RSNA 2016

Abstract Archives of the RSNA, 2016


SSA02-02

Comparison of Automated Volume Breast Ultrasound to Hand Held Ultrasound for Diagnostic Breast Ultrasound Work-Up

Sunday, Nov. 27 10:55AM - 11:05AM Room: N228



Richard G. Barr, MD, PhD, Youngstown, OH (Presenter) Consultant, Siemens AG; Consultant, Koninklijke Philips NV; Research Grant, Siemens AG; Research Grant, SuperSonic Imagine; Speakers Bureau, Koninklijke Philips NV; Research Grant, Bracco Group; Speakers Bureau, Siemens AG; Consultant, Toshiba Corporation; Research Grant, Esaote SpA; Research Grant, B and K Ultrasound; Research Grant, Hitachi Aloka Ultrasound
Robert DeVita, McDonald, OH (Abstract Co-Author) Nothing to Disclose
Stamatia V. Destounis, MD, Scottsville, NY (Abstract Co-Author) Nothing to Disclose
Federica Manzoni, PhD, Pavia, Italy (Abstract Co-Author) Nothing to Disclose
Annalisa DeSilvestri, PhD, Pavia, Italy (Abstract Co-Author) Nothing to Disclose
Carmine Tinelli, MD, MSC, Pavia, Italy (Abstract Co-Author) Nothing to Disclose
PURPOSE

To compare the diagnostic accuracy and inter-observer variability of a hand held US (HH) and a single volume using AVBS centered over the clinical abnormality and to compare if there is a significant difference if the AVBS is performed by a sonographer (UT)or mammography technologist (MT).

METHOD AND MATERIALS

90 patients (age 53.1 years +/- 16.3) receiving a diagnostic US for a palpable mass (60), mammogram abnormality (25), follow-up study (1) or breast discharge (4) were enrolled in this HIPPA compliant, IRB approved study. Patients were randomized to have either a HH or AVBS first. HH was performed using a 14MHz transducer. The AVBS was performed using a L15-9 transducer. The technician performing the second study was blinded to results of the first exam. The AVBS was randomized between a UT and a MT. The studies were blinded, randomized and read by two radiologists each with greater than 10 years experience in breast ultrasound. The lesion with the highest BI-RADS score was used in the analysis. The HH studies were read 6 month before the AVBUS studies. Final diagnoses where made by core biopsy for follow-up for 2 years. Lesions included 9 malignant lesions and 81 benign lesions.

RESULTS

The K for benign/malignant was 0.831 (95% CI 0.744-0.925) while the global agreement using a 7-point BI-RADS score was 0.488 (95% CI 0.372-0.560). The K agreement between AVBS and HH in detecting breast pathology was 0.831 (95% CI 0.717-0.945). The first rater had a K of 0.910 (0.787-1.000) while the second 0.760 (0.578-0.943). The agreement between AVBS and HH was nearly the same when AVBS was performed by a MT (K=0.858 (0.723-0.963)) or UT (k=0.803(0.596-1.000)), p=0.47. The AUC for lesion characterization was AVBS reader 1 0.91 (0.84-0.96), AVBS reader 2 0.91 (0.83-0.96), HH reader 1 0.91 (0.84-0.96) and HH reader 2 0.83(0.74-0.90) with no statistical difference. The inter-observer agreement based on BIRADS was 0.568(0.468-0.647), with the HH k of 0.631(0.584-0.665) and for AVBS 0.492(0.457-0.564). The agreement based on pathology was K=0.831(0.718-0.944) with HH K=0.795 (0.623-0.967) and AVBS 0.869 (0.725-1.000).

CONCLUSION

Performing a one view diagnostic AVBS is equivalent to performing a HH (p=0.47) in diagnostic US work-up. There is no difference if the AVBS is performed by a trained UT or MT.

CLINICAL RELEVANCE/APPLICATION

For Diagnostic US workup HH and AVBS performed by a UT or MT are statistically equivalent.