Jan Van Zelst, Presenter: Nothing to Disclose

Tao Tan, Abstract Co-Author: Research Grant, QView Medical, Inc

Bram Platel PhD, Abstract Co-Author: Nothing to Disclose

Nico Karssemeijer PhD, Abstract Co-Author: Shareholder, Matakina International Limited Scientific Board, Matakina International Limited Shareholder, QView Medical, Inc Research Grant, Riverain Medical

Ritse Maarten Mann MD, PhD, Abstract Co-Author: Speakers Bureau, Bayer AG

To investigate the value of coronal reconstructions of transversal 3D ABUS data in differentiation of benign from malignant breast lesions.

This study received a waiver by the local ethics committee. For this reader study we obtained 96 3D ABUS casus with 37 malignant and 59 benign ultrasound guided core biopsied breast lesions. The localization of the lesions was done by a physician with 1 year 3D ABUS experience based on the primary radiology reports and biopsy results. The 3D ABUS view in which the lesion was best visible, was presented to 3 experienced breast radiologists with 2 years experience with 3D ABUS. They were first asked to detect and classify the most suspicious lesion in the view using the BIRADS lexicon and scoring system. A likelihood-of-malignancy (LOM) score between 0 and 100 was also requested. Thereafter the coronal reconstruction was shown and readers were asked to re-assess the lesion. Spiculation and retraction in the coronal plane were scored on a five point scale (Spiculation and Retraction Severity Index (SRSI)). Subsequently LOM and BI-RADS scores could be adjusted. Az-values for differentiation of benign from malignant lesions based on LOM scores were computed with DBM-MRMC method. Pearson’s correlation coefficient between the re-assessed LOM on the coronal reconstructions and SRSI was calculated for all readers.  

Three readers respectively pointed out 92%, 97% and 92% of 37 cancers as the most suspicious lesion in the 3D ABUS acquisition. After evaluation of the coronal reconstructions, detected malignant lesions were not downgraded to BI-RADS 2, however, 7 benign lesions were downgraded from BI-RADS 3 to BI-RADS 2. After re-evaluation the discrimination between benign and malignant lesions significantly improved from 0.84 (95% CI 0.76-0.92) to 0.87(95% CI 0.80-0.94) (p=0.02). SRSI scores correlated significantly with the re-assessed LOM scores for all readers, r = 0.85, 0.75 and 0.75, respectively (p<0.001).

Coronal reconstructions in 3D ABUS significantly improve the differentiation between benign and malignant breast lesions, by providing new visual information on breast cancer spiculation and retraction.

Better differentiation between malignant and benign breast lesions may reduce false positive biopsies in evaluation of automated breast ultrasound.

Van Zelst, J, Tan, T, Platel, B, Karssemeijer, N, Mann, R, Evaluation of Spiculation and Retraction Patterns in Coronal Reconstructions in 3D Automated Breast Ultrasound (ABUS) Improve Differentiation between Benign and Malignant Breast Lesions.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13044488.html