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1105: Does the “Sun Sign” on Coronal Plane and 3D Ultrasound Imaging Aid the Accurate Diagnosis of Breast Lesions?
S126
Ultrasound in Medicine and Biology
26.88)and 0.14(95%CI,0.06 to 0.30); for mammography, was 4.34(95%CI,1.63-11.42)and 0.33(95%CI,0.19-0.63). Conclusions: Sonoelastography and mammography were both effective technology in the diagnosis of breast lesions. Sonoelastography has higher diagnostic value than mammography in breast lesions, especially,in the lesions which were no calcification. To combine sonoelastography with mammography can elevate the accuracy differentiating the benign from malignant breast lesions. 1104 The Value of Relative CEUS Parameters in the Differential Diagnosis of Breast Lesions Yan Zhang, Department of Ultrasound, General Hospital of People Liberation Army, Beijing, China Jun Lai Li, Department of Ultrasound, General Hospital of People Liberation Army, Beijing, China Objective: To study the value of parameters and relative parameters of contrast-enhanced ultrasound(CEUS) in the differential diagnosis of breast lesions. Methods: 54 patients (31 benign, 23 malignant) with breast lesions accepted the examination by CEUS. The time-intensity curves of 54 lesions and their surrounding tissues were drawn by software of ACQ. Then, obtaining the parameters and calculating the relative parameters of CEUS. Results: 1. The time-intensity curves of benign masses showed wash-in slowly and wash-out quickly, or its shapes closed to the surrounding tissues’. But the time-intensity curves of malignant masses showed wash-in quickly and wash-out slowly (P⬍0.05). Compared with the surrounding tissues, malignant peak appeared earlier than benign. 2. The lesions’ relative arrival time, time to peak and peak intensity were different between benign and malignant ones (P⬍0.05). But the relative base intensity had no difference between benign and malignant lesions. Conclusions: More attention should be paid to the surrounding tissues in the study of lesion’s parameters of CEUS. It was more valuable for the differential diagnosis between benign and malignant lesions by calculating the relative parameters. The relative parameters of CEUS and the shapes of time-intensity curves may help to the diagnosis of breast lesions. Keywords: Breast lesions; CEUS; Peak intensity 1105 Does the “Sun Sign” on Coronal Plane and 3D Ultrasound Imaging Aid the Accurate Diagnosis of Breast Lesions? Shin-Chong Zhou Wei Zeng Yi-Wu Fan Cai Chang Zhi-Zhang Xu Ting-Qiu Zhang Purpose: The aim was to evaluate the importance and diagnostic accuracy of three-dimensional (3D) ultrasound, especially the “sun sign” summarized on the basis of “retraction” from the coronal plane, compared with conventional two-dimensional (2D) ultrasound in breast tumors. Method: The 2D and 3D ultrasound data of 605 lesions (349 benign, 256 malignant) were digitally stored, analyzed and compared. The sun sign appeared consistently in malignant tumors in 3D ultrasound. It was described as striated hyperechoic or iso-echoic lines pointing to the hypoechoic lesion radially; hyperechoic normal
Volume 35, Number 8S, 2009 tissue surrounding the lesion boundary was distorted. Logistic regression was used to analyze each criterion of the sign. Pathology results were used to compare 2D and 3D ultrasound diagnostic accuracy using the Chi-square test. Result: The diagnostic accuracy and specificity of 3D ultrasound (88.1%, 86.0%, respectively) were higher than 2D ultrasound (73.1%, 62.8%, respectively), particularly when combined with the sun sign. The sun sign on the coronal plane observed by 3D ultrasound is a reliable supplemental method for ultrasound diagnosis of breast tumors. Conclusions: 3D technology significantly improves ultrasound diagnostic accuracy for breast tumors.
