Diagnostic Accuracy of Spectral Doppler Indices and Sonoelastography in Predicting Malignancy in Breast Imaging Reporting and Database System 3 Breast Lesions With Histopathology as the Reference Standard.

Autor:	Prabakaran L; Radiodiagnosis, Sri Ramaswamy Memorial Medical College Hospital and Research Centre, Chengalpattu, IND., Aiyappan SK; Radiodiagnosis, Sri Ramaswamy Memorial Medical College Hospital and Research Centre, Chengalpattu, IND., Ramesh S; Radiodiagnosis, Sri Ramaswamy Memorial Medical College Hospital and Research Centre, Chengalpattu, IND., Ramesh R; Radiodiagnosis, Sri Ramaswamy Memorial Medical College Hospital and Research Centre, Chengalpattu, IND., Kumaran S; Radiodiagnosis, Sri Ramaswamy Memorial Medical College Hospital and Research Centre, Chengalpattu, IND.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2024 Nov 11; Vol. 16 (11), pp. e73481. Date of Electronic Publication: 2024 Nov 11 (Print Publication: 2024).
DOI:	10.7759/cureus.73481
Abstrakt:	Introduction Breast cancer is a significant health concern in India, representing a large portion of all cancers affecting women and ranking as one of the most common cancers overall. Reliable diagnostic tools are essential for accurately predicting malignancy and reducing the need for unnecessary biopsies. A Breast Imaging Reporting and Database System (BI-RADS) 3 designation suggests a low likelihood of cancer, indicating that findings are likely benign. For these cases, short-term follow-up imaging is generally preferred over immediate biopsy as the probability of malignancy is minimal. This study evaluates the effectiveness of strain elastography, specifically the strain ratio, in predicting malignancy in BI-RADS 3 breast lesions in a cohort of 50 patients. Additionally, it examines the role of Doppler indices, including the Pulsatility Index (PI) and Resistance Index (RI). Histopathological analysis was used as the reference standard. Methods A descriptive cross-sectional study was conducted on 50 patients presenting with palpable breast lumps or abnormalities detected via ultrasonography or mammography. Conventional B-mode ultrasound examinations were performed on all the patients, and those with BI-RADS 3 lesions were identified. The Doppler technique was employed to calculate PI and RI values, followed by strain elastography to determine the strain ratio. Histopathological confirmation was performed for all patients. Results Histopathological analysis revealed that 92% (N=46) of the lesions were benign, while 8% (N=4) were malignant. For strain elastography, the sensitivity was 75%, specificity was 97.83%, positive predictive value (PPV) was 75%, negative predictive value (NPV) was 97.83%, and the diagnostic accuracy was 96%. For Doppler PI, the sensitivity was 75%, specificity was 95.65%, PPV was 60%, NPV was 97.78%, and the overall diagnostic accuracy was 94%. Similarly, for Doppler RI, the sensitivity was 75%, specificity was 95.65%, PPV was 60%, NPV was 97.78%, and the overall diagnostic accuracy was 94%. Conclusion B-mode ultrasound remains the first-line imaging investigation for evaluating breast masses. In BI-RADS 3 lesions, where the likelihood of malignancy is minimal, the combined use of strain elastography and Doppler PI and RI indices can serve as a valuable adjunct in predicting malignancy and reducing the need for unnecessary biopsies. Moreover, strain elastography demonstrates higher diagnostic accuracy compared to Doppler PI and RI. Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. SRM Institutional Ethics Committee issued approval SRMIEC-ST0722-019. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. (Copyright © 2024, Prabakaran et al.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu