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Ma Q, Shen C, Gao Y, Duan Y, Li W, Lu G, Qin X, Zhang C, Wang J. Radiomics Analysis of Breast Lesions in Combination with Coronal Plane of ABVS and Strain Elastography. BREAST CANCER (DOVE MEDICAL PRESS) 2023; 15:381-390. [PMID: 37260586 PMCID: PMC10228588 DOI: 10.2147/bctt.s410356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 05/23/2023] [Indexed: 06/02/2023]
Abstract
Background Breast cancer is the most common tumor globally. Automated Breast Volume Scanner (ABVS) and strain elastography (SE) can provide more useful breast information. The use of radiomics combined with ABVS and SE images to predict breast cancer has become a new focus. Therefore, this study developed and validated a radiomics analysis of breast lesions in combination with coronal plane of ABVS and SE to improve the differential diagnosis of benign and malignant breast diseases. Patients and Methods 620 pathologically confirmed breast lesions from January 2017 to August 2021 were retrospectively analyzed and randomly divided into a training set (n=434) and a validation set (n=186). Radiomic features of the lesions were extracted from ABVS, B-ultrasound, and strain elastography (SE) images, respectively. These were then filtered by Gradient Boosted Decision Tree (GBDT) and multiple logistic regression. The ABVS model is based on coronal plane features for the breast, B+SE model is based on features of B-ultrasound and SE, and the multimodal model is based on features of three examinations. The evaluation of the predicted performance of the three models used the receiver operating characteristic (ROC) and decision curve analysis (DCA). Results The area under the curve, accuracy, specificity, and sensitivity of the multimodal model in the training set are 0.975 (95% CI:0.959-0.991),93.78%, 92.02%, and 96.49%, respectively, and 0.946 (95% CI:0.913 -0.978), 87.63%, 83.93%, and 93.24% in the validation set, respectively. The multimodal model outperformed the ABVS model and B+SE model in both the training (P < 0.001, P = 0.002, respectively) and validation sets (P < 0.001, P = 0.034, respectively). Conclusion Radiomics from the coronal plane of the breast lesion provide valuable information for identification. A multimodal model combination with radiomics from ABVS, B-ultrasound, and SE could improve the diagnostic efficacy of breast masses.
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Affiliation(s)
- Qianqing Ma
- Department of Ultrasound, the First Affiliated Hospital of Anhui Medical University, Hefei, People’s Republic of China
| | - Chunyun Shen
- Department of Ultrasound, Wuhu No. 2 People’s Hospital, Wuhu, People’s Republic of China
| | - Yankun Gao
- Department of Radiology, the First Affiliated Hospital of Anhui Medical University, Hefei, People’s Republic of China
| | - Yayang Duan
- Department of Ultrasound, the First Affiliated Hospital of Anhui Medical University, Hefei, People’s Republic of China
| | - Wanyan Li
- Department of Ultrasound, Linquan Country People’s Hospital, Fuyang, People’s Republic of China
| | - Gensheng Lu
- Department of Pathology, Wuhu No. 2 People’s Hospital, Wuhu, People’s Republic of China
| | - Xiachuan Qin
- Department of Ultrasound, the First Affiliated Hospital of Anhui Medical University, Hefei, People’s Republic of China
| | - Chaoxue Zhang
- Department of Ultrasound, the First Affiliated Hospital of Anhui Medical University, Hefei, People’s Republic of China
| | - Junli Wang
- Department of Ultrasound, Wuhu No. 2 People’s Hospital, Wuhu, People’s Republic of China
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Wu H, Wang C, An Q, Qu X, Wu X, Yan Y. Comparing the accuracy of shear wave elastography and strain elastography in the diagnosis of breast tumors: A systematic review and meta-analysis. Medicine (Baltimore) 2022; 101:e31526. [PMID: 36343055 PMCID: PMC9646582 DOI: 10.1097/md.0000000000031526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Shear wave elastography (SWE) and strain elastography (SE) are 2 new ultrasonic technologies which have developed rapidly in recent years. Elastography transforms the elastic information of tissue into optical information for display, thus more intuitive display of tissue elasticity. Conflicting results have been obtained in different scholars' studies on the accuracy comparison of the 2 elastography technologies in the diagnosis of breast tumors. This meta-analysis aims to compare the accuracy of the 2 elastography technologies in the diagnosis of breast tumors, and provide a reference for clinical decision making. METHODS We have searched Chinese and English literatures on the accuracy of SWE and SE in the diagnosis of breast tumors from PubMed, Web of Science, China national knowledge infrastructure and Wanfang databases, and the time was up to December30, 2020. Two literature reviewers screened the literatures according to the screening