revealed that malignant neoplasms usually showed high heterogeneous enhancement, unclear enhancement boundary, perfusion defect, perforating vessels, large post-enhanced area, and high PI and tAUC values.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of diagnostic efficacy of multimode ultrasound in BI-RADS 4 breast neoplasms and establishment of a predictive model

Chen

et al. 2022

Front. Oncol.

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ObjectivesTo explore the diagnostic efficacy of ultrasound (US), two-dimensional and three-dimensional shear-wave elastography (2D-SWE and 3D-SWE), and contrast-enhanced ultrasound (CEUS) in breast neoplasms in category 4 based on the Breast Imaging Reporting and Data System (BI-RADS) from the American College of Radiology (ACR) and to develop a risk-prediction nomogram based on the optimal combination to provide a reference for the clinical management of BI-RADS 4 breast neoplasms.MethodsFrom September 2021 to April 2022, a total of 104 breast neoplasms categorized as BI-RADS 4 by US were included in this prospective study. There were 78 breast neoplasms randomly assigned to the training cohort; the area under the receiver-operating characteristic curve (AUC), 95% confidence interval (95% CI), sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 2D-SWE, 3D-SWE, CEUS, and their combination were analyzed and compared. The optimal combination was selected to develop a risk-prediction nomogram. The performance of the nomogram was assessed by a validation cohort of 26 neoplasms.ResultsOf the 78 neoplasms in the training cohort, 16 were malignant and 62 were benign. Among the 26 neoplasms in the validation cohort, 6 were malignant and 20 were benign. The AUC values of 2D-SWE, 3D-SWE, and CEUS were not significantly different. After a comparison of the different combinations, 2D-SWE+CEUS showed the optimal performance. Least absolute shrinkage and selection operator (LASSO) regression was used to filter the variables in this combination, and the variables included Emax, Eratio, enhancement mode, perfusion defect, and area ratio. Then, a risk-prediction nomogram with BI-RADS was built. The performance of the nomogram was better than that of the radiologists in the training cohort (AUC: 0.974 vs. 0.863). In the validation cohort, there was no significant difference in diagnostic accuracy between the nomogram and the experienced radiologists (AUC: 0.946 vs. 0.842).ConclusionsUS, 2D-SWE, 3D-SWE, CEUS, and their combination could improve the diagnostic efficiency of BI-RADS 4 breast neoplasms. The diagnostic efficacy of US+3D-SWE was not better than US+2D-SWE. US+2D-SWE+CEUS showed the optimal diagnostic performance. The nomogram based on US+2D-SWE+CEUS performs well.

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Section: Discussionmentioning

confidence: 99%

Evaluation of diagnostic efficacy of multimode ultrasound in BI-RADS 4 breast neoplasms and establishment of a predictive model

Chen

et al. 2022

Front. Oncol.

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“…Abnormal blood perfusion or blood vessel filing patterns observed on CEUS images and videos could reveal perfusion characteristics associated with malignant tumors. Studies on the role of CEUS in the past decade have shown that CEUS could increase the specificity of conventional US (11)(12)(13).…”

Section: Introductionmentioning

confidence: 99%

Multi-parameter ultrasonography-based predictive model for breast cancer diagnosis

Chen

Ma²,

Li³

et al. 2022

Front. Oncol.

