{"title":"通过对 BI-RADS 3 和 4a 病变进行重新分类，利用超声应变弹性成像提高乳腺病变的诊断性能：一项多中心诊断研究。","authors":"Yang Gu, Jiawei Tian, Haitao Ran, Weidong Ren, Cai Chang, Jianjun Yuan, Chunsong Kang, Youbin Deng, Hui Wang, Baoming Luo, Shenglan Guo, Qi Zhou, Ensheng Xue, Weiwei Zhan, Qing Zhou, Jie Li, Ping Zhou, Chunquan Zhang, Man Chen, Ying Gu, Jinfeng Xu, Wu Chen, Yuhong Zhang, Jianchu Li, Hongyan Wang, Yuxin Jiang","doi":"10.1093/bjr/tqae197","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To investigate the added value of strain elastography (SE) by recategorizing ultrasound (US) Breast Imaging Reporting and Data System (BI-RADS) 3 and 4a lesions.</p><p><strong>Methods: </strong>A total of 4371 patients underwent US and SE with BI-RADS 2-5 categories solid breast lesions were included from thirty-two hospitals. We evaluated the elastographic images according to elasticity scores (ES) and strain ratios (SR). Three combined methods (BI-RADS+ES, BI-RADS+SR, BI-RADS+ES+SR) and two reclassified methods were used (method one: upgrading BI-RADS 3 and downgrading BI-RADS 4a, method two: downgrading BI-RADS 4a alone). The diagnostic performance and the potential reduction of unnecessary biopsies were evaluated.</p><p><strong>Results: </strong>Combining BI-RADS with SE had a higher area under the curve (AUC) than BI-RADS alone (0.822-0.898 vs. 0.794, P<0.01). For reclassified method one, the sensitivity, specificity, and accuracy were 99.36%, 66.70%, 78.36% for BI-RADS+ES and 98.01%, 66.45%, 77.72% for BI-RADS+SR, and 99.42%, 66.70%, 78.38% for BI-RADS+ES+SR, respectively. For reclassified method two, the sensitivity, specificity, and accuracy were 99.17%, 70.72%, 80.87% for BI-RADS+ES and 97.76%, 81.75%, 87.46% for BI-RADS+SR, and 99.23%, 69.83%, 80.32% for BI-RADS+ES+SR, respectively. Downgrading BI-RADS 4a alone had higher AUC, specificity, and accuracy (P<0.01) and similar sensitivity (P>0.05) to upgrading BI-RADS 3 and downgrading BI-RADS 4a. Combining SE with BI-RADS could help reduce unnecessary biopsies by 17.64%-55.20%.</p><p><strong>Conclusions: </strong>Combining BI-RADS with SE improved the diagnostic performance in distinguishing benign from malignant lesions and could decrease false-positive breast biopsy rates. Downgrading BI-RADS 4a lesions alone might be sufficient for achieving good diagnostic performance.</p><p><strong>Advances in knowledge: </strong>Downgrading BI-RADS category 4a lesions alone had higher AUC, specificity, and accuracy, and similar sensitivity to upgrading or downgrading BI-RADS category 3 and 4a lesions.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8000,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Ultrasound strain elastography to improve diagnostic performance of breast lesions by reclassifying BI-RADS 3 and 4a lesions: a multicenter diagnostic study.\",\"authors\":\"Yang Gu, Jiawei Tian, Haitao Ran, Weidong Ren, Cai Chang, Jianjun Yuan, Chunsong Kang, Youbin Deng, Hui Wang, Baoming Luo, Shenglan Guo, Qi Zhou, Ensheng Xue, Weiwei Zhan, Qing Zhou, Jie Li, Ping Zhou, Chunquan Zhang, Man Chen, Ying Gu, Jinfeng Xu, Wu Chen, Yuhong Zhang, Jianchu Li, Hongyan Wang, Yuxin Jiang\",\"doi\":\"10.1093/bjr/tqae197\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To investigate the added value of strain elastography (SE) by recategorizing ultrasound (US) Breast Imaging Reporting and Data System (BI-RADS) 3 and 4a lesions.</p><p><strong>Methods: </strong>A total of 4371 patients underwent US and SE with BI-RADS 2-5 categories solid breast lesions were included from thirty-two hospitals. We evaluated the elastographic images according to elasticity scores (ES) and strain ratios (SR). Three combined methods (BI-RADS+ES, BI-RADS+SR, BI-RADS+ES+SR) and two reclassified methods were used (method one: upgrading BI-RADS 3 and downgrading BI-RADS 4a, method two: downgrading BI-RADS 4a alone). The diagnostic performance and the potential reduction of unnecessary biopsies were evaluated.