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. 2019 Jun 13:11:5481-5487.
doi: 10.2147/CMAR.S203376. eCollection 2019.

Vascular index measured by smart 3-D superb microvascular imaging can help to differentiate malignant and benign breast lesion

Xiao-Yan Zhang  1 , Li Zhang  1 , Na Li  1 , Qing-Li Zhu  1 , Jian-Chu Li  1 , Qiang Sun  2 , Hong-Yan Wang #  1 , Yu-Xin Jiang #  1
Affiliations

Vascular index measured by smart 3-D superb microvascular imaging can help to differentiate malignant and benign breast lesion

Xiao-Yan Zhang et al. Cancer Manag Res. .

Abstract

Purpose: The purpose of our study was to prospectively evaluate the diagnostic performance of the vascular index (VI, defined as the ratio of Doppler signal pixels to pixels in the total lesion) measured via Smart 3-D superb microvascular imaging (SMI) for breast lesions. Patients and methods: Two hundred and thirty-two consecutive patients with 236 breast lesions referred for biopsy at Peking Union Medical College Hospital were enrolled in the study from December 2016 to November 2017. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of VI were calculated with histopathologic results as the reference standard. Results: Of the 236 breast lesions, 121 were malignant and 115 were benign. The mean VI was significantly higher in malignant lesions (9.7±8.2) than that in benign ones (3.4±3.3) (P<0.0001). Sensitivity, specificity, PPV, NPV and accuracy of VI (4.0 as the threshold) were respectively: 76.0%, 66.1%, 70.2%, 72.4% and 71.2% (P<0.05). Conclusion: Smart three-dimensional (3-D) SMI is a noninvasive tool using two-dimensional (2-D) scanning to generate 3-D vascular architecture with a high-resolution image of micro-vessels. This can be used as a qualitative guide to identify the optimal 2-D SMI plane with the most abundant vasculature to guide VI quantitative measurements of breast lesions. Smart 3-D SMI may potentially serve as a noninvasive tool to accurately characterize benign versus malignant breast lesions.

Keywords: breast neoplasms; diagnostic imaging; superb microvascular imaging; ultrasonography.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Scatter plot shows vascular index (VI) distribution in 236 malignant and benign lesions. Patients’ codes are shown on the horizontal axis. Red dots represent malignant lesions and blue dots benign ones.
Figure 2
Figure 2
Box plot of vascular index distribution in 236 breast lesions. The mean vascular index (VI) was significantly higher in patients with malignant breast lesions (mean VI 9.7±8.2, range 0–48) than that in patients with benign breast lesions (mean VI 3.4±3.3, range 0–15.9) (P<0.0001).
Figure 3
Figure 3
A 34-year-old woman with invasive ductal carcinoma. (A) Color Doppler flow image shows abundant and disordered blood flow signals. (B and C) Smart three-dimensional superb microvascular imaging reveals detailed and abundant vascular architecture with crab claw-like blood flow. (D) Vascular index was measured on the plane containing the most abundant vasculature with a value of 19.8.
Figure 4
Figure 4
A 20-year-old woman with fibroadenoma. (A) Color Doppler flow imaging image shows few blood flow signals. (B and C) Smart three-dimensional superb microvascular imaging reveals few spots and linear blood flow. (D) Vascular index was measured on the plane containing the most abundant vasculature with a value of 0.3.
See this image and copyright information in PMC

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