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ObjectivesTo develop, validate, and evaluate a predictive model for breast cancer diagnosis using conventional ultrasonography (US), shear wave elastography (SWE), and contrast-enhanced US (CEUS).Materials and methodsThis retrospective study included 674 patients with 674 breast lesions. The data, a main and an independent datasets, were divided into three cohorts. Cohort 1 (80% of the main dataset; n = 448) was analyzed by logistic regression analysis to identify risk factors and establish the predictive model. The area under the receiver operating characteristic curve (AUC) was analyzed in Cohort 2 (20% of the main dataset; n = 119) to validate and in Cohort 3 (the independent dataset; n = 107) to evaluate the predictive model.ResultsMultivariable regression analysis revealed nine independent breast cancer risk factors, including age > 40 years; ill-defined margin, heterogeneity, rich blood flow, and abnormal axillary lymph nodes on US; enhanced area enlargement, contrast agent retention, and irregular shape on CEUS; mean SWE higher than the cutoff value (P < 0.05 for all). The diagnostic performance of the model was good, with AUC values of 0.847, 0.857, and 0.774 for Cohorts 1, 2, and 3, respectively. The model increased the diagnostic specificity (from 31% to 81.3% and 7.3% to 73.1% in cohorts 2 and 3, respectively) without a significant loss in sensitivity (from 100.0% to 90.1% and 100.0% to 81.8% in cohorts 2 and 3, respectively).ConclusionThe multi-parameter US-based model showed good performance in breast cancer diagnosis, improving specificity without a significant loss in sensitivity. Using the model could reduce unnecessary biopsies and guide clinical diagnosis and treatment.

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“…Image quality in the detection of breast cancer using SHF-CEUS is limited by insu cient signal generation from microbubbles released at high frequencies from linear transducers(18). Per uorobutane (PFB) has been shown to have a high resonance frequency and stable outer shell and can resist acoustic pressure, leading to increased microbubble oscillations that minimize collapse and loss of signal (19)(20)(21).…”

Section: Introductionmentioning

confidence: 99%

Head-to-head Comparison of Perfluorobutane-Contrast Enhanced US and Multiparametric-MRI for Breast Cancer: A prospective, multicenter study

Lang

Liang

Shen³

et al. 2022

Preprint

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Background: Multiparametric - Magnetic Resonance Imaging (MP-MRI) has high sensitivity for diagnosing breast cancers but cannot always be used as a routine diagnostic tool. To evaluate whether the diagnostic performance of Perfluorobutane (PFB)-contrast enhanced ultrasound (CEUS) is like MP-MRI in the breast cancer and if combining the two methods would enhance diagnostic efficiency. Patients and Methods: This was a head-to-head, prospective, multicenter study. Patients with breast lesions diagnosed by US as Breast Imaging Reporting and Data System (BI-RADS) 3, 4, and 5 categories underwent both PFB-CEUS and MP-MRI scans. On-site operators and three reviewers categorized the BI-RADS of all lesions on two images, respectively. Logistic-bootstrap 1000-sample analysis and cross-validation were used to construct PFB-CEUS, MP-MRI, and hybrid (PFB-CEUS + MP-MRI) models to distinguish breast lesions. Results: In total, 179 women with 186 breast lesions were evaluated from 17 centers in China. The area under the receiver operating characteristic curve (AUC) for the PFB-CEUS model (0.89; 95% confidence interval [CI]: 0.74, 0.97) was like that of the MP-MRI model (0.89; 95% CI: 0.73, 0.97), whereas both were inferior to the hybrid model (0.92, 95% CI: 0.77, 0.98). 90.3% false-positive and 66.7% false-negative results of PFB-CEUS radiologists, 90.5% false-positive and 42.8% false-negative results of MP-MRI radiologists could be corrected by Hybrid model, respectively. Dynamic nomograms of three models are accessible on websites. Conclusions: PFB-CEUS can be used in differential diagnosis of breast cancer with the performance comparable to MP-MRI. Using PFB-CEUS and MP-MRI as joint diagnostics could further strengthen the diagnostic ability. Trial registration: Clinicaltrials.gov; NCT04657328. Registered 26 September 2020.

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Contrast-Enhanced Ultrasonography in the Diagnosis and Treatment Modulation of Breast Cancer

Cited by 26 publications

References 69 publications

Evaluation of diagnostic efficacy of multimode ultrasound in BI-RADS 4 breast neoplasms and establishment of a predictive model

Evaluation of diagnostic efficacy of multimode ultrasound in BI-RADS 4 breast neoplasms and establishment of a predictive model

Multi-parameter ultrasonography-based predictive model for breast cancer diagnosis

Head-to-head Comparison of Perfluorobutane-Contrast Enhanced US and Multiparametric-MRI for Breast Cancer: A prospective, multicenter study

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