Comparison and Combination of Two Ultrasound Modalities, Handheld Ultrasound and Automated Breast Volume Scanner, With and Without Knowledge of MRI

Abstract

Background: When a suspicios breast lesion is found on MRI but is not observed on conventional imaging, targeted ultrasound of the MRI-detected lesion is commonly performed for its detection and characterization. Nonetheless, there are limitations of handheld ultrasound (HHUS). Another ultrasound modality named automated breast volume scanner (ABVS) has achieved automation and high resolution recently. The detection rate and accuracy of conjunctive and disjunctive combination of each ultrasound modality (HHUS and ABVS) have not yet been evaluated. Objectives: To compare the diagnostic performance using HHUS, ABVS, and the combination method for suspicious lesions found on MRI. Patients and Methods: From March to September on 2014, we prospectively enrolled 40 consecutive breast cancer patients who underwent HHUS and ABVS for newly detected suspicious lesions found on MRI. All patients underwent mammography and HHUS before MRI. Whole breast ABVS and another HHUS were performed after MRI. We reviewed the detection rate and diagnostic accuracy of each imaging and analyzed the conjunctive and disjunctive combination results of two ultrasound modalities. We then compared them with or without knowledge of MRI. Results: In 120 suspicious lesions of 40 patients, seventy-six malignant and 44 nonmalignant lesions were included. With knowledge of MRI, cancer detection sensitivities of HHUS, ABVS, conjunctive and disjunctive combination were higher than those without knowledge of MRI (94.7%, 98.7%, 100%, 93.4% vs. 65.8%, 64.5%, 67.1%, 63.2%). In conjunctive combination of HHUS and ABVS, the detection sensitivities were improved in both cases with and without knowledge of MRI. Conclusion: With knowledge of MRI, HHUS and ABVS imaging detected most lesions and the conjunctive combination showed the highest detection sensitivity.