Virtual Touch Tissue Imaging Quantification Combined With BI-RADS Classification In The Differential Diagnosis Of Benign And Malignant Breast Lesions

Objective(s):To explore the application value of Virtual Touch Tissue Imaging Quantification(VTIQ)combined with BI-RADS classification in the differential diagnosis of benign and malignant breast lesions.Methods:152 case(all females)with breast lesions which detected by ultrasound in the Fifth Affiliated Hospital of Kunming Medical University from April 2019 to February 2021,total of 261 breast lesions which all were subjected to conventional ultrasound and were classified with BI-RADS classification before surgery or biopsy.After were classified,VTIQ technology was used to measure the SWV value of the lesion and calculate the average value(denoted as SWVmean).Based on the pathological results of the lesions,the ROC curve of the BI-RADS classification method and the VTIQ technique for diagnosing benign and malignant breast lesions were constructed respectively,calculate the area under the curve,the maximum Yoden index was taken to determine the best diagnosis boundary point of the VTIQ curve,and its sensitivity,specificity and accuracy were calculated.The original BI-RADS classification results of all lesions are expressed as numerical values(class 3 is 3,4a is 4,4b is 5,4c is 6,5 is 7),and the SWVmean value of lesions is recorded as 0 and 1(0 is<diagnosis boundary point,1 is≥diagnosis boundary point)based on the best diagnosis boundary point of VTIQ in breast benign and malignant,two data are added to obtain the joint score of BI-RADS classification method combined with VTIQ technology in the diagnosis of all breast lesions.Same as above,based on the pathological results of the lesions,construct the ROC curve of joint score in the diagnosis of benign and malignant breast lesions,calculate the area under the curve,determine the best diagnosis boundary point,and its sensitivity,specificity and accuracy were calculated.χ2 tests was used to compare the sensitivity,specificity and accuracy,the Z test was used to compare the area under the ROC curve of the single BI-RADS classification method,the VTIQ technique and the joint score of two methods in the differential diagnosis of benign and malignant breast lesions.According to the diameter of the largest section of the lesion,261 lesions were divided into:maximum diameter≤lcm group(n=103),>1cm and<2cm group(n=85),≥2cm group(n=73),The Z test was used to compare the area under the ROC curve of the BI-RADS classification method,the VTIQ technique and the joint score of the two methods in each group.Divide 261 breast lesions into the following subgroups:(1)Divided into malignant breast lesions group(n=111)and benign breast lesions group(n=150)according to pathological results.(2)Divided into malignant breast lesions with microcalcification group(n=43)and malignant breast lesions without microcalcification group(n=68)according to the presence or absence of microcalcification in malignant breast lesions.The t test was used to compare the SWVmean differences of the above subgroups.Results:(1)The best diagnosis boundary point of VTIQ technique and joint score in benign and malignant breast lesions are:5.05m/s,5 points,respectively.(2)The sensitivity of BI-RADS classification method,VTIQ technique and the joint score of the two methods in diagnosing benign and malignant breast lesions are 66.7%,82.0%,and 98.2%.The specificities are respectively:91.3%,90.7%,88.7%.The accuracy are 80.8%,87.0%,92.7%.the area under the ROC curve is 0.899,0.926,0.960,respectively.Except for the difference between the single VTIQ technique and the single BI-RADS classification method in the area under the ROC curve for the diagnosis of benign and malignant breast lesions was not statistically significant(Z=1.270,P=0.204),the sensitivity,specificity,accuracy and area under the ROC curve of the other methods compared in pairs,the differences were statistically significant(P<0.05).(3)For the breast lesions with a maximum diameter of≤1cm,the area under the ROC curve of the differential diagnosis of benign and malignant breast lesions with VTIQ technique and joint score was higher than that of the single BI-RADS classification method,and the difference was statistically significant(P<0.05).For breast lesions with a maximum diameter of>1cm and<2 cm,the area under the ROC curve of joint score of the VTIQ technique and BI-RADS classification method to diagnose is higher than that of the single BI-RADS classification method and the single VTIQ technique,and the difference is statistically significant(P<0.05).For breast lesions with the maximum diameter≥2cm,the BI-RADS classification method,VTIQ technique and the joint score of the two methods have a larger area under the ROC curve for the differential diagnosis of benign and malignant,and there is no statistically significant difference between the two comparisons(P>0.05).(4)The SWVmean value of the malignant breast lesion group was greater than that of the benign breast lesion group,and the difference was statistically significant(P<0.05).(5)The SWVmean value of the malignant breast lesions combined with microcalcification group was greater than that of the malignant lesions without microcalcification group,and the difference was statistically significant(P<0.05).Conclusion(s):(1)The joint score of BI-RADS classification method and VTIQ technology can be used as an effective index for the differential diagnosis of benign and malignant breast lesions by ultrasound.For breast lesions with a maximum diameter of≤cm,it is recommended to use the VTIQ technique or the joint score for diagnosis.For breast lesions with a maximum diameter of>1cm and<2cm,it is recommended to use the joint score for differential diagnosis.For breast lesions with a maximum diameter of≥2 cm,the BI-RADS classification method,VTIQ technique and the joint score of the two methods can effectively distinguish benign and malignant breast lesions.(2)The joint score of BI-RADS classification method and VTIQ technology can improve the sensitivity and accuracy of single BI-RADS classification method and VTIQ technology in diagnosing benign and malignant breast lesions.(3)Single BI-RADS classification method and VTIQ technology have their own advantages in the differential diagnosis of breast lesions.VTIQ technology can enrich the evaluation index of BI-RADS classification method in the differential diagnosis of benign and malignant breast lesions,combined with the two-dimensional ultrasound performance of breast lesions features,reasonable selection of conventional ultrasound and VTIQ technology,has important guiding value for the differential diagnosis of benign and malignant breast lesions.(4)Microcalcification can increase the overall hardness of malignant breast lesions and increase the difference in SWV value between benign and malignant breast lesions,which is conducive to the differential diagnosis of benign and malignant breast lesions with VTIQ technology.