Application of Multimodal Ultrasound Combined With BI-RADS in Classification and Diagnosis of Non-Mass Breast Lesions.

Introduction: The primary objective of this study is to assess the diagnostic accuracy of multimodal ultrasound, including microvascular flow imaging (MVFI), shear wave elastography (SWE), and contrast-enhanced ultrasound (CEUS), in conjunction with the breast imaging reporting and data system (BI-RADS) for non-mass breast lesions (NMLs).

Methods: A total of 100 patients who received treatment in our hospital from April 2021 to June 2024 were retrospectively collected. All patients had complete pre-operative ultrasound BI-RADS, MVFI, SWE, and CEUS. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated; the diagnostic efficacy of the methods was compared, and the diagnostic performance of the subjects was plotted.

Results: The agreement between the BI-RADS-MVFI-SWE-CEUS alone and the pathological results was very high, with a Kappa value of 0.806. The area under the curve (AUC) of the combined diagnosis of MVFI-SWE-CEUS and BI-RADS-MVFI-SWE-CEUS was 0.885 (p < 0.001) and 0.922 (p < 0.001). The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of BI-RADS-MVFI-SWE-CEUS for the diagnosis of NMLs were higher than those of the diagnosis alone (p < 0.05), with 95.24%, 89.19%, 93.75%, 91.67%, and 93%, respectively.

Conclusion: The combination of multimodal ultrasound and BI-RADS provides a significant improvement in the diagnostic accuracy and sensitivity for NMLs, offering a more comprehensive and reliable diagnostic tool for evaluating NMLs.