criteria, and Quality Assessment of Diagnostic Accuracy Study tool was used to evaluate the quality of included literatures. Meta Disc1.4 and Stata14.0 softwares were used to perform heterogeneity test, sensitivity analysis and publication bias test. RESULTS Ten literatures included 1599 patients and 1709 breast lesions. The final results in the SWE as follow: The pooled sensitivity was 0.852 (95% confidence interval [CI] [0.826-0.874]), the pooled specificity (Spe) was 0.799 (95% CI [0.776-0.820]), the pooled positive likelihood ratio was 4.758 (95% CI [3.443-6.576]), the pooled negative likelihood ratio was 0.192 (95% CI [0.147-0.250]), the pooled diagnostic odds ratio was 29.071 (95% CI [16.967-49.811]), and the area under the summary receiver operating characteristic curve was 0.9159. The final results in the SE as follow: The pooled sensitivity was 0.843 (95% CI [0.817-0.866]), the pooled Spe was 0.766 (95% CI [0.743-0.789]), the pooled positive likelihood ratio was 4.387 (95% CI [3.088-6.233]), the pooled negative likelihood ratio was 0.216 (95% CI [0.179-0.261]), the pooled diagnostic odds ratio was 22.610 (95% CI [15.622-32.724]), and the area under the summary receiver operating characteristic curve was 0.8987. CONCLUSION The sensitivity and Spe of SWE were higher than those of SE, suggesting that SWE may have a higher accuracy in the diagnosis of breast tumors. REGISTER NAME PROSPERO. Registration number: CRD42021251110.
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Affiliation(s)
- Huayu Wu
- The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Cong Wang
- Ultrasound Department of the First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Qi An
- Ultrasound Department of the First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Xiaomeng Qu
- The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Xiaohang Wu
- Ultrasound Department of the First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Yumei Yan
- Ultrasound Department of the First Affiliated Hospital of Dalian Medical University, Dalian, China
- *Correspondence: Yumei Yan, Ultrasound department of the First Affiliated Hospital of Dalian Medical University, No. 222 Zhongshan Road, Xigang District, Dalian City, Liaoning Province 116011, China (e-mail: )
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Mutala TM, Mwango GN, Aywak A, Cioni D, Neri E. Determining the elastography strain ratio cut off value for differentiating benign from malignant breast lesions: systematic review and meta-analysis. Cancer Imaging 2022; 22:12. [PMID: 35151365 PMCID: PMC8841096 DOI: 10.1186/s40644-022-00447-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 01/10/2022] [Indexed: 12/15/2022] Open
Abstract
Background Elastography is an addition to grey-scale ultrasonic examination that has gained substantial traction within the last decade. Strain ratio (SR) has been incorporated as a semiquantitative measure within strain elastography, thus a potential imaging biomarker. The World Federation for Ultrasound in Medicine and Biology (WFUMB) published guidelines in 2015 for breast elastography. These guidelines acknowledge the marked variance in SR cut-off values used in differentiating benign from malignant lesions. The objective of this review was to include more recent evidence and seek to determine the optimal strain ratio cut off value for differentiating between benign and malignant breast lesions. Methods Comprehensive search of MEDLINE and Web of Science electronic databases with additional searches via Google Scholar and handsearching set from January 2000 to May 2020 was carried out. For retrieved studies, screening for eligibility, data extraction and analysis was done as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Diagnostic Test Accuracy (PRISMA-DTA) Statement guidelines of 2018. Quality and risk of bias assessment of the studies were performed using the revised Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. Results A total of 424 articles, 412 from electronic database and 12 additional searches were retrieved and 65 studies were included in the narrative synthesis and subgroup analysis. The overall threshold effect indicated significant heterogeneity among the studies with Spearman correlation coefficient of Logit (TPR) vs Logit (FPR) at − 0.301, p-value = 0.015. A subgroup under machine model consisting seven studies with 783 patients and 844 lesions showed a favourable threshold, Spearman’s correlation coefficient,0.786 (p = 0.036). Conclusion From our review, currently the optimal breast SR cut-off point or value remains unresolved despite the WFUMB guidelines of 2015. Machine model as a possible contributor to cut-off value determination was suggested from this review which can be subjected to more industry and multi-center research determination. Supplementary Information The online version contains supplementary material available at 10.1186/s40644-022-00447-5.
