Abstract
BackgroundThe study was conducted to investigate the diagnostic performance of infrared (IR) imaging of the breast using an interpretive model derived from a scoring system.MethodsThe study was approved by the Institutional Review Board of our hospital. A total of 276 women (mean age = 50.8 years, SD 11.8) with suspicious findings on mammograms or ultrasound received IR imaging of the breast before excisional biopsy. The interpreting radiologists scored the lesions using a scoring system that combines five IR signs. The ROC (receiver operating characteristic) curve and AUC (area under the ROC curve) were analyzed by the univariate logistic regression model for each IR sign and an age-adjusted multivariate logistic regression model including 5 IR signs. The cut-off values and corresponding sensitivity, specificity, Youden's Index (Index = sensitivity+specificity-1), positive predictive value (PPV), negative predictive value (NPV) were estimated from the age-adjusted multivariate model. The most optimal cut-off value was determined by the one with highest Youden's Index.ResultsFor the univariate model, the AUC of the ROC curve from five IR signs ranged from 0.557 to 0.701, and the AUC of the ROC from the age-adjusted multivariate model was 0.828. From the ROC derived from the multivariate model, the sensitivity of the most optimal cut-off value would be 72.4% with the corresponding specificity 76.6% (Youden's Index = 0.49), PPV 81.3% and NPV 66.4%.ConclusionsWe established an interpretive age-adjusted multivariate model for IR imaging of the breast. The cut-off values and the corresponding sensitivity and specificity can be inferred from the model in a subpopulation for diagnostic purpose.Trial RegistrationNCT00166998.
Highlights
The study was conducted to investigate the diagnostic performance of infrared (IR) imaging of the breast using an interpretive model derived from a scoring system
Infrared (IR) imaging of the breast, known as breast thermography, is a non-invasive, painless examination which does not expose the subject to ionizing radiation, and is mainly a test of physiologic response of the breast findings [1,2,3,4,5,6]
IR imaging has been used for breast cancer detection since the
Summary
The study was conducted to investigate the diagnostic performance of infrared (IR) imaging of the breast using an interpretive model derived from a scoring system. It is based on the mechanism that the skin temperature overlying a malignancy is higher than skin overlying normal breast tissue This is due to increasing infrared radiation and is most likely caused by elevated blood flow, metabolic activity, and angiogenesis at and around the lesion site [2,5]. IR imaging was dropped at an early stage of the project due to unsatisfactory results [1,2,3,4] This may have been due to technical difficulties, widely variable and subjective interpretation among image readers, unacceptably high false-positive and false-negative rates, and no direct aid for spatial localization of surgery [1,2,3,4]. We investigated the diagnostic performance of computerized breast IR imaging using an integrated interpretative model for breast IR imaging
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