| Part1: The value of virtual touch tissue quantification(VTQ)technique in the differential diagnosis of benign and malignant breast solid nodulesObjective: virtual touch tissue quantification(VTQ)technique in the differential diagnosis of benign and malignant breast nodulesMethods: A total of 145 breast nodules were examined and received surgical treatment in our hospital from 2017 to 2018.Routine ultrasound examination and virtual touch tissue quantification(VTQ)examination were performed before operation.Measure the shear wave velocity(SWV)respectively of the cancer of the lesion and marginal between the lesion and the parenchyma.Pathological results were taken as golden standards for statistical analysis.Results: The SWV in the central region of benign nodules was 3.37±1.14m/s,and the SWV of marginal between the lesion and the parenchyma of benign nodules was3.02±1.92m/s;The SWV in the central region of malignant nodules was7.16±2.00m/s,and the SWV of marginal between the malignant lesion and the parenchyma of nodules was 6.02±1.92m/s.SWV in the central region of malignant nodules and junction of nodules and peripheral glands were higher than those in the central region of benign nodules and junction of nodules and peripheral glands,the difference was statistically significant(P<0.001);The sensitivity,specificity and accuracy of SWV in the central region of all nodules in the diagnosis of benign and malignant were 91.2%,89.6% and 80.79%,The area under the curve was 0.926.The sensitivity,specificity,and accuracy of SWV values at the junction of all nodules and peripheral glands in the diagnosis of benign and malignant were 82.4%,90.90% and73.26%,the area under the curve was 0.910.There were statistically significant differences in the diagnosis of benign and malignant nodule central area and the junction area of surrounding glands(P<0.001).The receiver operating characteristic(ROC)curve was drawn,the SWV value of 4.66m/s in the central region was taken as the best cut-off value,and its corresponding sensitivity,specificity,and accuracy were 91.2% and 89.60%,the area under the curve were 0.926.Conclusion: VTQ technology has clinical significance in the differential diagnosis of benign and malignant nodules,and can be used as an important supplement to conventional ultrasound.Moreover,SWV value in the central region of the nodules has higher diagnostic performance than SWV value in the junction area between the nodules and surrounding glands.Part2: Preliminary study on adjusting the classification of BI-RADS by virtual touch tissue quantification(VTQ)technique combined with resistance index(RI)Objective: To explore the value of virtual touch tissue quantitative technique(VTQ)combined with resistance index(RI)in adjusting BI-RADS classification.Methods: 140 patients who underwent surgery or biopsy in our hospital from 2017 to 2018 were retrospectively selected as research objects,There were 145 breast nodules,conventional ultrasound examination and VTQ examination were performed before surgery.Draw the receiver operating characteristic curve(ROC),to obtain the best cut-off value of resistance index for benign and malignant nodules,and its corresponding sensitivity,specificity and area under the curve(AUC).The BI-RADS subclassification of 145 nodules was adjusted by VTQ and VTQ with RI.To analyze the diagnostic efficacy of BI-RADS in benign and malignant breast nodules before and after adjustment.Results: The difference in the resistance index between benign and malignant nodules was statistically significant(P <0.001).The best cut-off value of RI was > 0.54 when the modern index is highest,the corresponding sensitivity and specificity were 0.98 and 0.96 respectively,and the area under the curve was 0.979.Before adjustment,BI-RADS category 3 nodules contained 25 benign nodules(32.5%),6 malignant nodules(8.8%),BI-RADS category 4 and 5 nodules contained 52 benign nodules(67.5%)and 62 malignant nodules(91.2%).After adjusting with VTQ alone,62(80.5%)benign nodules were found in 3 categories and 7(10.3%)malignant nodules were found,15(19.5%)benign nodules were found in 4 and 5 categories and 61(89.7%)malignant nodules were found in it;After adjusting with VTQ and RI,BIRADS category 3 nodules contained 60 benign nodules(77.9%),1 malignant nodule(1.5%),17 benign nodules(22.1%)and 67 malignant nodules(98.5%)were found in 4 and 5 categories.After adjusting classification by VTQ alone,the number of benign cases of 3 types of nodules was significantly increased,while the number of benign cases of 4 and 5 types of nodules was significantly reduced.The sensitivity and specificity were 89.7% and 80.5%,the positive predictive value was 0.803(95%CI: 0.69-0.88),and the Kappa consistency was 0.70;After adjusting the classification with RI,and VTQ,the number of benign cases was improved and the number of malignant cases was reduced in BI-RADS category 3 nodules,meanwhile,it also improved the number of malignant cases of 4 and 5 types of nodules,with sensitivity and specificity of 98.5% and 77.9%,positive predictive value of 0.798(95%CI: 0.69-0.87),and Kappa consistency of 0.76.Conclusion: Adjustment of BI-RADS classification by VTQ combined with resistance index RI can reduce the unnecessary biopsy rate and surgical rate of BIRADS category 4 nodules,and reduce the missed diagnosis rate of malignant nodules in BI-RADS category 3 nodules,which is an effective supplement to BI-RADS classification. |
PDF Full Text Request