Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2020 Aug;93(1112):20200195.
doi: 10.1259/bjr.20200195. Epub 2020 Jun 2.

Does contrast-enhanced ultrasound (CEUS) play a better role in diagnosis of breast lesions with calcification? A comparison with MRI

Jiamin Pan  1 , Wenjuan Tong  1 , Jia Luo  1 , Jinyu Liang  1 , Fushun Pan  1 , Yanling Zheng  1 , Xiaoyan Xie  1
Affiliations
Comparative Study

Does contrast-enhanced ultrasound (CEUS) play a better role in diagnosis of breast lesions with calcification? A comparison with MRI

Jiamin Pan et al. Br J Radiol. 2020 Aug.

Abstract

Objective: To compare the efficacy of contrast-enhanced ultrasound enabled reclassification of Breast Imaging Reporting and Data System (CEUS-BI-RADS) with MRI in the diagnosis of breast lesions with calcification.

Methods: A total of 52 breast lesions with calcification from 51 patients were detected by ultrasound as hyperechoic foci and categorized as BI-RADS 3-5. The 51 patients further underwent CEUS scan and MRI. The ultrasound-BI-RADS combined with CEUS 5-point score system redefined the classification of BI-RADS which was called CEUS-BI-RADS. The diagnostic efficacy of three methods was assessed by receiver operating characteristic (ROC) curve analysis. Histopathological assessment used as the gold-standard.

Results: The sensitivities of Ultrasound-BI-RADS, MRI classification of BI-RADS (MRI-BI-RADS) and CEUS-BI-RADS were 85%, 90% and 95% without significant difference among the three modalities (p > 0.05). The diagnostic specificities of ultrasound-BI-RADS, MRI-BI-RADS and CEUS-BI-RADS were 78.1%, 78.1% and 96.8%, respectively (p < 0.05); and the accuracy were 80.7%, 82.6% and 96.1% for ultrasound-BI-RADS, MRI-BI-RADS and CEUS-BI-RADS, respectively (p < 0.05). The area under ROC (AUROC) in differentiation of breast lesions with calcification was 0.945 for CEUS-BI-RADS, 0.907 for MRI-BI-RADS and 0.853 for ultrasound-BI-RADS, with no significant difference among the three modalities (p > 0.05).

Conclusion: The CEUS-BI-RADS has a better diagnostic efficiency than MRI-BI-RADS in the differentiation of the breast lesions with calcification.

Advances in knowledge: •CEUS is a better method in differentiation of breast lesions with calcification.•CEUS-BI-RADS increases the efficiency of diagnosis compared to MRI.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
A 45-years-old female with an invasive ductal carcinoma, diffuse spotty breast calcifications in the right side. (a/b) Ultrasound scans of the breast lesion categorized as ultrasound-BI-RADS 4A. (c) On CEUS dual image mode, lesion was reclassified as CEUS-BI-RADS 4B. (d) The lesion was categorized as MRI-BI-RADS 4B, all pointing to a malignant lesion. (lesion marked with‘↑’, area of CEUS enhancement was marked with white‘▲’). CEUS-BI-RADS, contrast-enhanced ultrasound reclassification of Breast Imaging Reporting and Data System.
Figure 2.
Figure 2.
A 33-years-old female with breast usual ductal hyperplasia, found breast lesion in the right side for 1 month after bilateral ovarian cancer resection. (a/b) Ultrasound scans of the breast lesion categorized as ultrasound-BI-RADS 4B. (c) On CEUS dual image mode, the lesion was reclassified as CEUS-BI-RADS 3. (d) The lesion was categorized as MRI-BI-RADS 4B by MRI. Both of ultrasound and MRI pointed to a malignant lesion. (lesion marked with‘↑’, area of CEUS enhancement was marked with white‘▲’). CEUS-BI-RADS, contrast-enhanced ultrasound reclassification of Breast Imaging Reporting and Data System.
Figure 3.
Figure 3.
ROC curves representing the diagnostic efficacy of ultrasound-BI-RADS, CEUS-BI-RADS and MRI-BI-RADS for all of 52 breast lesions with calcification. The areas under the receiver operating characteristic curve for ultrasound-BI-RADS, CEUS-BI-RADS and MRI-BI-RADS were 0.853, 0.945 and 0.907, respectively.. CEUS-BI-RADS, contrast-enhanced ultrasound reclassification of Breast Imaging Reporting and Data System.
See this image and copyright information in PMC

References

    1. Xiao X, Dong L, Jiang Q, Guan X, Wu H, Luo B. Incorporating contrast-enhanced ultrasound into the BI-RADS scoring system improves accuracy in breast tumor diagnosis: a preliminary study in China. Ultrasound Med Biol 2016; 42: 2630–8. doi: 10.1016/j.ultrasmedbio.2016.07.005 - DOI - PubMed
    1. Bonfiglio R, Scimeca M, Toschi N, Pistolese CA, Giannini E, Antonacci C, et al. Radiological, histological and chemical analysis of breast microcalcifications: diagnostic value and biological significance. J Mammary Gland Biol Neoplasia 2018; 23(1-2): 89–99. doi: 10.1007/s10911-018-9396-0 - DOI - PubMed
    1. Delorme S. Ultrasound in oncology: screening and staging. Internist 2012; 53: 271–81. doi: 10.1007/s00108-011-2958-5 - DOI - PubMed
    1. Du J, Wang L, Wan C-F, Hua J, Fang H, Chen J, et al. Differentiating benign from malignant solid breast lesions: combined utility of conventional ultrasound and contrast-enhanced ultrasound in comparison with magnetic resonance imaging. Eur J Radiol 2012; 81: 3890–9. doi: 10.1016/j.ejrad.2012.09.004 - DOI - PubMed
    1. Xu H-X. Contrast-Enhanced ultrasound: the evolving applications. World J Radiol 2009; 1: 15–24. doi: 10.4329/wjr.v1.i1.15 - DOI - PMC - PubMed

Publication types