Document Detail

Suspicious breast lesions: assessment of 3D Doppler US indexes for classification in a test population and fourfold cross-validation scheme.
MedLine Citation:
PMID:  18936310     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To assess the diagnostic performance of various Doppler ultrasonographic (US) vascularity measures in conjunction with grayscale (GS) criteria in differentiating benign from malignant breast masses, by using histologic findings as the reference standard. MATERIALS AND METHODS: Institutional Review Board and HIPAA standards were followed. Seventy-eight women (average age, 49 years; range, 26-70 years) scheduled for breast biopsy were included. Thirty-eight patient scans were partially analyzed and published previously, and 40 additional scans were used as a test set to evaluate previously determined classification indexes. In each patient, a series of color Doppler images was acquired and reconstructed into a volume encompassing a suspicious mass, identified by a radiologist-defined ellipsoid, in which six Doppler vascularity measures were calculated. Radiologist GS ratings and patient age were also recorded. Multivariable discrimination indexes derived from the learning set were applied blindly to the test set. Overall performance was also confirmed by using a fourfold cross-validation scheme on the entire population. RESULTS: By using all cases (46 benign, 32 malignant), the area under the receiver operating characteristic curve (A(z)) values confirmed results of previous analyses: Speed-weighted pixel density (SWPD) performed the best as a diagnostic index, although statistical significance (P = .01) was demonstrated only with respect to the normalized power-weighted pixel density. In both learning and test sets, the three-variable index (SWPD-age-GS) displayed significantly better diagnostic performance (A(z) = 0.97) than did any single index or the one two-variable index (age-GS) that could be obtained without the data from the Doppler scan. Results of the cross validation confirmed the trends in the two data sets. CONCLUSION: Quantitative Doppler US vascularity measurements considerably contribute to malignant breast tissue identification beyond subjective GS evaluation alone. The SWPD-age-GS index has high performance (A(z) = 0.97), regardless of incidental performance variations in its single variable components.
Gerald L LeCarpentier; Marilyn A Roubidoux; J Brian Fowlkes; Jochen F Krücker; Karen A Hunt; Chintana Paramagul; Timothy D Johnson; Nancy J Thorson; Karen D Engle; Paul L Carson
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, Non-P.H.S.; Validation Studies    
Journal Detail:
Title:  Radiology     Volume:  249     ISSN:  1527-1315     ISO Abbreviation:  Radiology     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2008-10-21     Completed Date:  2008-11-18     Revised Date:  2010-09-21    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  463-70     Citation Subset:  AIM; IM    
Copyright Information:
(c) RSNA, 2008.
Department of Radiology, University of Michigan, Ann Arbor, MI 48109-0553, USA.
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MeSH Terms
Breast Neoplasms / pathology,  ultrasonography*
Diagnosis, Differential
Discriminant Analysis
Imaging, Three-Dimensional*
Middle Aged
ROC Curve
Sensitivity and Specificity
Ultrasonography, Doppler, Color*
Ultrasonography, Mammary / methods*
Grant Support

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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