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Wei Q, Yan YJ, Wu GG, Ye XR, Jiang F, Liu J, Wang G, Wang Y, Wang Y, Pan ZP, Hu JH, Song J, Dietrich CF, Cui XW. Added Value of a New Strain Elastography Technique in Conventional Ultrasound for the Diagnosis of Breast Masses: A Prospective Multicenter Study. Front Oncol 2021; 11:779612. [PMID: 34858859 PMCID: PMC8631107 DOI: 10.3389/fonc.2021.779612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Accepted: 10/18/2021] [Indexed: 11/23/2022] Open
Abstract
Objective This study aimed to explore the value of elasticity score (ES) and strain ratio (SR) combined with conventional ultrasound in distinguishing benign and malignant breast masses and reducing biopsy of BI-RADS (Breast Imaging Reporting and Data System) 4a lesions. Methods This prospective, multicenter study included 910 patients from nine different hospitals. The acquisition and analysis of conventional ultrasound and strain elastography (SE) were obtained by radiologists with more than 5 years of experience in breast ultrasound imaging. The diagnostic sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under curve (AUC) of conventional ultrasound alone and combined tests with ES and/or SR were calculated and compared. Results The optimal cutoff value of SR for differentiating benign from malignant masses was 2.27, with a sensitivity of 60.2% and a specificity of 84.8%. When combined with ES and SR, the AUC of the new BI-RADS classification increased from 0.733 to 0.824 (p < 0.001); the specificity increased from 48.1% to 68.5% (p < 0.001) without a decrease in the sensitivity (98.5% vs. 96.4%, p = 0.065); and the PPV increased from 52.2% to 63.7% (p < 0.001) without a loss in the NPV (98.2% vs. 97.1%, p = 0.327). All three combinations of conventional ultrasound, ES, and SR could reduce the biopsy rate of category 4a lesions without reducing the malignant rate of biopsy (from 100% to 68.3%, 34.9%, and 50.4%, respectively, all p < 0.001). Conclusions SE can be used as a useful and non-invasive additional method to improve the diagnostic performance of conventional ultrasound by increasing AUC and specificity and reducing the unnecessary biopsy of BI-RADS 4a lesions.
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Affiliation(s)
- Qi Wei
- Sino-German Tongji-Caritas Research Center of Ultrasound in Medicine, Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yu-Jing Yan
- Sino-German Tongji-Caritas Research Center of Ultrasound in Medicine, Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ge-Ge Wu
- Sino-German Tongji-Caritas Research Center of Ultrasound in Medicine, Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xi-Rong Ye
- Department of Medical Ultrasound, The Central Hospital of EDong Healthcare, Huangshi, China
| | - Fan Jiang
- Department of Medical Ultrasound, The Second Hospital of Anhui Medical University, Hefei, China
| | - Jie Liu
- Department of Medical Ultrasound, Yichang General Hospital, Renmin Hospital of Three Gorges University, Yichang, China
| | - Gang Wang
- Department of Medical Ultrasound, Taizhou Hospital of Zhejiang Province, Linhai, China
| | - Yi Wang
- Department of Medical Ultrasound, Macheng People's Hospital, Macheng, China
| | - Yu Wang
- Department of Medical Ultrasound, Xiangyang No. 1 People's Hospital, Affiliated Hospital of Hubei University of Medicine, Xiangyang, China
| | - Zhi-Ping Pan
- Department of Medical Ultrasound, Yixing Traditional Chinese Medicine Hospital, Yixing, China
| | - Jin-Hua Hu
- Department of Medical Ultrasound, Anqing First People's Hospital of Anhui Medical University, Anqing, China
| | - Juan Song
- Department of Medical Ultrasound, Xiangyang No. 1 People's Hospital, Affiliated Hospital of Hubei University of Medicine, Xiangyang, China
| | | | - Xin-Wu Cui
- Sino-German Tongji-Caritas Research Center of Ultrasound in Medicine, Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Turnaoğlu H, Haberal KM, Arslan S, Yavuz Çolak M, Ulu Öztürk F, Uslu N. Interobserver and intermethod variability in data interpretation of breast strain elastography in suspicious breast lesions. Turk J Med Sci 2021; 51:547-554. [PMID: 32950046 PMCID: PMC8203122 DOI: 10.3906/sag-2006-257] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 09/16/2020] [Indexed: 12/21/2022] Open
