Radiologists' performance in the detection of benign and malignant masses with 3D automated breast ultrasound (ABUS)

Abstract

Objectives: To retrospectively evaluate the detection performance of benign and malignant breast masses using 3D volume data obtained by ABUS and to determine lesion variables which affect detectability. Methods: Between November and December of 2007, bilateral whole breast US images were obtained using ABUS in 67 consecutive women who were scheduled to undergo US-guided needle biopsy due to suspicious breast masses. Twenty-four invasive ductal cancers in 23 breasts, 46 benign breast lesions in 44 breasts and 38 normal breasts were included. Three breast radiologists (experience range, 8-16 years) who did not perform the examinations and were blinded to the histology independently reviewed the ABUS data of the 105 breasts to detect suspicious solid masses with pathology as the standard of reference. Sensitivity and specificity in detecting benign and malignant masses were calculated, and lesion characteristics affecting detectability were analyzed. Results: Sensitivities for benign and malignant mass detections were 65.2% (30/46), 95.8% (23/24) for reader 1 (p = 0.007), 66.7% (31/46), 87.5% (21/24) for reader 2 (p = 0.087), and 56.3% (24/46), 91.7% (22/24), for reader 3 (p = 0.001), respectively. Logistic analysis showed that mass size (odds ratio, 95% CI; 1.12, 1.02-1.24), surrounding tissue changes (odds ratio, 95% CI; 0.11, 0.02-0.47), and shape of the mass (odds ratio, 95% CI; 3.12, 1.02-9.55) were the variables associated with detectability at ABUS. Conclusion: In reader studies using ABUS data, significantly higher sensitivity was noted for malignant breast masses than for benign masses.