Comparison of Diagnostic Efficacy Between Contrast-Enhanced Ultrasound and DCE-MRI for Mass- and Non-Mass-Like Enhancement Types in Breast Lesions

Abstract

Wei Liu,1,* Min Zong,2,* Hai-yan Gong,1,* Li-jun Ling,3 Xin-hua Ye,1 Shui Wang,3 Cui-ying Li1 1Department of Ultrasound, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, People’s Republic of China; 2Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, People’s Republic of China; 3Department of Breast Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, People’s Republic of China*These authors contributed equally to this workCorrespondence: Cui-ying LiDepartment of Ultrasound, The First Affiliated Hospital of Nanjing Medical University, No. 300, Guangzhou Road, Nanjing 210029, People’s Republic of ChinaTel [phone]Email [email protected] WangDepartment of Breast Surgery, The First Affiliated Hospital of Nanjing Medical University, No. 300, Guangzhou Road, Nanjing 210029, People’s Republic of ChinaTel [phone]Email [email protected]: Contrast-enhanced ultrasound (CEUS) can provide angiogenesis information about breast lesions; however, its diagnostic performance in comparison with that of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) has not been systematically investigated. This study aimed to evaluate the diagnostic efficacy of CEUS and DCE-MRI in mass-like and non-mass-like enhancement types of breast lesions.Material and Methods: A retrospective study was conducted on 252 patients with breast lesions who underwent CEUS and DCE-MRI before surgery between January 2016 and February 2020. Histopathological results were used as reference standards. All patients were classified into mass-like and non-mass-like enhancement lesion groups. The mass-like lesion group was further divided into three categories according to different sizes (group 1: < 10 mm, group 2: 10– 20 mm, and group 3: > 20 mm). Sensitivity, specificity, positive predictive value, negative predictive value, and receiver operating characteristic curve were analyzed to assess the diagnostic performance of these two modalities.Results: For mass-like breast lesions, DCE-MRI (Az=0.981) manifested better diagnostic performance than CEUS (Az=0.940) in medium-sized (10– 20 mm) tumors (Z=2.018, P=0.043), but both had similar diagnostic performance in smaller (< 10 mm) and larger (> 20 mm) tumors (P=0.717, P=0.394). For non-mass-like enhancement lesions, CEUS and DCE-MRI showed no significant difference (Z=1.590, P=0.119) and revealed good diagnostic performance (Az=0.859, Az=0.947) in differentiating the two groups.Conclusion: For mass-like breast lesions, DCE-MRI showed better diagnostic performance than CEUS in differentiating benign and malignant tumors of medium-sizes (10– 20mm) but not of smaller (< 10mm) and larger (> 20 mm) sizes. For non-mass-like lesions, both modalities showed similar diagnostic performance.Keywords: contrast-enhanced ultrasound, dynamic contrast-enhanced MRI, mass-like breast lesion, non-mass-like breast lesion, breast cancer

Keywords

• contrast-enhanced ultrasound
• dynamic contrast-enhanced mri
• mass-like breast lesion
• non-mass-like breast lesion
• breast cancer