TY - JOUR
T1 - Downgrading and upgrading gray-scale ultrasound BI-RADS categories of benign and malignant masses with optoacoustics
T2 - A pilot study
AU - Neuschler, Erin I.
AU - Lavin, Philip T.
AU - Lee Tucker, F.
AU - Barke, Lora D.
AU - Bertrand, Margaret L.
AU - Böhm-Vélez, Marcela
AU - Destounis, Stamatia
AU - Dogan, Basak E.
AU - Grobmyer, Stephen R.
AU - Katzen, Janine
AU - Kist, Kenneth A.
AU - Makariou, Erini V.
AU - Parris, Tchaiko M.
AU - Young, Catherine A.
AU - Butler, Reni
N1 - Funding Information:
F. L. Tucker has a research contract with Seno Medical Instruments, Inc. to provide central pathology review and histopathology analysis services. B. E. Dogan has a research grant from GE Healthcare. S. R. Grobmyer has received research funding from Provista Diagnostics and Mitaka US. E. I. Neuschler, P. T. Lavin, F. L. Tucker, L. D. Barke, M. L. Bertrand, M. Böhm-Vélez, B. E. Dogan, S. R. Grobmyer, J. Katzen, K. A. Kist, E. V. Makariou, C. A. Young, and R. Butler had travel expenses related to training and research meetings paid by Seno Medical Instruments, Inc. Northwestern University Feinberg School of Medicine, Weinstein Imaging Associates, Elizabeth Wende Breast Care, MD Anderson Cancer Center, the Cleveland Clinic, Weill Cornell Medicine, UT Health San Antonio, MedStar Georgetown University Hospital, Radnet, Austin Radiological Association, and Yale School of Medicine had research grants from Seno Medical Instruments, Inc. Boston Biostatistics Research Foundation has a research contract with Seno Medical Instruments, Inc. to provide study design and analysis services. Radiologic Imaging Associates, P.C., received funds from Seno Medical Instruments, Inc. for the conduct of the study at their site. Solis Mammography Greensboro was compensated for expenses related to the Seno research.
Publisher Copyright:
© American Roentgen Ray Society.
PY - 2018/9
Y1 - 2018/9
N2 - OBJECTIVE. False-positive findings remain challenging in breast imaging. This study investigates the incremental value of optoacoustic imaging in improving BI-RADS categorization of breast masses at ultrasound. SUBJECTS AND METHODS. The study device is an optoacoustic breast imaging device with a handheld duplex laser and internal gray-scale ultrasound probe, fusing functional and morphologic information (optoacoustic ultrasound). In this prospective multisite study, breast masses assessed as BI-RADS category 3, 4A, 4B, 4C, or 5 by site radiologists underwent both gray-scale ultrasound and optoacoustic imaging with the study device. Independent reader radiologists assessed internal gray-scale ultrasound and optoacoustic ultrasound features for each mass and assigned a BI-RADS category. The percentage of mass reads for which optoacoustic ultrasound resulted in a downgrade or upgrade of BI-RADS category relative to internal gray-scale ultrasound was determined. RESULTS. Of 94 total masses, 39 were biopsy-proven malignant, 44 were biopsy-proven benign, and 11 BI-RADS category 3 masses were stable at 12-month follow-up. The sensitivity of both optoacoustic ultrasound and internal gray-scale ultrasound was 97.1%. The specificity was 44.3% for optoacoustic ultrasound and 36.4% for internal gray-scale ultrasound. Using optoacoustic ultrasound, 41.7% of benign masses or BI-RADS category 3 masses that were stable at 12-month follow-up were downgraded to BI-RADS category 2 by independent readers; 36.6% of masses assigned BI-RADS category 4A were downgraded to BI-RADS category 3 or 2, and 10.1% assigned BI-RADS category 4B were downgraded to BI-RADS category 3 or 2. Using optoacoustic ultrasound, independent readers upgraded 75.0% of the malignant masses classified as category 4A, 4B, 4C, or 5, and 49.4% of the malignant masses were classified as category 4B, 4C, or 5. CONCLUSION. Optoacoustic ultrasound resulted in BI-RADS category downgrading of benign masses and upgrading of malignant masses compared with gray-scale ultrasound.
AB - OBJECTIVE. False-positive findings remain challenging in breast imaging. This study investigates the incremental value of optoacoustic imaging in improving BI-RADS categorization of breast masses at ultrasound. SUBJECTS AND METHODS. The study device is an optoacoustic breast imaging device with a handheld duplex laser and internal gray-scale ultrasound probe, fusing functional and morphologic information (optoacoustic ultrasound). In this prospective multisite study, breast masses assessed as BI-RADS category 3, 4A, 4B, 4C, or 5 by site radiologists underwent both gray-scale ultrasound and optoacoustic imaging with the study device. Independent reader radiologists assessed internal gray-scale ultrasound and optoacoustic ultrasound features for each mass and assigned a BI-RADS category. The percentage of mass reads for which optoacoustic ultrasound resulted in a downgrade or upgrade of BI-RADS category relative to internal gray-scale ultrasound was determined. RESULTS. Of 94 total masses, 39 were biopsy-proven malignant, 44 were biopsy-proven benign, and 11 BI-RADS category 3 masses were stable at 12-month follow-up. The sensitivity of both optoacoustic ultrasound and internal gray-scale ultrasound was 97.1%. The specificity was 44.3% for optoacoustic ultrasound and 36.4% for internal gray-scale ultrasound. Using optoacoustic ultrasound, 41.7% of benign masses or BI-RADS category 3 masses that were stable at 12-month follow-up were downgraded to BI-RADS category 2 by independent readers; 36.6% of masses assigned BI-RADS category 4A were downgraded to BI-RADS category 3 or 2, and 10.1% assigned BI-RADS category 4B were downgraded to BI-RADS category 3 or 2. Using optoacoustic ultrasound, independent readers upgraded 75.0% of the malignant masses classified as category 4A, 4B, 4C, or 5, and 49.4% of the malignant masses were classified as category 4B, 4C, or 5. CONCLUSION. Optoacoustic ultrasound resulted in BI-RADS category downgrading of benign masses and upgrading of malignant masses compared with gray-scale ultrasound.
KW - BI-RADS
KW - Breast cancer
KW - Breast ultrasound
KW - Optoacoustic imaging
KW - Photoacoustic imaging
UR - http://www.scopus.com/inward/record.url?scp=85052557213&partnerID=8YFLogxK
U2 - 10.2214/AJR.17.18436
DO - 10.2214/AJR.17.18436
M3 - Article
C2 - 29975115
AN - SCOPUS:85052557213
SN - 0361-803X
VL - 211
SP - 689
EP - 700
JO - American Journal of Roentgenology
JF - American Journal of Roentgenology
IS - 3
ER -