1106 The Study of BI-RADS in China Shin-Chong Zhou Cai Chang Yi-Wu Fan Wei Zhen, Department of Ultrasound, National Key Laboratory of Oncology in Southern China, Cancer Center, Sun Yat-Sen University, China Purpose: To analyze diagnostic values of different criteria in BIRADS, to make BI-RADS be fit for Chinese and to spread it in China, we studied every criterion of BI-RADS and accounted the predictive value of them on the basis of Chinese patients. Method: All 352 cases of 323 patients were under surgery and got pathological results from June 2007 to Jun 2008 in our hospital. All of these cases were diagnosed following BI-RADS criteria before surgery. According to the pathological results, all criteria were calculated their positive predictive value, negative predictive value and accuracy Following the BI-RADS, criteria were shape, orientation, margin, boundary, echo pattern, background echo and surrounding tissue. Following ACR recommendation and our experiences in daily work, criteria were supplied as microcalcification, vasculazation and axillary lymph node. Result: All 352 cases were 198 benign and 154 malignant. The predictive values of all criteria were in tables. The predictive values of benign tumor are high in regular shape (94.3%), abrupt boundary (87.6%), homogenous echo pattern (83.3%), posterior acoustic enhancement (80.9%), circumscribed margin (95.2%) and continued ducts in surrounding tissue (94.7%). The predictive values of malignant tumor are posterior acoustic shadowing (78.9%), microcalcification (81.3%), architectural distortion in surrounding tissue (100%), vasculazation inside (77.8%), axillary lymph node (97.6%) and more than one characters of not circumscribed marhin (76.3%-100%). The portion of different breast ultrasonography criteria in diagnose were calculated and analyzed. Discussion: As the result, some criteria are not as valuable as we thought conventionally. They are only 50%-60% predictive accuracy when they are used independently in differentiation. Therefore, all criteria can be divided into two kinds: necessary condition has high predictive value and sufficient condition has poor predictive value. Some criteria, such as shape and orientation, are poor malignancy predictive value, which is different from our normal thought. It proves that benignancy predictive value and malignancy predictive value are not same in the same criterion, and we must make a difference between them. The predictive values of all criteria should be confirmed, because the ultrasound image is read and all criteria are analyzed by us at first. Knowing benign and malignant predictive values of different criteria, breast ultrasonography can be quantitative and breast ultrasound CAD may be based on this way.
Ultrasound in Medicine and Biology
26.88)and 0.14(95%CI,0.06 to 0.30); for mammography, was 4.34(95%CI,1.63-11.42)and 0.33(95%CI,0.19-0.63). Conclusions: Sonoelastography and mammography were both effective technology in the diagnosis of breast lesions. Sonoelastography has higher diagnostic value than mammography in breast lesions, especially,in the lesions which were no calcification. To combine sonoelastography with mammography can elevate the accuracy differentiating the benign from malignant breast lesions. 1104 The Value of Relative CEUS Parameters in the Differential Diagnosis of Breast Lesions Yan Zhang, Department of Ultrasound, General Hospital of People Liberation Army, Beijing, China Jun Lai Li, Department of Ultrasound, General Hospital of People Liberation Army, Beijing, China Objective: To study the value of parameters and relative parameters of contrast-enhanced ultrasound(CEUS) in the differential diagnosis of breast lesions. Methods: 54 patients (31 benign, 23 malignant) with breast lesions accepted the examination by CEUS. The time-intensity curves of 54 lesions and their surrounding tissues were drawn by software of ACQ. Then, obtaining the parameters and calculating the relative parameters of CEUS. Results: 1. The time-intensity curves of benign masses showed wash-in slowly and wash-out quickly, or its shapes closed to the surrounding tissues’. But the time-intensity curves of malignant masses showed wash-in quickly and wash-out slowly (P⬍0.05). Compared with the surrounding tissues, malignant peak appeared earlier than benign. 