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AJR Am J Roentgenol. 2018 Sep;211(3):689-700. doi: 10.2214/AJR.17.18436. Epub 2018 Jul 5.

Downgrading and Upgrading Gray-Scale Ultrasound BI-RADS Categories of Benign and Malignant Masses With Optoacoustics: A Pilot Study.

Author information

1
1 Department of Radiology, Northwestern University Feinberg School of Medicine, 676 N St Clair St, Ste 800, Chicago, IL 60611.
2
2 Boston Biostatistics Research Foundation, Framingham, MA.
3
3 Virginia Biomedical Laboratories, LLC, Wirtz, VA.
4
4 Radiologic Imaging Associates, Englewood, CO.
5
5 Solis Mammography Greensboro, Greensboro, NC.
6
6 Weinstein Imaging Associates, Pittsburgh, PA.
7
7 Elizabeth Wende Breast Care, Rochester, NY.
8
8 Department of Radiology and Breast Imaging, MD Anderson Cancer Center, Houston, TX.
9
9 Present address: Department of Radiology, UT Southwestern Medical Center, Dallas, TX.
10
10 Cleveland Clinic, Cleveland, OH.
11
11 Department of Radiology, Weill Cornell Medicine, New York, NY.
12
12 UT Health San Antonio, San Antonio, TX.
13
13 Department of Radiology, MedStar Georgetown University Hospital, Washington, DC.
14
14 Breastlink Temecula Valley, Murrieta, CA.
15
15 Austin Radiological Association, Austin, TX.
16
16 Present address: Mallinckrodt Institute of Radiology, Washington University School of Medicine in St. Louis, St. Louis, MO.
17
17 Department of Radiology and Biomedical Imaging, Yale-New Haven Hospital/Smilow Cancer Hospital, New Haven, CT.

Abstract

OBJECTIVE:

False-positive findings remain challenging in breast imaging. This study investigates the incremental value of optoacoustic imaging in improving BI-RADS categorization of breast masses at ultrasound.

SUBJECTS AND METHODS:

The study device is an optoacoustic breast imaging device with a handheld duplex laser and internal gray-scale ultrasound probe, fusing functional and morphologic information (optoacoustic ultrasound). In this prospective multisite study, breast masses assessed as BI-RADS category 3, 4A, 4B, 4C, or 5 by site radiologists underwent both gray-scale ultrasound and optoacoustic imaging with the study device. Independent reader radiologists assessed internal gray-scale ultrasound and optoacoustic ultrasound features for each mass and assigned a BI-RADS category. The percentage of mass reads for which optoacoustic ultrasound resulted in a downgrade or upgrade of BI-RADS category relative to internal gray-scale ultrasound was determined.

RESULTS:

Of 94 total masses, 39 were biopsy-proven malignant, 44 were biopsy-proven benign, and 11 BI-RADS category 3 masses were stable at 12-month follow-up. The sensitivity of both optoacoustic ultrasound and internal gray-scale ultrasound was 97.1%. The specificity was 44.3% for optoacoustic ultrasound and 36.4% for internal gray-scale ultrasound. Using optoacoustic ultrasound, 41.7% of benign masses or BI-RADS category 3 masses that were stable at 12-month follow-up were downgraded to BI-RADS category 2 by independent readers; 36.6% of masses assigned BI-RADS category 4A were downgraded to BI-RADS category 3 or 2, and 10.1% assigned BI-RADS category 4B were downgraded to BI-RADS category 3 or 2. Using optoacoustic ultrasound, independent readers upgraded 75.0% of the malignant masses classified as category 4A, 4B, 4C, or 5, and 49.4% of the malignant masses were classified as category 4B, 4C, or 5.

CONCLUSION:

Optoacoustic ultrasound resulted in BI-RADS category downgrading of benign masses and upgrading of malignant masses compared with gray-scale ultrasound.

KEYWORDS:

BI-RADS; breast cancer; breast ultrasound; optoacoustic imaging; photoacoustic imaging

PMID:
29975115
DOI:
10.2214/AJR.17.18436
[Indexed for MEDLINE]

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