Yeon Hwa Yoo MD, Presenter: Nothing to Disclose

Sungjun Kim, Abstract Co-Author: Nothing to Disclose

Jeong Seon Park MD, Abstract Co-Author: Nothing to Disclose

Jeong Ah Ryu MD, PhD, Abstract Co-Author: Nothing to Disclose

Doo Hoe Ha MD, Abstract Co-Author: Nothing to Disclose

Kyu-Sung Kwack, Abstract Co-Author: Nothing to Disclose

Choon Sik Yoon, Abstract Co-Author: Nothing to Disclose

Jin-Suck Suh MD, Abstract Co-Author: Nothing to Disclose

To determine which mode of ultrasonography (US) among compound (CP), tissue-harmonic (TH), and conventional (CV) ones is best in triage performance of soft tissue mass-like lesions in terms of differentiating cysts from solid lesions.

A total of 45 patients, whose soft tissue masses were pathologically confirmed later, underwent preoperative US performed in the 4 different modes of CP, TH, CP with TH (CP-TH), and CV. The representative images from each mode were reviewed by two musculoskeletal radiologists, who did not perform US, in consensus with 2-month intervals between review sessions. The observers scored confidence for interpreting a lesion as a cyst using a 5-point scale in probability order from 1 (definitely solid) to 5 (definitely cyst) based on traditional US criteria. The observers also categorized the lesions into 6 category from 1 (benign cystic lesion) to 6 (indeterminate solid mass). Diagnostic performances of each mode in discerning cysts from solid lesions were analyzed through the ROC curve analysis, and areas under the curves (AUCs) were compared each other. Sensitivity and specificity of each mode in interpreting cysts were calculated considering scores of 4 or 5 as positive results. Categorization performances were assessed through concordance rates between the US interpretation and pathologic confirmation. The concordance rates were compared between the modes through kappa test.

AUCs of set CP, TH, CP-TH, and CV were 0.961, 0.893, 0.944, 0.921 respectively, but differences of the values between the modes were statistically insignificant. Sensitivity/Specificity (%) of set CP, TH, CP-TH, and CV were 91.3(21/23)/100(22/22), 95.7(22/23)/68.2(15/22), 95.7(22/23)/72.7(16/22) 95.7(22/23)/77.3(17/22). Specificity of set CP was higher than those of the remaining sets significantly. Concordance rates of CP, TH, CP-TH, and CV between US interpretation and pathologic reference standards were 80%, 73.3%, 73.3%, 75.6 % respectively, but statistically significant differences between the values were not found.

Compound mode of US is most suitable in differentiating cysts from solid lesions, albeit overall triage is not affected by the US modes.  

In the US triage of soft tissue mass-like lesions, compound mode is most suitable as a primary mode in terms of its superiority differentiating cysts from solid lesions.

Yoo, Y, Kim, S, Park, J, Ryu, J, Ha, D, Kwack, K, Yoon, C, Suh, J, Comparison of Triaging Performance of Ultrasonography among Conventional, Compound, and Tissue-harmonic Nodes in the Evaluation of Soft Tissue Mass-like Lesions: Determining the most Suitable Mode.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9012921.html