</p><p><strong>Results: </strong>Combining BI-RADS with SE had a higher area under the curve (AUC) than BI-RADS alone (0.822-0.898 vs. 0.794, P<0.01). For reclassified method one, the sensitivity, specificity, and accuracy were 99.36%, 66.70%, 78.36% for BI-RADS+ES and 98.01%, 66.45%, 77.72% for BI-RADS+SR, and 99.42%, 66.70%, 78.38% for BI-RADS+ES+SR, respectively. For reclassified method two, the sensitivity, specificity, and accuracy were 99.17%, 70.72%, 80.87% for BI-RADS+ES and 97.76%, 81.75%, 87.46% for BI-RADS+SR, and 99.23%, 69.83%, 80.32% for BI-RADS+ES+SR, respectively. Downgrading BI-RADS 4a alone had higher AUC, specificity, and accuracy (P<0.01) and similar sensitivity (P>0.05) to upgrading BI-RADS 3 and downgrading BI-RADS 4a. Combining SE with BI-RADS could help reduce unnecessary biopsies by 17.64%-55.20%.</p><p><strong>Conclusions: </strong>Combining BI-RADS with SE improved the diagnostic performance in distinguishing benign from malignant lesions and could decrease false-positive breast biopsy rates. Downgrading BI-RADS 4a lesions alone might be sufficient for achieving good diagnostic performance.</p><p><strong>Advances in knowledge: </strong>Downgrading BI-RADS category 4a lesions alone had higher AUC, specificity, and accuracy, and similar sensitivity to upgrading or downgrading BI-RADS category 3 and 4a lesions.</p>\",\"PeriodicalId\":9306,\"journal\":{\"name\":\"British Journal of Radiology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.8000,\"publicationDate\":\"2024-10-10\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"British Journal of Radiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1093/bjr/tqae197\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"British Journal of Radiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/bjr/tqae197","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
Ultrasound strain elastography to improve diagnostic performance of breast lesions by reclassifying BI-RADS 3 and 4a lesions: a multicenter diagnostic study.
Objective: To investigate the added value of strain elastography (SE) by recategorizing ultrasound (US) Breast Imaging Reporting and Data System (BI-RADS) 3 and 4a lesions.
Methods: A total of 4371 patients underwent US and SE with BI-RADS 2-5 categories solid breast lesions were included from thirty-two hospitals. We evaluated the elastographic images according to elasticity scores (ES) and strain ratios (SR). Three combined methods (BI-RADS+ES, BI-RADS+SR, BI-RADS+ES+SR) and two reclassified methods were used (method one: upgrading BI-RADS 3 and downgrading BI-RADS 4a, method two: downgrading BI-RADS 4a alone). The diagnostic performance and the potential reduction of unnecessary biopsies were evaluated.
Results: Combining BI-RADS with SE had a higher area under the curve (AUC) than BI-RADS alone (0.822-0.898 vs. 0.794, P<0.01). For reclassified method one, the sensitivity, specificity, and accuracy were 99.36%, 66.70%, 78.36% for BI-RADS+ES and 98.01%, 66.45%, 77.72% for BI-RADS+SR, and 99.42%, 66.70%, 78.38% for BI-RADS+ES+SR, respectively. For reclassified method two, the sensitivity, specificity, and accuracy were 99.17%, 70.72%, 80.87% for BI-RADS+ES and 97.76%, 81.75%, 87.46% for BI-RADS+SR, and 99.23%, 69.83%, 80.32% for BI-RADS+ES+SR, respectively. Downgrading BI-RADS 4a alone had higher AUC, specificity, and accuracy (P<0.01) and similar sensitivity (P>0.05) to upgrading BI-RADS 3 and downgrading BI-RADS 4a. Combining SE with BI-RADS could help reduce unnecessary biopsies by 17.64%-55.20%.
Conclusions: Combining BI-RADS with SE improved the diagnostic performance in distinguishing benign from malignant lesions and could decrease false-positive breast biopsy rates. Downgrading BI-RADS 4a lesions alone might be sufficient for achieving good diagnostic performance.
Advances in knowledge: Downgrading BI-RADS category 4a lesions alone had higher AUC, specificity, and accuracy, and similar sensitivity to upgrading or downgrading BI-RADS category 3 and 4a lesions.
期刊介绍：
BJR is the international research journal of the British Institute of Radiology and is the oldest scientific journal in the field of radiology and related sciences.
Dating back to 1896, BJR’s history is radiology’s history, and the journal has featured some landmark papers such as the first description of Computed Tomography "Computerized transverse axial tomography" by Godfrey Hounsfield in 1973. A valuable historical resource, the complete BJR archive has been digitized from 1896.
Quick Facts:
- 2015 Impact Factor – 1.840
- Receipt to first decision – average of 6 weeks
- Acceptance to online publication – average of 3 weeks
- ISSN: 0007-1285
- eISSN: 1748-880X
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