Comparison Of The Detection Rate Of Breast Cancer By Ultrasound Shear Wave Elastography Combined With S-DETECT Technology And Breast BI-RADS

Objective:Through the study on the diagnostic efficacy of breast tumors with benign and malignant diagnosis by the three methods of BI-RADS classification,shear wave elastography and S-Detect technology,this study explored whether the diagnostic efficacy of shear wave elastography combined with S-Detect technology is better than that of BI-RADS classification alone,so as to reduce unnecessary needle biopsy or surgery of breast tumors in clinical practice.Methods:A total of 176 breast masses were selected from 153 patients who underwent breast ultrasound examination in the outpatient department of ultrasound department of the second clinical college of Cheng De Medical College from September 2018 to September 2019.With pathology as the gold standard,preoperative routine ultrasonic examination was performed for BI-RADS classification.Then,shear wave elastography was performed for qualitative and quantitative analysis of the characteristics of breast lumps,color elastic pattern classification and elastic modulus parameter measurement were conducted,and the optimal diagnostic threshold was calculated to compare the diagnostic efficacy of shear wave elastography and BI-RADS classification for benign and malignant breast lumps.S-Detect technology was used to compare the diagnostic efficacy of S-Detect technology and BI-RADS classification for benign and malignant breast lumps,and the consistency of the two was compared in the evaluation indexes of S-Detect technology.The detection rates of breast masses by SWE combined with S-Detect technology and conventional ultrasound BI-RADS classification were compared respectively.The detection rates of breast cancer by BI-RADS classification,shear wave elastography,S-Detect and the combination of the two were compared.Results:1.Through pathology examination of 176 breast masses 109 benign masses,67 malignant masses.2.In the conventional ultrasound classification of BI-RADS,the classification of BI-RADS 4a and BI-RADS 4b was used as the diagnostic threshold,and the difference between benign and malignant breast was statistically significant(P<0.05).In the qualitative analysis of shear wave elastography,in the color elastic mode classification,mode 2 and mode 3 were used as the diagnostic thresholds,and the difference between benign and malignant breast masses was statistically significant(P<0.05).3.In quantitative analysis,the elastic modulus parameters Emax,Emean,Esd and Eratio of malignant breast mass were greater than those of benign breast mass,and the difference was statistically significant(P<0.05).The area under ROC curve of elastic modulus parameters Emax,Emean,Esd and Eratio was 0.931,0.894,0.906 and 0.915,respectively.The area under the ROC curve of Emax was the best,with a diagnostic threshold of 84.2kpa.Among BI-RADS classification,color elastic mode classification and elastic modulus parameters in the differential diagnosis of benign and malignant breast tumors,BI-RADS classification has the highest sensitivity and Emax has the highest specificity.4.In the comparison between S-Detect technology and BI-RADS classification for breast lumps,S-Detect technology has higher specificity and higher sensitivity for BI-RADS classification.Among the evaluation indexes of S-Detect technology,the BI-RADS classification and S-Detect technology are highly consistent in terms of the internal structure and growth direction of tumors.The consistency on shape and boundary is low.5.Compared with conventional ultrasound BI-RADS,the detection rate of breast lumps classified by ultrasound BI-RADS was 81.82%,and that of breast lumps detected by SWE combined with S-Detect technology was 98.30%,which was close to the pathological diagnosis,that is,there was no statistically significant difference between groups(P>0.05).6.61 cases of breast cancer were detected by BI-RADS classification,with a true positive rate of 91%.SWE detected 57 cases of breast cancer,with a true positive rate of 85.1%.Breast cancer was detected by S-Detect technology in 56 cases,with a true positive rate of 83.6%.The SWE+ S-Detect technology detected 66 cases of breast cancer,with a true positive rate of 98.5%.The results of the ROC curve showed that the AUC of BI-RADS classification,SWE,S-Detect technology and SWE+ S-Detect technology were 0.861,0.834,0.819 and 0.960,respectively.The AUC of the detection rate of breast cancer by SWE+ S-Detect technology was larger than that by BI-RADS classification,with statistically significant difference(Z=3.16,P < 0.05).Conclusion:Compared with conventional ultrasound BI-RADS,shear wave elastography combined with S-Detect technology has a higher diagnostic efficiency for breast lumps and a higher detection rate for breast cancer,It can provide valuable diagnostic basis for clinic,reduce unnecessary biopsy or operation of breast mass,and has good promotion and application value.