Application Of Multimodal Elastography(SE+VTIQ) Combined With Automatic Breast Volumetric Scanning System(ABVS) In Ultrasound Diagnosis Of Breast Tumors

OBJECTIVE:To investigate the Automated Breast Volume Scanner(ABVS)technique combined with multimodal elastography-Stress Elastography(SE)and Virtual Touch Issue Quantification(Virtual Touch Issue Quantification,The value of VTIQ)technology in the diagnosis of breast tumors by ultrasound.Methods:Retrospective analysis of 310 cases of breast masses with ABVS,SE,VTIQ results,with histopathology as the gold standard,evaluation of imaging results and corresponding data of three techniques,comparing different inspection methods-The effects of ABVS,SE,VTIQ alone and in combination with each other(ABVS+SE,ABVS+VTIQ,SE+VTIQ,ABVS+SE+VTIQ)on ultrasound diagnosis of breast tumor outcomes.Patients with breast cancer who underwent ABVS examination from August 2016 to August 2017 in Yunnan Provincial Cancer Hospital were selected.Those who met the inclusion criteria were first performed with Hand Held ultrasonography(HUUS)and reported breast masses and data.System Classification(Breast Imaging Reporting And Date System,BI-RADS),BI-RADS?3 is considered benign,and BI-RADS?4 is considered malignant[1].Next,these patients underwent ABVS imaging and SE,VTIQ technical examination and obtained corresponding images and data,including 298 cases of pathological results.Breast masses were examined with ABVS,SE,and VTIQ,respectively,and standard images of the masses and related data were obtained.ABVS observed the mass in the transverse,coronal and sagittal planes respectively and judged whether there was a"convergence sign,on the coronal surface according to the morphological features.SE:Obtained the mammary gland under the elastic imaging state and the two-dimensional imaging state under the largest section of the tumor.Tissue/tumor strain ratio,area ratio,aspect ratio;VTIQ:Shear Wave Velocity(SWV)at 8 different locations with the largest section of the mass.These shear wave values should take into account different parts of the mass.The inside of the mass should be measured,and the junction with other tissues should be included.In general,the shear wave information of the different parts should be included as much as possible.Finally,the maximum shear wave velocity(SWVmax)and minimum in the mass should be calculated.Value(SWVmin)and average(SWVmean)(units are n/s).The results of HHUS and ABVS,SE,VTIQ and mutual association were compared and analyzed by surgical pathology or puncture histopathological results.ABVS:According to the presence or absence of "convergence sign" in the coronal plane,there is a "convergence sign",which is recorded as positive,no "convergence sign",recorded as negative,comparing the difference between the "convergence sign" on the coronal plane and pathological results;SE:adopted 5 points,? 4 points were diagnosed as malignant,recorded as positive,? 4 points were diagnosed as malignant,recorded as negative[2],compared with SE 5 and pathological results;VTIQ:judgment of benign and malignant species SWVmax,SWVmin and SWVmean,according to the Recseve Operating Characteristic(ROC)curve to determine the highest accuracy of a set of SWV values,to obtain the best cut-off value for the diagnosis of benign and malignant tumors;to evaluate the ABVS coronal"convergence sign" ",SE,VTIQ technology combined with each other(ABVS+SE,ABVS+VTIQ,SE+VTIQ,ABVS+SE+VTIQ)to diagnose the benign and malignant breast mass.RESULTS:Pathological findings of 298 breast tumors:211 lesions in the benign group and 87 lesions in the malignant group.ABVS:There were 27 lesions on the coronal plane with "convergence sign",all pathologically confirmed as malignant;271 lesions with no "convergence sign" on the ABVS coronal plane,and 221 cases confirmed benign pathology.The sensitivity of ABVS for the diagnosis of breast tumors was 31%,the specificity was 100%,the correct index was 0.31,El:166 benign,132 were malignant,the sensitivity of diagnosis was 60.9%,the specificity was 62.6%,and the correct index was 0.23.SWVmax,SWVmean,and SWVmean were statistically different between the malignant group and the benign group.The sensitivity of SWVmax was 50.6,the specificity was 83.9,the sensitivity of SWVmean was 37.9,the specificity was 94.8,and the sensitivity was 40.2,the specificity is 86.7;SWV value(SWVmax,SWVmean,SWVmax)ROC curve area can be obtained SWVmax confidence interval 0.646?0.753,SWVmin confidence interval 0.613?0.723,SWVmean confidence interval 0.651?0.758.In a single diagnostic test,ABVS,SE and VTIQ were the most specific,ABVS had the highest specificity,and SE sensitivity was the highest.Conventional ultrasound showed a significant increase in specificity and correctness index without decreasing sensitivity.In the two-two combination test,the VTIQ+ABVS coronal "convergence sign" has the highest sensitivity,and the ABVS coronal "convergence sign" + SE specificity is the highest.ABVS+SE+VTIQ has a combined sensitivity of 49.4 and a specificity of 100,both of which increase,providing more information for the diagnosis of breast masses.Conclusions:1.ABVS coronal "convergence sign" has higher sensitivity and specificity,and the specificity of malignant tumor in the coronal plane is higher.The identification of benign and malignant breast mass is important.2,El quantitative analysis of breast tissue/mass strain ratio,transverse diameter ratio,area ratio in the diagnosis of benign and malignant breast tumors,the sensitivity decreased,the specificity increased,the critical values were 7.19,1.14,1.03;3.When VTIQ is applied alone,SWVmax,SWVmix,and SWVmean are statistically significant.The three specificities are higher than HHUS,which can avoid misdiagnosis.4,comprehensive examination methods,ABVS coronal surface "convergence sign+SE specificity is the highest,ABVS coronal surface "convergence sign"+VTIQ sensitivity is the highest,the best comprehensive effect.