Analysis of 3D power Doppler ultrasound parameters in the diagnosis and efficacy of BI-RADS IV breast masses

Abstract

Objective To investigate diagnostic efficiency of vascular parameters in the diagnosis of BI-RADS Ⅳ breast masses using three-dimensional power Doppler ultrasound (3D-PDUS). Methods After adjusting the ultrasonic instrument under property conditions, 3D-PDUS were applied to scan BI-RADS Ⅳ breast masses before surgery with QLab software, the following parameters of breast masses were obtained: total tumor volume, vascularization index (VI), flow index (FI), and vascularization flow index (VFI). According to the pathological results, the diagnostic value of vascular parameters from 3D-PDUS were assessed with receiver operating characteristic (ROC) curve, and the diagnostic efficiency were analyzed by best cut-off limits of various vascular parameters. Results The volume and vascular parameters of benign group were remarkably lower than those of malignant group (all P VFI (0.866) >FI (0.778). AUC of FI was significantly smaller than that of VI (P=0.016) and of VFI (P=0.039), while no statistical difference between that of VI and of VFI (P=0.294). The diagnostic accuracies of VI (cut-point: 1.2, sensitivity: 84.1%, specificity: 83.3%, accuracy: 83.8%) and of VFI (cut-point: 0.5, sensitivity: 82.5%, specificity: 85.2%, accuracy: 82.9%) were higher than that of FI (cut-point: 35.3, sensitivity: 74.6%, specificity: 70.4%, accuracy: 72.6%). AUC of VI (P=0.001) and of VFI (P=0.033) in small-volume group (<2 cm3) were both larger than those of large-volume group (≥2 cm3), no significant difference in AUC of FI between these two groups (P=0.09). Conclusions Vascular parameters obtained using 3D-PDUS have affirmative value in the diagnosis of BI-RADS Ⅳ breast masses, especially in masses less than 2 cm3 in volume. Key words: Ultrasonography, three-dimensional; Breast disease; Hemodynamics