Differentiation of benign from malignant solid breast masses: conventional US versus spatial compound imaging.
OBJECTIVE
To compare prospectively the diagnostic performance of radiologists who used conventional ultrasonography (US) with that of radiologists who used spatial compound imaging for the differentiation of benign from malignant solid breast masses.


METHODS
The study was approved by the institutional review board, and informed consent was obtained. Before excisional or needle biopsy was performed, conventional US and spatial compound images were obtained in 67 patients (age range, 25-67 years; mean age, 45 years) with 75 solid breast masses (21 cancers and 54 benign lesions). Three experienced radiologists who did not perform the examinations independently analyzed US findings and indicated the probability of malignancy. Results were evaluated with kappa statistics and receiver operating characteristic (ROC) analysis.


RESULTS
For US findings, the presence of calcifications was the most discordant feature (kappa = 0.372) between conventional US and spatial compound imaging, followed by echotexture (kappa = 0.439), boundary echo (kappa = 0.496), orientation (kappa = 0.518), echogenicity (kappa = 0.523), shape (kappa = 0.526), margin (kappa = 0.569), and posterior acoustic transmission (kappa = 0.669). The area under the ROC curve for conventional US was 0.79 for reader 1, 0.88 for reader 2, and 0.82 for reader 3, and the area under the ROC curve for spatial compound imaging was 0.85 for reader 1, 0.88 for reader 2, and 0.89 for reader 3. The partial area index for conventional US was 0.29 for reader 1, 0.69 for reader 2, and 0.39 for reader 3, and the partial area index for spatial compound imaging was 0.29 for reader 1, 0.65 for reader 2, and 0.39 for reader 3. The difference between the diagnostic performances of the two techniques was not significant (P > .05).


CONCLUSIONS
The performance of the radiologists with respect to the characterization of solid breast masses was not significantly improved with spatial compound imaging.
Cha
Joo Hee
JH
Dept of Radiology, Seoul Municipal Boramae Hosp, Seoul, Korea.
Moon
Woo Kyung
WK
Cho
Nariya
N
Chung
Sun Yang
SY
Park
Seong Ho
SH
Park
Jeong Mi
JM
Han
Boo Kyung
BK
Choe
Yeon Hyun
YH
Cho
Gyunggoo
G
Im
Jung-Gi
JG
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008327:Mammography; D008875:Middle Aged; D015588:Observer Variation; D011446:Prospective Studies; D012372:ROC Curve; D012680:Sensitivity and Specificity; D016217:Ultrasonography, Mammary