2. The lesions’ relative arrival time, time to peak and peak intensity were different between benign and malignant ones (P⬍0.05). But the relative base intensity had no difference between benign and malignant lesions. Conclusions: More attention should be paid to the surrounding tissues in the study of lesion’s parameters of CEUS. It was more valuable for the differential diagnosis between benign and malignant lesions by calculating the relative parameters. The relative parameters of CEUS and the shapes of time-intensity curves may help to the diagnosis of breast lesions. Keywords: Breast lesions; CEUS; Peak intensity 1105 Does the “Sun Sign” on Coronal Plane and 3D Ultrasound Imaging Aid the Accurate Diagnosis of Breast Lesions? Shin-Chong Zhou Wei Zeng Yi-Wu Fan Cai Chang Zhi-Zhang Xu Ting-Qiu Zhang Purpose: The aim was to evaluate the importance and diagnostic accuracy of three-dimensional (3D) ultrasound, especially the “sun sign” summarized on the basis of “retraction” from the coronal plane, compared with conventional two-dimensional (2D) ultrasound in breast tumors. Method: The 2D and 3D ultrasound data of 605 lesions (349 benign, 256 malignant) were digitally stored, analyzed and compared. The sun sign appeared consistently in malignant tumors in 3D ultrasound. It was described as striated hyperechoic or iso-echoic lines pointing to the hypoechoic lesion radially; hyperechoic normal
Volume 35, Number 8S, 2009 tissue surrounding the lesion boundary was distorted. Logistic regression was used to analyze each criterion of the sign. Pathology results were used to compare 2D and 3D ultrasound diagnostic accuracy using the Chi-square test. Result: The diagnostic accuracy and specificity of 3D ultrasound (88.1%, 86.0%, respectively) were higher than 2D ultrasound (73.1%, 62.8%, respectively), particularly when combined with the sun sign. The sun sign on the coronal plane observed by 3D ultrasound is a reliable supplemental method for ultrasound diagnosis of breast tumors. Conclusions: 3D technology significantly improves ultrasound diagnostic accuracy for breast tumors.
1106 The Study of BI-RADS in China Shin-Chong Zhou Cai Chang Yi-Wu Fan Wei Zhen, Department of Ultrasound, National Key Laboratory of Oncology in Southern China, Cancer Center, Sun Yat-Sen University, China Purpose: To analyze diagnostic values of different criteria in BIRADS, to make BI-RADS be fit for Chinese and to spread it in China, we studied every criterion of BI-RADS and accounted the predictive value of them on the basis of Chinese patients. Method: All 352 cases of 323 patients were under surgery and got pathological results from June 2007 to Jun 2008 in our hospital. All of these cases were diagnosed following BI-RADS criteria before surgery. According to the pathological results, all criteria were calculated their positive predictive value, negative predictive value and accuracy Following the BI-RADS, criteria were shape, orientation, margin, boundary, echo pattern, background echo and surrounding tissue. Following ACR recommendation and our experiences in daily work, criteria were supplied as microcalcification, vasculazation and axillary lymph node. Result: All 352 cases were 198 benign and 154 malignant. The predictive values of all criteria were in tables. The predictive values of benign tumor are high in regular shape (94.3%), abrupt boundary (87.6%), homogenous echo pattern (83.3%), posterior acoustic enhancement (80.9%), circumscribed margin (95.2%) and continued ducts in surrounding tissue (94.7%). The predictive values of malignant tumor are posterior acoustic shadowing (78.9%), microcalcification (81.3%), architectural distortion in surrounding tissue (100%), vasculazation inside (77.8%), axillary lymph node (97.6%) and more than one characters of not circumscribed marhin (76.3%-100%). The portion of different breast ultrasonography criteria in diagnose were calculated and analyzed. Discussion: As the result, some criteria are not as valuable as we thought conventionally. They are only 50%-60% predictive accuracy when they are used independently in differentiation. Therefore, all criteria can be divided into two kinds: necessary condition has high predictive value and sufficient condition has poor predictive value. Some criteria, such as shape and orientation, are poor malignancy predictive value, which is different from our normal thought. It proves that benignancy predictive value and malignancy predictive value are not same in the same criterion, and we must make a difference between them. The predictive values of all criteria should be confirmed, because the ultrasound image is read and all criteria are analyzed by us at first. Knowing benign and malignant predictive values of different criteria, breast ultrasonography can be quantitative and breast ultrasound CAD may be based on this way.