Abstract
Background/aim Strain elastography has the disadvantage of being operator-dependent. Interobserver variability is observed during image acquisition and interpretation. This study aimed to analyze the interobserver and intermethod variability of strain elastography in image interpretation and evaluate the diagnostic performance combining elasticity score and strain ratio with ultrasonography. Materials and methods A retrospective study was conducted on 70 breast lesions evaluated with B-mode ultrasonography and strain elastography. B-mode ultrasonography findings, elasticity scores, and strain ratio values were evaluated using static images by two radiologists. BI-RADS assessment of the lesions and the decision of both observers as to whether the biopsy was required using B-mode ultrasonography, and the combined ultrasonography+elasticity score, and the combined ultrasonography+elasticity score+strain ratio were compared with the histopathological results. Also, the interobserver agreement was analyzed for all the combinations. Results There was very good agreement (weighted κ = 0.865) between the observers for the elasticity scores. Very good agreement was observed between the observers for BI-RADS assessments using the combined ultrasonography+elasticity score and the combined ultrasonography+elasticity score+strain ratio (weighted κ = 0.848, and 0.902, respectively). Area under the curve of B-mode ultrasonography, the combined B-mode ultrasonography+elasticity score, and the combined B-mode ultrasonography+elasticity score+strain ratio, were calculated as 0.859, 0.866, and 0.916 for observer 1, and 0.851, 0.829, and 0.916 for observer 2, respectively. There were no statistically significant differences between the observers’ diagnostic performances in any of the combinations (P = 0.703, 0.067, and 0.972, respectively). Conclusion In the evaluation and further assessment of breast lesions, semiquantitative strain ratio calculation may help improve diagnostic accuracy by reducing interpretational variety, when used together with B-mode ultrasonography and elasticity scoring, especially for inexperienced individuals.
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Affiliation(s)
- Hale Turnaoğlu
- Department of Radiology, Faculty of Medicine, Başkent University, Ankara, Turkey
| | - Kemal Murat Haberal
- Department of Radiology, Faculty of Medicine, Başkent University, Ankara, Turkey
| | - Serdar Arslan
- Department of Radiology, Faculty of Medicine, Başkent University, Ankara, Turkey
- Department of Radiology, Cerrahpaşa Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Meriç Yavuz Çolak
- Department of Biostatistics, Faculty of Medicine, Başkent University, Ankara, Turkey
| | - Funda Ulu Öztürk
- Department of Radiology, Faculty of Medicine, Başkent University, Ankara, Turkey
| | - Nihal Uslu
- Department of Radiology, Faculty of Medicine, Başkent University, Ankara, Turkey
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Georgieva M, Prantl L, Utpatel K, Wiesinger I, Stroszczynski C, Jung F, Jung E. Diagnostic performance of ultrasound strain elastography for differentiation of malignant breast lesions. Clin Hemorheol Microcirc 2019; 71:237-247. [DOI: 10.3233/ch-189415] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- M. Georgieva
- Department of Radiology, University Hospital Regensburg, Germany
| | - L. Prantl
- Centre of Plastic, Aesthetic, Hand and Reconstructive Surgery, University of Regensburg, Regensburg, Germany
| | - K. Utpatel
- Department of Pathology, University Regensburg, Germany
| | - I. Wiesinger
- Centre of Plastic, Aesthetic, Hand and Reconstructive Surgery, University of Regensburg, Regensburg, Germany
| | - C. Stroszczynski
- Department of Radiology, University Hospital Regensburg, Germany
| | - F. Jung
- Institute of Clinical Haemostasiology and Transfusion Medicine, University of Saarland, Homburg, Germany
| | - E.M. Jung
- Department of Radiology, University Hospital Regensburg, Germany
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