The Diagnostic Significance of the BI-RADS Classification Combined With Automated Breast Volume Scanner and Shear Wave Elastography for Breast Lesions

Abstract

Objective: We herein compared the diagnostic accuracy of the BI-RADS, ABVS, SWE, and combined techniques for the classification of breast lesions.

Methods: Breast lesions were appraised using the BI-RADS classification system as well as the combinations of BI-RADS plus ABVS (BI-RADS + ABVS) and BI-RADS plus SWE (BI-RADS + SWE), and both methods (BI-RADS + ABVS + SWE) by two specialties Medical Ultrasound physician. The Fisher's exact and χ² tests were performed to compare the degree of malignancy for the various methods with a pathology ground truth. Receiver operating characteristic curves (ROC) were generated and the corresponding area under the curve (AUC) values were determined to test the diagnostic efficacy of the various methods and identify the optimal SWE cut-off indicative of malignancy.

Results: The incidence of the retraction phenomenon on ABVS images of the malignant group was significantly higher (P < .001) than that of the benign group. The specificity, sensitivity, and positive and negative predictive values of the BI-RADS classification were 88.72, 79.38, 83.70, and 85.50%, respectively. BI-RADS plus SWE-Max exhibited enhanced specificity, sensitivity, and positive and negative predictive values of 88.72, 92.78, 85.70, and 94.40%, respectively. Similarly, when BI-RADS + ABVS was utilized, the sensitivity and negative predictive value increased to 95.88 and 96.40%, respectively. BI-RADS + ABVS + SWE possessed the highest overall sensitivity (96.91%), specificity (94.74%), and positive (93.10%) and negative (97.70%) predictive values from all four indices.

Conclusion: ABVS and SWE can reduce the subjectivity of BI-RADS. As a result, BI-RADS + ABVS + SWE resulted in the best diagnostic accuracy.

Keywords: BI-RADS classification; automated breast volume scanner; breast lesion; shear wave elastography.