Contrast-enhanced ultrasound to predict malignant upgrading of atypical ductal hyperplasia.

IF 7.4 1区 医学 Q1 Medicine
Jun Kang Li, Zhi Ying Jin, Yong Jie Xu, Nai Qin Fu, Ying Jiang, Shi Yu Li, Rui Lan Niu, Gang Liu, Zhi Li Wang
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引用次数: 0

Abstract

Background: A malignancy might be found at surgery in cases of atypical ductal hyperplasia (ADH) diagnosed via US-guided core needle biopsy (CNB). The objective of this study was to investigate the diagnostic performance of contrast-enhanced ultrasound (CEUS) in predicting ADH diagnosed by US-guided CNB that was upgraded to malignancy after surgery.

Methods: In this retrospective study, 110 CNB-diagnosed ADH lesions in 109 consecutive women who underwent US, CEUS, and surgery between June 2018 and June 2023 were included. CEUS was incorporated into US BI-RADS and yielded a CEUS-adjusted BI-RADS. The diagnostic performance of US BI-RADS and CEUS-adjusted BI-RADS for ADH were analyzed and compared.

Results: The mean age of the 109 women was 49.7 years ± 11.6 (SD). The upgrade rate of ADH at CNB was 48.2% (53 of 110). The sensitivity, specificity, positive predictive value, and negative predictive value of CEUS for identification of malignant upgrading were 96.2%, 66.7%,72.9%, and 95.0%, respectively, based on BI-RADS category 4B threshold. The two false-negative cases were low-grade ductal carcinoma in situ. Compared with the US, CEUS-adjusted BI-RADS had better specificity for lesions smaller than 2 cm (76.7% vs. 96.7%, P = 0.031). After CEUS, 16 (10 malignant and 6 nonmalignant) of the 45 original US BI-RADS category 4A lesions were up-classified to BI-RADS 4B, and 3 (1 malignant and 2 nonmalignant) of the 41 original US BI-RADS category 4B lesions were down-classified to BI-RADS 4A.

Conclusions: CEUS is helpful in predicting malignant upgrading of ADH, especially for lesions smaller than 2 cm and those classified as BI-RADS 4A and 4B on ultrasound.

对比增强超声波预测非典型导管增生的恶性升级。
背景:通过美国引导下核心针活检(CNB)诊断的非典型导管增生(ADH)病例在手术时可能会发现恶性肿瘤。本研究的目的是探讨对比增强超声(CEUS)在预测经 US 引导的核心针活检确诊的 ADH 在手术后升级为恶性肿瘤方面的诊断性能:在这项回顾性研究中,纳入了2018年6月至2023年6月期间连续接受US、CEUS和手术的109名女性中110例CNB诊断的ADH病变。将 CEUS 纳入 US BI-RADS,得出 CEUS 调整后的 BI-RADS。分析并比较了 US BI-RADS 和 CEUS 调整后的 BI-RADS 对 ADH 的诊断性能:结果:109 名女性的平均年龄为 49.7 岁 ± 11.6 岁(标清)。CNB检查的ADH升级率为48.2%(110人中有53人)。根据 BI-RADS 4B 类阈值,CEUS 识别恶性升级的敏感性、特异性、阳性预测值和阴性预测值分别为 96.2%、66.7%、72.9% 和 95.0%。两例假阴性病例为低级别导管原位癌。与 US 相比,CEUS 调整后的 BI-RADS 对小于 2 厘米的病变有更好的特异性(76.7% 对 96.7%,P = 0.031)。CEUS检查后,45个原始US BI-RADS类别4A病变中的16个(10个恶性,6个非恶性)上调为BI-RADS类别4B,41个原始US BI-RADS类别4B病变中的3个(1个恶性,2个非恶性)下调为BI-RADS类别4A:结论:CEUS有助于预测ADH的恶性升级,尤其是对于小于2厘米的病变和在超声检查中被归类为BI-RADS 4A和4B的病变。
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来源期刊
CiteScore
12.00
自引率
0.00%
发文量
76
审稿时长
12 weeks
期刊介绍: Breast Cancer Research, an international, peer-reviewed online journal, publishes original research, reviews, editorials, and reports. It features open-access research articles of exceptional interest across all areas of biology and medicine relevant to breast cancer. This includes normal mammary gland biology, with a special emphasis on the genetic, biochemical, and cellular basis of breast cancer. In addition to basic research, the journal covers preclinical, translational, and clinical studies with a biological basis, including Phase I and Phase II trials.
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