Available value of semi-quantitative scoring system for contrast-enhanced ultrasound quantitative analysis's color images in the differential diagnosis of breast nodules

Abstract

Objective To assess the feasibility of semi-quantitative scoring system for contrast-enhanced ultrasound(CEUS) quantitative analysis's color images in the differential diagnosis of breast nodules. Methods Totally 244 BI-RADS 4 breast solid lesions received CEUS before core needle biopsy or surgical resection were included. A semi-quantitative scoring system for color images of CEUS quantitative analysis were built. The scores were given as follows: 1)Color type and its distribution (0 to 4); 2)Color scope (0 to 1); 3)Color margin (0 to 1); 4)Color shape (0 to1). The total score for each lesion would be from 0 to 7. And the differenital value between benign and malignant lesions were assessed. Results The total semi-quantitative scores of 102 malignant tumors (5.1±1.7) was significant higher than that of benign lesions (3.34±0.7) (P<0.05). In 102 malignant lesions, the total scores of 81 lesions (79.41%) were more than 4 points, and in 142 benign lesions, the total scores of 89 lesions (62.67%) were less than 4 points. Depending on the Wilcox rank sum test (Mann-Whitney) analysis, the distribution of total scores between benign and malignant lesions was significant different (P<0.000 1). Total score 4 was selected as the best cutoff, the area under ROC curve was 0.749, on which the sensitivity, specificity and accuracy were 79.4%, 62.7% and 69.67%, respectively. Conclusions The semi-quantitative scoring system of CEUS quantitative analysis color images showed good sensitivity but not satisfied specificity and accuracy in differential diagnosis between malignant and benign breast lesions. Key words: Ultrasonography; Microbubbles; Breast diseases; Diagnosis, differenital