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. 2022 Nov 3:12:1049991.
doi: 10.3389/fonc.2022.1049991. eCollection 2022.

Ultrasound super-resolution imaging for differential diagnosis of breast masses

Ge Zhang  1   2 , Yu-Meng Lei  1 , Nan Li  1 , Jing Yu  1 , Xian-Yang Jiang  1 , Mei-Hui Yu  1 , Hai-Man Hu  3 , Shu-E Zeng  4 , Xin-Wu Cui  5 , Hua-Rong Ye  1
Affiliations

Ultrasound super-resolution imaging for differential diagnosis of breast masses

Ge Zhang et al. Front Oncol. .

Abstract

Objective: Ultrasound imaging has been widely used in breast cancer screening. Recently, ultrasound super-resolution imaging (SRI) has shown the capability to break the diffraction limit to display microvasculature. However, the application of SRI on differential diagnosis of breast masses remains unknown. Therefore, this study aims to evaluate the feasibility and clinical value of SRI for visualizing microvasculature and differential diagnosis of breast masses.

Methods: B mode, color-Doppler flow imaging (CDFI) and contrast-enhanced ultrasound (CEUS) images of 46 patients were collected respectively. SRI were generated by localizations of each possible contrast signals. Micro-vessel density (MVD) and microvascular flow rate (MFR) were calculated from SRI and time to peak (TTP), peak intensity (PI) and area under the curve (AUC) were obtained by quantitative analysis of CEUS images respectively. Pathological results were considered as the gold standard. Independent chi-square test and multivariate logistic regression analysis were performed using these parameters to examine the correlation.

Results: The results showed that SRI technique could be successfully applied on breast masses and display microvasculature at a significantly higher resolution than the conventional CDFI and CEUS images. The results showed that the PI, AUC, MVD and MFR of malignant breast masses were significantly higher than those of benign breast masses, while TTP was significantly lower than that of benign breast masses. Among all five parameters, MVD showed the highest positive correlation with the malignancy of breast masses.

Conclusions: SRI is able to successfully display the microvasculature of breast masses. Compared with CDFI and CEUS, SRI can provide additional morphological and functional information for breast masses. MVD has a great potential in assisting the differential diagnosis of breast masses as an important imaging marker.

Keywords: breast mass; contrast-enhanced ultrasound; differential diagnosis; super-resolution imaging; ultrasound.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of data acquisition.
Figure 2
Figure 2
Ultrasound images of benign and malignant breast masses respectively. (A, G) Color-Doppler flow images of benign and malignant breast masses respectively; (B, K) super-resolution images of benign and malignant breast masses respectively; (C, I) super-resolved velocity images of benign and malignant breast masses respectively. (D–F) Zoomed-in sections as the yellow box indicated in (A–C); (J–L) Zoomed-in sections as the yellow box indicated in (G–I).
Figure 3
Figure 3
Ultrasound images of a representative benign breast mass. (A) B-mode image. (B) Contrast-enhanced ultrasound image. (C) Super-resolution image. (D) Super-resolved velocity image. (E–H) Shows the zoomed-in regions of (A–D) as the red box indicated in (A). Yellow lines in (E–H) highlight the resolution improvement among the images.
Figure 4
Figure 4
Ultrasound images of a representative malignant breast mass. (A) B-mode image. (B) Contrast-enhanced ultrasound image. (C) Super-resolution image. (D) Super-resolved velocity image. (E–H) shows the zoomed-in regions of (A–D) as the red box indicated in (A). Yellow lines in (E–H) highlight the resolution improvement among the images.
Figure 5
Figure 5
The box plot shows the quantification of microvascular flow rate (A) and micro-vessel density (B) measured in the super-resolution imaging between benign and malignant breast masses.
See this image and copyright information in PMC

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