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Objective To explore the value of color pixel density （CPD） in differential diagnosis of Breast Imaging Reporting and Data System （BI-RADS） 4 breast masses by high-frequency ultrasound. Methods Relevant data of 81 pathologically-confirmed BI-RADS 4 breast masses were collected. All the masses were examined with color Super Microvascular Imaging （cSMI） before operation. CPD was calculated with the integrated software in the ultrasonic diagnostic instrument. Pathological biopsy results were regarded as the gold standard. The area under the receiver operating characteristic curve （ROC AUC） was created to evaluate the diagnostic efficiency of CPD. BI-RADS categories were corrected by CPD, and the sensitivity, specificity, accuracy, positive and negative predictive values of diagnosing breast masses were compared before and after correction. Results The ROC AUC of CPD was 0.854 （P < 0.05）. According to the cut-off values （9.55%） from ROC curve, the sensitivity, specificity, accuracy, positive and negative predictive values of CPD for differential diagnosis were 73%, 83%, 78%, 85% and 71%, respectively. After corrected by CPD, the sensitivity, specificity, accuracy, positive and negative predictive values of the BI-RADS were 87%, 83%, 85%, 87% and 83%, slightly higher than those before correction （80%, 67%, 74%, 75% and 73%）. The classification accuracy was improved by 23% （P < 0.05）. Conclusions CPD in high-frequency ultrasound is of certain value in the differential diagnosis of breast masses. In clinical practice, CPD can be employed to correct BI-RADS classification, aiming to improve the diagnostic efficiency of BI-RADS 4 breast masses. |
