Breast Cancer Classification: A CAD System for a Combined Use of Elastography and B-Mode Sonography

Abstract

Purpose: The aim of this study was to evaluate and compare the diagnostic performance of elastography, B-mode Ultrasound (US), and a combination of elastography and B-mode US for the differentiation between benign and malignant lesions. Methods: A prospective study was carried out from July to December 2015, which 87 patients with 83 lesions were examined with conventional B-mode ultrasound and strain elastography. All the lesions had been proven by biopsy, resulting in 31 malignant and 52 benign lesions. A radiologist with 16 years of experience classified visually these cases. We also used a CAD sys-tem to classify the lesions classified visually by the most experienced radiologist and using a CAD system. The data obtained were compared with the results provided by another radiologist and a resident with 2 years of experience. Sensitivity, specificity and AUC for the three observers using the CAD system were calculated. Results: The developed CADx system provided a diagnostic concordance in the classification of breast lesions from the different ways of contour determination (manual and automatic), allowing to reduce the diagnostic variability. In addition, the CADx system showed superior results to the visual analysis of the radiologist. When the radiologist associated both examinations (B-mode ultrasound and elastography), his visual analysis provided 87.1%, 55.8% and 0.714 of sensitivity, specificity and AUC, respectively. When we considered the result provided by the association between B-mode ultrasound and elastography images, the CADx system provided a comparative increase of about 7% of sensitivity and 17.2% of specificity, using the contour delimited by the most experienced radiologist. In addition, a positive influence was observed in the use of the computational tool by radiologists, since, on average, their sensitivity and specificity indexes also increased in relation to the conventional analysis, from 87.1% and 55.8% to 90.3% and 73.1%, respectively. Conclusion: Thus, it can be concluded that the developed CADx system performed well in distinguishing benign from malignant lesions for both B-mode ultrasound and elastography. The AUC obtained was higher than the radiologist’s visual analysis in most of the cases analyzed. Citation: Marcomini KD, Fleury EFC, Schiabela H. Breast Cancer Classification: A CAD System for a Combined Use of Elastography and B-Mode Sonography. J Cancer Sci. 2020;7(1): 6. J Cancer Sci 7(1): 6 (2020) Page 02 ISSN: 2377-9292