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Review
. 2020 Jun;23(2):207-215.
doi: 10.1007/s40477-020-00447-w. Epub 2020 Mar 17.

S-Detect characterization of focal breast lesions according to the US BI RADS lexicon: a pictorial essay

Tommaso Vincenzo Bartolotta  1   2 , Alessia Angela Maria Orlando  3 , Luigi Spatafora  1 , Mariangela Dimarco  1 , Cesare Gagliardo  1 , Adele Taibbi  1
Affiliations
Review

S-Detect characterization of focal breast lesions according to the US BI RADS lexicon: a pictorial essay

Tommaso Vincenzo Bartolotta et al. J Ultrasound. 2020 Jun.

Abstract

High-resolution ultrasonography (US) is a valuable tool in breast imaging. Nevertheless, US is an operator-dependent technique: to overcome this issue, the American College of Radiology (ACR) has developed the breast imaging-reporting and data system (BI-RADS) US lexicon. Despite this effort, the variability in the assessment of focal breast lesions (FBLs) with the use of BI-RADS US lexicon is still an issue. Within this framework, evidence shows that computer-aided image analysis may be effective in improving the radiologist's assessment of FBLs. In particular, S-Detect is a newly developed image-analytic computer program that provides assistance in morphologic analysis of FBLs seen on US according to the BI-RADS US lexicon. This pictorial essay describes state-of-the-art of sonographic characterization of FBLs by using S-Detect.

Keywords: BI-RADS; Breast neoplasms; Computer-assisted diagnosis; Decision-making; Problem-solving; Ultrasonography.

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Conflict of interest statement

Tommaso Vincenzo Bartolotta is lecturer and scientific advisor for Samsung. Other authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
BI-RADS 2. In a 28-year-old-woman, with palpable right breast lump, B-mode US depicts a 3 cm FBL. According to BI-RADS lexicon, with S-Detect (green line contour) this FBL was classified as oval-shaped, with parallel orientation and circumscribed margins (arrow). The echo pattern was judged anechoic, with enhancement as posterior feature. Final diagnosis: simple cyst
Fig. 2
Fig. 2
BI-RADS 3. In a 35-year-old-woman, B-mode US shows a 6 mm FBL. According to BI-RADS lexicon, with S-Detect (green line contour) this FBL was assessed as round-shaped, with not parallel orientation and circumscribed margins (arrow). The echo pattern was assessed as hypoechoic, with enhancement as posterior feature. Final diagnosis: complicated cyst
Fig. 3
Fig. 3
BI-RADS 3. In a 32-year-old-woman, with palpable right breast lump, B-mode US depicted a 2.6 cm FBL. According to BI-RADS lexicon, with S-Detect (green line contour) this FBL was classified as oval-shaped, with parallel orientation and circumscribed margins (arrow). The echo pattern was assessed as hypoechoic, with no posterior features. Final diagnosis: fibroadenoma
Fig. 4
Fig. 4
BI-RADS 3. In a 38-year-old-woman, B-mode US showed a 1.3 cm FBL in her left breast. According to BI-RADS lexicon, with S-Detect (green line contour) this FBL was classified as irregular-shaped, with parallel orientation and microlobulated margins. The echo pattern was assessed as complex echogenicity, with no posterior features. Final diagnosis: clustered microcysts
Fig. 5
Fig. 5
BI-RADS 4a. In a 40-year-old-woman, with a history of multiple bilateral fibroadenomas and a new palpable left breast lump, B-mode US showed a 9 mm FBL. According to BI-RADS lexicon, with S-Detect (green line contour) this FBL was evaluated as an oval-shaped hypoechoic mass with parallel orientation (arrow). Margins were partially circumscribed (< 75%) and partially microlobulated (curved arrow). Core-needle biopsy proved the mass to be a fibroadenoma
Fig. 6
Fig. 6
BI-RADS 4a. In a 47-year-old-woman, with a palpable left breast lump, B-mode US showed a 3.4 cm FBL. According to BI-RADS, with S-Detect (green line contour) this FBL was described as an oval-shaped hypoechoic mass with parallel orientation and enhancement as posterior feature (arrow). Margins were partially circumscribed (< 75%) and partially indistinct. Core-needle biopsy proved the mass to be a mucinous carcinoma
Fig. 7
Fig. 7
BI-RADS 4b. In a 43-year-old-woman, with a palpable left breast lump, B-mode US depicted a 2 cm FBL. According to BI-RADS lexicon, with S-Detect (green line contour) this FBL was assessed as an oval-shaped hypoechoic mass with parallel orientation and enhancement as posterior feature (arrow). Margins were not circumscribed, indistinct and microlobulated. Core-needle biopsy proved the mass to be a medullary breast carcinoma
Fig. 8
Fig. 8
BI-RADS 4c. In a 50-year-old-woman, with a palpable left breast lump, B-mode US depicted a 1.6 cm FBL. According to BI-RADS lexicon, with S-Detect (green line contour) this FBL was judged as an irregular-shaped hypoechoic mass with angular margins, not parallel orientation and no posterior features (arrow). Core-needle biopsy proved the mass to be an invasive ductal breast carcinoma
Fig. 9
Fig. 9
BI-RADS 5. In a 41-year-old-woman, with a palpable left breast lump, B-mode US showed a 1.3 cm FBL. According to BI-RADS lexicon, with S-Detect (green line contour) this FBL was classified as an irregular-shaped hypoechoic mass with spiculated margins, not parallel orientation and no posterior features (arrow). Core-needle biopsy proved the mass to be an invasive ductal breast carcinoma.
Fig. 10
Fig. 10
BI-RADS 5. In a 55-year-old-woman, with a palpable left breast lump, B-mode US depicted a 1.4 cm FBL. According to BI-RADS lexicon, with S-Detect (green line contour) this FBL was judged as an irregular-shaped hypoechoic mass with spiculated margins, parallel orientation and no posterior features (arrow). Core-needle biopsy proved the mass to be an invasive ductal breast carcinoma
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