Michael Herbert Fuchsjaeger MD, Presenter: Nothing to Disclose

Ansgar Malich MD, Abstract Co-Author: Nothing to Disclose

Thomas Christian Diebold MD, Abstract Co-Author: Nothing to Disclose

Thomas Josef Vogl MD, Abstract Co-Author: Nothing to Disclose

Werner Alois Kaiser MD, PhD, Abstract Co-Author: Nothing to Disclose

Thomas Helbich MD, Abstract Co-Author: Nothing to Disclose

To assess a new algorithm based software post-processing technique on electrical impedance scanning (EIS) for non-invasive characterization of malignant and benign breast lesions.

545 mammographically and/or sonographically equivocal or suspicious breast lesions (BI-RADS® III-V) in 484 women (mean age 53.7+/-12.9ys) were evaluated with EIS (TransScan TS2000®, TransScan Medical, Israel, Siemens-Elema, Sweden). The software under evaluation features a post-processing function with colored indicator bar representing 5 levels of suspicion. This algorithm takes into account data across 7 frequencies, including the critical frequency at 5,000 Hz, the nipple recording, presence or absence of a high conductivity focal spot and the patient's age. We also used a 5-level, BI-RADS-like level of suspicion (LOS) scoring method for evaluation of sonography (1-negative, 2-benign finding, 3-probably benign finding, 4-suspicious abnormality, 5-highly suggestive of malignancy). For all modalities, LOS 1,2 and 3 were considered negative, LOS 4 and 5 were considered as positive. Histopathologic correlation was obtained in all cases.

Histology proved 228 lesions to be malignant, 317 benign. EIS achieved a sensitivity of 82.5% (188/228 true positive), a specificity of 58.9% (187/317 true negative). PPV and NPV were 59.1% and 84.4% respectively.Mean lesion size was 15.1 mm (3-69 mm). Sensitivity in lesions 6- 10 mm in size (n=75 cancers) was 92.0% but lower for smaller and larger cancers. Sensitivity was also higher in post-menopausal patients (90.1%; n=146) and at depth < 10 mm (87.4%;n=99 cancers). ROC-analysis revealed a larger area under the curve for the combination of mammography, ultrasound and EIS than for mammography and ultrasound alone.

Our results suggest that EIS may be of use in lesion differentiation, particularly in small lesions, in shallow-lying lesions and in post-menopausal patients. Highest diagnostic accurracy may be achieved by a combination mammography, ultrasound and EIS.

Fuchsjaeger, M, Malich, A, Diebold, T, Vogl, T, Kaiser, W, Helbich, T, Electrical Impedance Scanning Multicenter Trial: Adjunctive Value to Mammography and Ultrasound for the Differentiation of Malignant from Benign Breast Lesions.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4415950.html