Ultrasound-Based Nomogram for Distinguishing Malignant Tumors from Nodular Sclerosing Adenoses in Solid Breast Lesions
| Autor: | Shufang Pei, Ting Liang, Junhui Shen, Chunwang Huang, Shuzhen Cong, Zaiyi Liu, Zongjian Yi, Juanjuan Liu, Gaowen Chen |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Radiological and Ultrasound Technology medicine.diagnostic_test business.industry Breast imaging Concordance Biopsy Ultrasound Echogenicity Nomogram Confidence interval Nomograms Brier score Neoplasms Medicine Humans Radiology Nuclear Medicine and imaging Female Radiology business Fibrocystic Breast Disease Ultrasonography |
| Zdroj: | Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in MedicineReferences. 40(10) |
| ISSN: | 1550-9613 |
| Popis: | Objectives Nodular sclerosing adenoses (NSAs) and malignant tumors (MTs) may coexist and are often classified into the same Breast Imaging Reporting and Data System (BI-RADS) category. We aimed to build and validate an ultrasound-based nomogram to distinguish MT from NSA for building a precise sequence of biopsies. Materials and methods The training cohort included 156 patients (156 masses) with NSA or MT at one study institution. We used best subset regression to determine the predictors for building a nomogram from ultrasonic characteristics and patients' age. Model performance and clinical utility were evaluated using Brier score, concordance (C)-index, calibration curve, and decision curve analysis. The independent validation cohort consisted of 162 patients (162 masses) from a separate institution. Results Through best subset regression, we selected 6 predictors to develop nomogram: age, calcification, echogenic rim, vascularity distribution, tumor size, and thickness of breast parenchyma. Brier score and C-index of the nomogram in the training cohort were 0.068 and 0.967 (95% confidence interval [CI]: 0.941-0.993), respectively. In addition, calibration curve demonstrated good agreement between prediction and pathological result. In the validation cohort, the nomogram still obtained a favorable C-index score of 0.951 (95% CI: 0.919-0.983) and fine calibration. Decision curve analysis showed that the model was clinically useful. Conclusions If multiple NSA and MT masses are present in the same patient and are classified into the same BI-RADS category, our nomogram can be used as a supplement to the BI-RADS category for accurate biopsy of the mass most likely to be MT. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text