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The performance of 3D ABUS versus HHUS in the visualisation and BI-RADS characterisation of breast lesions in a large cohort of 1,886 women

European Radiology volume 28, pages 592–601 (2018)Cite this article

Abstract

Objectives

This study aimed to evaluate automated breast ultrasound (ABUS) compared to hand-held traditional ultrasound (HHUS) in the visualisation and BIRADS characterisation of breast lesions.

Materials and methods

From January 2016 to January 2017, 1,886 women with breast density category C or D (aged 48.6±10.8 years) were recruited. All participants underwent ABUS and HHUS examination; a subcohort of 1,665 women also underwent a mammography.

Results

The overall agreement between HHUS and ABUS was 99.8 %; kappa=0.994, p<0.0001. Two cases were graded as BI-RADS 1 in HHUS, but were graded as BIRADS 4 in ABUS; biopsy revealed a radial scar. Three carcinomas were graded as BI-RADS 2 in mammography but BI-RADS 4 in ABUS; two additional carcinomas were graded as BI-RADS 2 in mammography but BI-RADS 5 in ABUS. Two carcinomas, appearing as a well-circumscribed mass or developing asymmetry in mammography, were graded as BI-RADS 4 in mammography but BI-RADS 5 in ABUS.

Conclusions

ABUS could be successfully used in the visualisation and characterisation of breast lesions. ABUS seemed to outperform HHUS in the detection of architectural distortion on the coronal plane and can supplement mammography in the detection of non-calcified carcinomas in women with dense breasts.

Key Points

• The new generation of ABUS yields comparable results to HHUS.

• ABUS seems superior to HHUS in detecting architectural distortions.

• In dense breasts, supplemental ABUS to mammography detects additional cancers.

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Abbreviations

3D ABUS:

Three-dimensional automated breast ultrasound system

ADH:

Atypical ductal hyperplasia

ALH:

Atypical lobular hyperplasia

BI-RADS:

Breast Imaging Reporting and Data System

DCIS:

Ductal carcinoma in situ

FFDM:

Full-digital mammography

FOV:

Field of view

HHUS:

Hand-held ultrasound

IDC:

Invasive ductal carcinoma

ILC:

Invasive lobular carcinoma

LCIS:

Lobular carcinoma in situ

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Acknowledgements

The authors would like to thank the technologists Kalliopi Konstantinakou and Evangelia Stamatiou for their contribution in performing ABUS, mammography and collecting the data.

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Affiliations

  1. ‘Diagnostic Mammography’ Medical Diagnostic Imaging Unit, Kifisias Ave 362, Chalandri, 15233, Athens, Greece

    Athina Vourtsis & Aspasia Kachulis

Authors
  1. Athina Vourtsis
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  2. Aspasia Kachulis
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Corresponding author

Correspondence to Athina Vourtsis.

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Guarantor

The scientific guarantor of this publication is Athina Vourtsis MD, PhD, Founding President of the Hellenic Breast Imaging Society.

Conflict of interest

The authors of this manuscript declare relationships with the following companies: The corresponding author has received honoraria from GE Healthcare for giving lectures and for moderating workshops.

Funding

The authors state that this work has not received any funding.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• prospective

• observational

• performed at one institution

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Vourtsis, A., Kachulis, A. The performance of 3D ABUS versus HHUS in the visualisation and BI-RADS characterisation of breast lesions in a large cohort of 1,886 women. Eur Radiol 28, 592–601 (2018). https://doi.org/10.1007/s00330-017-5011-9

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  • DOI: https://doi.org/10.1007/s00330-017-5011-9

Keywords

  • Automated breast ultrasound system
  • Breast ultrasonography
  • Breast cancer
  • Breast density
  • Digital mammography