Characterization of benign and malignant solid breast masses: comparison of conventional US and tissue harmonic imaging

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Cha, Joo Hee; Moon, Woo Kyung; Cho, Nariya; Kim, Sun Mi; Park, Seong Ho; Han, Boo-Kyung; Choe, Yeon Hyeon; Park, Jeong Mi; Im, Jung-Gi
Issue Date
Radiological Society of North America
Radiology 2007;242:63-69
AdultAgedBreast Neoplasms/*classification/*ultrasonographyFemaleHumansImage Enhancement/*methodsMiddle AgedObserver VariationReproducibility of ResultsSensitivity and SpecificityUltrasonography, Mammary/methods
PURPOSE: To prospectively compare the diagnostic performance of radiologists by using conventional ultrasonography (US) and tissue harmonic imaging for the differentiation of benign from malignant solid breast masses, with histologic results used as the reference standard. MATERIALS AND METHODS: The study was approved by the institutional review board, and informed consent was obtained from all patients. Images were obtained with conventional US and tissue harmonic imaging in 88 patients (age range, 25-67 years; mean age, 45 years) with 91 solid breast masses (30 cancers and 61 benign lesions) before excisional or needle biopsy. Three experienced radiologists, who did not perform the examinations, independently analyzed the US findings and provided a level of suspicion to indicate the probability of malignancy. Results were evaluated by using kappa statistics and receiver operating characteristic (ROC) analyses. RESULTS: Regarding the descriptions of US findings, echogenicity (kappa=0.205) was the most discordant between conventional US and tissue harmonic imaging, followed by margin (kappa=0.495), lesion boundary (kappa=0.495), calcifications (kappa=0.537), posterior acoustic transmission (kappa=0.546), echotexture (kappa=0.586), shape (kappa=0.591), and orientation (kappa=0.594). The area under the ROC curve (Az) for conventional US and tissue harmonic imaging was 0.84 and 0.79, respectively, for reader 1; 0.88 and 0.85, respectively, for reader 2; and 0.91 and 0.89, respectively, for reader 3. The overall Az value for the three readers was 0.88 for conventional US and 0.84 for tissue harmonic imaging (95% confidence interval: -0.0950, 0.1646; P=.595). CONCLUSION: The performance of the radiologists with respect to the characterization of solid breast masses as benign or malignant was not significantly improved with tissue harmonic imaging.
0033-8419 (Print)
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College of Medicine/School of Medicine (의과대학/대학원)Dept. of Radiation Applied Life Science (대학원 협동과정 방사선응용생명과학전공)Journal Papers (저널논문_방사선응용생명과학)
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