LECANDUS study (LEsion CANdidate Detection in UltraSound Data): evaluation of image analysis algorithms for breast lesion detection in volume ultrasound data

Diagnostic efficacy of contrast-enhanced breast MRI versus X-ray mammography in women with different degrees of breast density

BACKGROUND

Detection of breast cancer in women with high breast densities is a clinical challenge.

PURPOSE

To study the influence of different degrees of breast density on the sensitivity of contrast-enhanced breast magnetic resonance imaging (CE-BMRI) versus X-ray mammography (XRM).

MATERIAL AND METHODS

We performed an additional analysis of two large Phase III clinical trials (G1; G2) which included women with histologically proven breast cancers, called "index cancers." Additional cancers were detected during image reading. We compared the sensitivity of CE-BMRI and XRM in women with different breast densities (ACR A→D; Version 5). For each study, six blinded readers evaluated the images. Results are given as the "Median Reader."

RESULTS

A total of 774 patients were included, 169 had additional cancers. While sensitivity of CE-BMRI for detecting all index cancers was independent of breast density (ACR A→D) (G1: 83%→83%; G2: 91%→91%) the sensitivity of XRM declined (ACR A→D) (G1: 79%→62%; G2: 82%→64%). Thus, the sensitivity difference between both imaging modalities in ACR A breasts of 3% (G1) and 9% (G2) increased to 21% (G1) and 26% (G2) in ACR D breasts. Sensitivity of CE-BMRI for detecting at least one additional cancer increased with increasing breast density (ACR A→D) (G1: 50%→73%, G2: 57%→81%). XRM's sensitivity decreased (G1: 34%→20%) or remained stable (G2: 24%→25%).

CONCLUSION

CE-BMRI showed significantly higher sensitivity compared to XRM.

The value of automated breast volume scanner combined with virtual touch tissue quantification in the differential diagnosis of benign and malignant breast lesions: A comparative study with mammography

This study aimed to evaluate the diagnostic value of automated breast volume scanner (ABVS) combined with virtual touch tissue quantification (VTQ) in the differential diagnosis of breast lesions.In this retrospective study, 183 patients (mean age, 49.8 ± 8.2 years) with 218 breast lesions underwent ABVS, VTQ, and mammography (MG). All lesions were confirmed by postoperative histopathology. A logistic regression model was constructed to generate a receiver operating characteristic (ROC) curve, calculate the area under the ROC curve (AUC), and compare and evaluate the diagnostic performance of ABVS, VTQ, MG, and ABVS combined with VTQ (ABVS-VTQ).The sensitivity, specificity, and accuracy of ABVS, VTQ, MG, and ABVS-VTQ in diagnosing breast lesions were 94.01% (110/117), 96.03% (97/101), and 94.95% (207/218); 80.34% (94/117), 94.05% (95/101), and 86.69% (189/218); 70.08% (82/117), 68.31% (69/101), and 69.26% (151/218); and 96.58% (113/117), 96.03% (97/101), and 96.33% (210/218), respectively. The AUC of ABVS-VTQ was higher than that of the other examinations alone. The detection rate of ABVS (100%, 218/218) was higher than that of MG (78.89%, 172/218), and the difference was statistically significant (χ2 = 51.426, P < .001).The combined application of ABVS and VTQ can improve the accuracy and specificity of the diagnosis and is a promising ultrasound method for the differential diagnosis of breast lesions.

Is there an extraclinical value of automated breast volume scanner compared with hand-held ultrasound?: A pilot study

The aim of this study was to investigate the extraclinical value of automated breast volume scanning (ABVS) in the diagnosis of breast tumor compare to hand-handle ultrasound (HHUS).One hundred twenty-four patients with breast tumor were performed HHUS and ABVS before operation. The research focused on whether there were newly found tumors or new findings on the coronal planes by using ABVS compared with HHUS. Then, the classification adjustments of breast imaging reporting and data system (BI-RADS) were made according to new findings on the coronal planes by using ABVS.There are totally 166 breast tumors found in 124 patients by HHUS, while 8 more were observed by ABVS, 4 of which were malignant and the rest were benign. The sensitivity and specificity of ABVS coronal plane findings were 37.0% and 92.5%, respectively. The area under receiver operating characteristic curve was 0.89 before the corrected classification versus 0.93 after the corrected classification, there were no significant differences (P > .05).There was no significant extraclinical value in differentiating diagnosis of malignant tumors and benign breast tumors by ABVS comparing to HHUS. However, those minimal lesions missed diagnosis could be found by ABVS with continuously automatic scanning.

Inter-rater reliability and double reading analysis of an automated three-dimensional breast ultrasound system: comparison of two independent examiners

PURPOSE

Breast ultrasound could be a valuable tool complementary to mammography in breast cancer screening. Automated 3D breast ultrasound (ABUS) addresses challenges of hand-held ultrasound and could allow double reading analysis of ultrasound images. This trial assesses the inter-rater reliability and double reading analysis of an ABUS system.

METHODS

To assess the reproducibility and diagnostic validity of the ABUS system, SomoV™, a blinded double reading analysis, was performed in 1019 patients (2038 breasts) by two examiners (examiner A/B) and compared to single reading results, as well as to the reference standard regarding its diagnostic validity. Cohen's kappa coefficients were calculated to measure the inter-rater reliability and agreement of the different diagnostic modalities. Patient comfort and time consumption for image acquisition and reading were analyzed descriptively as secondary objectives.

RESULTS

Analysis of inter-rater reliability yielded agreement in 81.6% (κ = 0.37; p < 0.0001) showing fair agreement. Single reading analysis of SomoV™ exams (examiner A/examiner B) compared to reference standard showed good specificity (examiner A: 88.3%/examiner B: 84.5%), fair inter-rater agreement (examiner A: κ = 0.31/examiner B: κ = 0.31), and adequate sensitivity (examiner A: 53.1%/examiner B: 64.2%). Double reading analysis yielded good sensitivity and specificity (73.7 and 77.7%). Mammography (n = 1911) alone detected 160 of 176 carcinomas (sensitivity 90.1%). Adding SomoV™ to mammography would have detected 12 additional carcinomas, resulting in a higher sensitivity of 97.7%.

CONCLUSION

SomoV™ is a promising technique with good sensitivity, high patient comfort, and fair inter-examiner reliability. It allows double reading analysis that, in combination with mammography, could increase detection rates in breast cancer screening.