Cost-Benefit relationship between Hand Held Ultra-Sound (HHUS) and Automated Breast Ultra-Sound (ABUS) as a complementary scan for Mammography in detection of breast lesions

Abstract

Abstract Aim of the Work to compare between HHUS and 3D ABUS, according to their benefits and limitations as a complementary scan for mammography in detection of breast lesions. Patients and Methods The study was conducted on 30 female patients with breast masses diagnosed by clinical examination or by sonomammography in Radiology Department at Al Sheikh Zayed Aal Nahian hospital and Ain Shams University Hospitals during the period from October 2018 and August 2019. Findings were confirmed by histopathological biopsy or at least 6 months follow up. Results Statistically significant difference between ABUS and HHUS time of examination in favor of ABUS with P-value >0.0001 and 95%CI-5.7:-4.4, as ABUS time of examination was (mean+/- SD: 4.1 +/-0.9) and HHUS was (mean +/- SD: 9.2 +/-2.0). In this study; 8 out of 30 were malignant lesions and 22 were benign findings. HHUS showed higher sensitivity than ABUS (100% versus 88%); specificity (86%, 91%), positive predictive value (73%, 78%) and negative predictive value (100%, 95%) respectively. HHUS and ABUS shows nearly perfect agreement regarding lesion classification(benign &malignant).with Cohen’s kappa (κ) 0.85, and also regarding BIRADS classification With Weighted kappa 0.824. Conclusion There is a near perfect agreement between ABUS and HHUS diagnostic performance (κ) 0.85,and statistically significant difference in time of examination in favor of ABUS as it is operator independent and provide large scanned area in every single sweep and also aided with computer software, but HHUS still have higher sensitivity than ABUS and that may be attributed to ABUS limitations to evaluate axillary lymph nodes and lack of Doppler, so ABUS may serve as an effective, adjunct, screening tool to mammography and hand held Sonography.