Incorporating Contrast-Enhanced Ultrasound into the BI-RADS Scoring System Improves Accuracy in Breast Tumor Diagnosis: A Preliminary Study in China

Abstract

The aim of the study was to develop a scoring model incorporating the Breast Imaging Reporting and Data System (BI-RADS) and the contrast-enhanced ultrasound (CEUS) scoring system to differentiate between malignant and benign breast lesions. A total of 524 solid breast masses in 490 consecutive patients were evaluated with conventional US and CEUS in this prospective study. Each lesion was scored according to BI-RADS, CEUS, and CEUS-rerated BI-RADS. The diagnostic specificity, sensitivity and accuracy of BI-RADS were 77.9%, 88.9% and 84.0%, respectively, and the area under the receiver operating characteristic curve was 0.834. The corresponding values for rerated BI-RADS were 82.1%, 96.9%, 90.3% and 0.895. The area under the receiver operating characteristic curve of BI-RADS alone was significantly smaller than that of CEUS and the rerated BI-RADS (p = 0.008 compared with CEUS, p = 0.002 compared with rerated BI-RADS). This study indicates that rerating BI-RADS with the CEUS scoring system improves its diagnostic accuracy.

Keywords: Breast tumors; Contrast agents; Differential diagnosis; Receiver operating characteristic curve; Ultrasonography.