title: Diagnosis of sub-centimetre breast lesions: combining BI-RADS-US with strain elastography and contrast-enhanced ultrasound-a preliminary study in China.
abstract: OBJECTIVE
  To compare the diagnostic efficacies of B-mode ultrasound (US), strain elastography (SE), contrast-enhanced ultrasound (CEUS) and the combination of these modalities for breast lesions <1 cm in size.
  
  
  METHODS
  Between January 2013 and October 2015, 203 inpatients with 209 sub-centimetre breast lesions categorised as BI-RADS-US (Breast Imaging Reporting and Data System for Ultrasound) 3-5 were included. US, SE and CEUS were performed to evaluate each lesion. The diagnostic performances of different ultrasonic modalities were compared. The diagnostic efficacies of BI-RADS-US and our re-rating systems were also compared. The pathology findings were used as the reference standard.
  
  
  RESULTS
  The specificities of US, SE and CEUS for tumour differentiation were 17.4 %, 56.2 % and 86.0 %, respectively (P < 0.05); and the sensitivities were 100 %, 93.2 % and 93.2 % for US, SE and CEUS, respectively (P < 0.05). The area under the curve (AUC) of the receiver operating characteristic (ROC) curve was 0.867 for original BI-RADS-US, 0.882 for BI-RADS-US combined with only SE, 0.953 for BI-RADS-US combined with only CEUS and 0.924 for BI-RADS-US combined with both SE and CEUS. The best combination was BI-RADS-US combined with only CEUS.
  
  
  CONCLUSIONS
  Evaluating sub-centimetre breast lesions with SE and CEUS could increase the diagnostic specificity while retaining high sensitivity compared with B-mode ultrasound.
  
  
  CONCLUSIONS
  • Evaluating breast lesions with SE and CEUS could increase the diagnostic specificity • SE and CEUS offer alternatives to biopsy and possibly allow shorter-interval follow-ups • BI-RADS-US combined with CEUS exhibited the best diagnostic performance.
authors.affiliation: Department of Ultrasound, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiangxi Rd, 510120, Guangzhou, China.
authors.forename: Xiaoyun
authors.initials: X
authors.lastname: Xiao
authors.affiliation: Department of Ultrasound, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiangxi Rd, 510120, Guangzhou, China.
authors.forename: Qiongchao
authors.initials: Q
authors.lastname: Jiang
authors.affiliation: Department of Ultrasound, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiangxi Rd, 510120, Guangzhou, China.
authors.forename: Huan
authors.initials: H
authors.lastname: Wu
authors.affiliation: Department of Ultrasound, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiangxi Rd, 510120, Guangzhou, China.
authors.forename: Xiaofeng
authors.initials: X
authors.lastname: Guan
authors.affiliation: Department of Ultrasound, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiangxi Rd, 510120, Guangzhou, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Qin
authors.affiliation: Department of Ultrasound, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiangxi Rd, 510120, Guangzhou, China. baomingluo2013@126.com.
authors.forename: Baoming
authors.initials: B
authors.lastname: Luo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019540:Area Under Curve; D001706:Biopsy; D001940:Breast / Q000000981:diagnostic imaging; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D002681:China; D003287:Contrast Media; D054459:Elasticity Imaging Techniques / Q000379:methods* / Q000592:standards; D005260:Female; D006801:Humans; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods / Q000592:standards; D012372:ROC Curve; D012680:Sensitivity and Specificity; D016217:Ultrasonography, Mammary / Q000379:methods* / Q000592:standards; D055815:Young Adult
chemical_list: D003287:Contrast Media
keywords: Breast; Contrast media; Diagnosis; Elastography; Ultrasound