RSNA 2019

Abstract Archives of the RSNA, 2019


Adjunctive Automated Breast Ultrasound Has Better Diagnostic Performance for Breast Cancer than Hand-Held Ultrasound

Wednesday, Dec. 4 11:40AM - 11:50AM Room: E450A

Mengmeng Jia, Beijing, China (Presenter) Research support, General Electric Company
Xiang Zhou, Beijing, China (Abstract Co-Author) Nothing to Disclose
Anhua Li, Guangzhou, China (Abstract Co-Author) Nothing to Disclose
Lingyun Bao, MD, Hangzhou, China (Abstract Co-Author) Nothing to Disclose
Peifang Liu, MD, PhD, Tianjin, China (Abstract Co-Author) Nothing to Disclose
Yaqing Chen, PhD, Shanghai, China (Abstract Co-Author) Nothing to Disclose
You-Lin Qiao, Beijing, China (Abstract Co-Author) Nothing to Disclose

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Adjunctive ultrasonography improves diagnosis of breast cancer. Automated breast ultrasound system(ABUS) can overcome the operator dependency and lack of standardization of Hand-held ultrasound(HHUS). We aimed to evaluate and compare the clinical value of adding HHUS or ABUS to mammography(MG) in the diagnostic workflow of breast cancer among Chinese women.


1266 female outpatients aged 40 to 69 years old were enrolled in this hospital-based multi-center study. All the women underwent HHUS, ABUS and MG, Breast Imaging-Reporting and Data System(BI-RADS) was used to imaging interpretation and mammographic breast density assessment. Lesions classified as BI-RADS 4 or 5 by any of three modalities were defined as suspicious findings and were referred to biopsy for diagnosis. Clinical performance of different strategy was compared in terms of sensitivity, specificity and area under the curve(AUC) of receiver operating characteristics, using McNemar's test and nonparametric Z test.


323 breast cancer cases were detected in our study. 958 out of 1266 women were classified as having dense breast. Increased sensitivity and AUC as well as decreased specificity were observed when adding HHUS or ABUS to MG(all P<0.001). Compared with the combination of MG and HHUS, the combination of MG and ABUS had almost same sensitivity (0.988v.s. 0.985, p=1.000), higher specificity (0.876 v.s. 0.857, p=0.003) and higher AUC(0.932 v.s. 0.921, p=0.018). Same trend was observed when HHUS or ABUS was only added to women with dense breast(p=1.000, 0.004 and 0.011, respectively). In addition, compared with adding ABUS to all participants, adding ABUS to women with dense breast decreased the sensitivity(0.969 v.s. 0.988,p=0.031) while increased the specificity (0.884 v.s. 0.876, p=0.008), leading to a nonsignificant increase in AUC(0.927 v.s. 0.932, p=0.213).


Adding ultrasonography to MG can improve breast cancer diagnosis. Adjunctive ABUS have significant better diagnostic performance compared with adjunctive HHUS.


The sensitivity of mammography in women with dense breast is limited in clinical practice. Adding ulrtasonography, especially ABUS, can improve diagnosis, and overcome the operator dependency.

Printed on: 03/01/22