3D Harmonic and Subharmonic Imaging for Characterizing Breast Lesions: A Multi-Center Clinical Trial.

Authors

• Flemming Forsberg
• Catherine W Piccoli
• Anush Sridharan
• Annina Wilkes
• Alexander Sevrukov
• Haydee Ojeda-Fournier
• Robert F Mattrey
• Priscilla Machado
• Maria Stanczak
• Daniel A Merton
• Kirk Wallace
• John R Eisenbrey

Publication/Presentation Date

7-1-2022

Abstract

OBJECTIVE: Breast cancer is the most frequent type of cancer among women. This multi-center study assessed the ability of 3D contrast-enhanced ultrasound to characterize suspicious breast lesions using clinical assessments and quantitative parameters.

METHODS: Women with suspicious breast lesions scheduled for biopsy were enrolled in this prospective, study. Following 2D grayscale ultrasound and power Doppler imaging (PDI), a contrast agent (Definity; Lantheus) was administrated. Contrast-enhanced 3D harmonic imaging (HI; transmitting/receiving at 5.0/10.0 MHz), as well as 3D subharmonic imaging (SHI; transmitting/receiving at 5.8/2.9 MHz), were performed using a modified Logiq 9 scanner (GE Healthcare). Five radiologists independently scored the imaging modes (including standard-of-care imaging) using a 7-point BIRADS scale as well as lesion vascularity and diagnostic confidence. Parametric volumes were constructed from time-intensity curves for vascular heterogeneity, perfusion, and area under the curve. Diagnostic accuracy was determined relative to pathology using receiver operating characteristic (ROC) and reverse, step-wise logistical regression analyses. The κ-statistic was calculated for inter-reader agreement.

RESULTS: Data were successfully acquired in 219 cases and biopsies indicated 164 (75%) benign and 55 (25%) malignant lesions. SHI depicted more anastomoses and vascularity than HI (P <  .021), but there were no differences by pathology (P > .27). Ultrasound achieved accuracies of 82 to 85%, which was significantly better than standard-of-care imaging (72%; P <  .03). SHI increased diagnostic confidence by 3 to 6% (P <  .05), but inter-reader agreements were medium to low (κ <  0.52). The best regression model achieved 97% accuracy by combining clinical reads and parametric SHI.

CONCLUSIONS: Combining quantitative 3D SHI parameters and clinical assessments improves the characterization of suspicious breast lesions.

Volume

41

Issue

7

First Page

1667

Last Page

1675

ISSN

1550-9613

Published In/Presented At

Forsberg, F., Piccoli, C. W., Sridharan, A., Wilkes, A., Sevrukov, A., Ojeda-Fournier, H., Mattrey, R. F., Machado, P., Stanczak, M., Merton, D. A., Wallace, K., & Eisenbrey, J. R. (2022). 3D Harmonic and Subharmonic Imaging for Characterizing Breast Lesions: A Multi-Center Clinical Trial. Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine, 41(7), 1667–1675. https://doi.org/10.1002/jum.15848

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

34694019

Department(s)

Administration and Leadership

Document Type

Article