ORIGINAL RESEARCH article
Front. Med.
Sec. Precision Medicine
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1596100
This article is part of the Research TopicRecent Trends and Advancements in Multispectral and Hyperspectral Imaging for Cancer DetectionView all 5 articles
The Application of Multimodal Ultrasound Examination in the Differential Diagnosis of Benign and Malignant Breast Lesions of BI-RADS Category 4
Provisionally accepted
- 1Cancer Hospital, College of Medicine, Shantou University, Shantou, Guangdong Province, China
- 2Shantou University, Shantou, China
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Objectives: This study aimed to assess the diagnostic value of conventional ultrasound (US), contrast - enhanced ultrasound (CEUS), and shear wave elastography (SWE) for distinguishing benign and malignant BI - RADS 4 breast lesions.Materials and methods: From January 2022 to January 2023, 95 female breast disease patients aged 20 - 90 with US - diagnosed BI - RADS 4 lesions were enrolled. Pathological confirmation was done via surgery or biopsy, followed by CEUS and SWE evaluations. Statistical analysis of sensitivity, specificity, PPV, NPV, accuracy, and ROC curves was conducted, comparing US, US + SWE, US + CEUS, and US + CEUS + SWE against pathology results.Results: Among 95 lesions, 44 were benign and 51 malignant. Conventional US had sensitivity, specificity, PPV, NPV, and accuracy of 86.3%, 72.7%, 78.6%, 82.1%, and 80.0% respectively. US + SWE achieved 96.1%, 79.5%, 84.5%, 94.6%, and 88.4%; US + CEUS got 84.3%, 86.4%, 87.8%, 82.6%, and 85.3%. The AUCs of US, US + SWE, and US + CEUS were 0.795, 0.877, and 0.917. US + CEUS + SWE showed the best performance with an AUC of 0.946, and sensitivity, specificity, PPV, NPV, and accuracy of 90.7%, 93.2%, 94.2%, 95.3%, and 94.7%.Conclusion: CEUS and SWE, which offer lesion microvascular and stiffness information, improve US - based breast tumor diagnosis, especially for BI - RADS 4a. Combining all three modalities achieves the highest diagnostic performance, enhancing sensitivity, specificity, and reducing unnecessary procedures for BI - RADS 4 lesions.
Keywords: Breast tumor, Ultrasonography, Shear-wave elastography, contrast-enhanced ultrasound, Multimodal Ultrasound Examination
Received: 19 Mar 2025; Accepted: 14 May 2025.
Copyright: © 2025 Li, Wu and Huang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: haiqing Huang, Shantou University, Shantou, China
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