Scholarlink

Background <p>Multiparametric ultrasound (mpUS) integrates BI-RADS (Breast Imaging Report And Data System) morphological assessment with biomechanical biomarkers, including strain elastography (SE) and shear-wave elastography (SWE), along with microvascular flow (M-Flow). Furthermore real-time computer-aided diagnosis (CAD/AI) systems, including Live Breast Assist and S-Detect are employed to standardize image interpretation, thereby reducing operator dependence.</p> Purpose <p>To evaluate the diagnostic accuracy and reproducibility of mpUS supported by CAD/AI versus B-mode ultrasound alone, assessing their concordance with histopathology for the benign/malignant dichotomy and the incremental contribution of SE, SWE, and M-Flow. Additionally inter-operator agreement was quantified.</p> Materials and methods <p>In this single-center prospective study 78 consecutive patients presenting with 78 breast lesions, underwent B-mode/BI-RADS evaluation, Color Doppler, M-Flow (percentage of vascularization), SE (strain ratio), and SWE (quantitative stiffness in kPa). Live Breast Assist was semi-automatically employed during data acquisition, while S-Detect provided focal lesion characterization when deemed necessary. Histopathological examination served as the gold standard.</p> Results <p>Histology identified 60 malignancies (76.9%) and 18 benign lesions (23.1%).The highest diagnostic performance was shown by M-Flow (AUC 0.926), reaching 95.1% of sensitivity and 82.4% of specificity. SE also showed strong discriminative ability (AUC 0.885). SWE exhibited lower accuracy (AUC 0.658). B-mode alone achieved an AUC of 0.864. Although with a higher false-negative rate compared with the expert operator, Live Breast Assist demonstrated high specificity (88.2%) and an excellent PPV (96.4%). Inter-operator agreement was substantial (<i>κ</i> = 0.63).</p> Conclusion <p>mpUS with CAD/AI support enhanced diagnostic accuracy and reproducibility for benign/malignant distinction, providing robust biomechanical and vascular biomarkers. This approach may reduce unnecessary biopsies in indeterminate BI-RADS lesions, though tumor grading remains the purview of pathology.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Can new ultrasound imaging techniques improve breast lesions characterization?: prospective comparison between ultrasound BI-RADS, histological result, semi-automatic software—“Live BreastAssist”, strain elastography, shear wave elastography and microvascular flow

  • 期刊论文

  • 发表日期：

    2026年1月19日

查看全文
  • Giacomo Bonito,
  • Maurizio Renda,
  • Silvia Gigli,
  • Emanuele David,
  • Patrizi Pacini,
  • Antonio Sili Scavalli,
  • Antonino Bella,
  • Gianmarco Lo Conte,
  • Bianca Rosini,
  • Arenta Shkelqimi,
  • Vito D’Andrea,
  • Vito Cantisani,
  • Federica Pediconi,
  • Corrado Caiazzo

摘要

Background

Multiparametric ultrasound (mpUS) integrates BI-RADS (Breast Imaging Report And Data System) morphological assessment with biomechanical biomarkers, including strain elastography (SE) and shear-wave elastography (SWE), along with microvascular flow (M-Flow). Furthermore real-time computer-aided diagnosis (CAD/AI) systems, including Live Breast Assist and S-Detect are employed to standardize image interpretation, thereby reducing operator dependence.

Purpose

To evaluate the diagnostic accuracy and reproducibility of mpUS supported by CAD/AI versus B-mode ultrasound alone, assessing their concordance with histopathology for the benign/malignant dichotomy and the incremental contribution of SE, SWE, and M-Flow. Additionally inter-operator agreement was quantified.

Materials and methods

In this single-center prospective study 78 consecutive patients presenting with 78 breast lesions, underwent B-mode/BI-RADS evaluation, Color Doppler, M-Flow (percentage of vascularization), SE (strain ratio), and SWE (quantitative stiffness in kPa). Live Breast Assist was semi-automatically employed during data acquisition, while S-Detect provided focal lesion characterization when deemed necessary. Histopathological examination served as the gold standard.

Results

Histology identified 60 malignancies (76.9%) and 18 benign lesions (23.1%).The highest diagnostic performance was shown by M-Flow (AUC 0.926), reaching 95.1% of sensitivity and 82.4% of specificity. SE also showed strong discriminative ability (AUC 0.885). SWE exhibited lower accuracy (AUC 0.658). B-mode alone achieved an AUC of 0.864. Although with a higher false-negative rate compared with the expert operator, Live Breast Assist demonstrated high specificity (88.2%) and an excellent PPV (96.4%). Inter-operator agreement was substantial (κ = 0.63).

Conclusion

mpUS with CAD/AI support enhanced diagnostic accuracy and reproducibility for benign/malignant distinction, providing robust biomechanical and vascular biomarkers. This approach may reduce unnecessary biopsies in indeterminate BI-RADS lesions, though tumor grading remains the purview of pathology.