Differentiating benign from malignant solid breast masses: comparison of two-dimensional and three-dimensional US

Area of Science:

• Medical Imaging
• Radiology
• Oncology

Background:

• Solid breast masses require accurate differentiation between benign and malignant conditions for appropriate patient management.
• Conventional two-dimensional (2D) ultrasonography (US) is a standard imaging modality for breast lesion evaluation.
• Advancements in US technology have led to the development of three-dimensional (3D) US, offering potentially improved visualization.

Purpose of the Study:

• To prospectively compare the diagnostic performance of static 2D and 3D US in differentiating benign from malignant solid breast masses.
• To evaluate radiologist accuracy using both 2D and 3D US imaging techniques.

Main Methods:

• 141 patients with 150 solid breast masses underwent both 2D and 3D US imaging prior to biopsy.
• Four radiologists independently reviewed 2D US images and 3D US data, assessing the probability of malignancy.
• Diagnostic performance metrics including sensitivity, specificity, and negative predictive values were compared between 2D and 3D US.

Main Results:

• 3D US showed comparable or slightly improved sensitivity, specificity, and negative predictive values across all four readers compared to 2D US.
• Observed differences in diagnostic performance between 2D and 3D US were not statistically significant (P > .05).
• Individual reader performance varied, but overall trends indicated similar efficacy for both modalities.

Conclusions:

• Static 2D and 3D US imaging demonstrate similar diagnostic performance for characterizing solid breast masses.
• The use of 3D US data did not significantly enhance radiologist performance in differentiating benign from malignant breast lesions compared to conventional 2D US.
• Further research may explore dynamic 3D US or integrated analysis for potential improvements.