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Using the Superb Microvascular Imaging Method in the Distinction of Intraductal Papilloma and Duct Ectasia With
Cihat Tek1, Pelin Seher Öztekin1, Pınar Celepli2
1Department of Radiology, Ankara Training and Research Hospital, Ankara, Turkey.
Objectives:
To investigate the diagnostic value of a Superb Microvascular Imaging (SMI; Toshiba Medical Systems, Tokyo, Japan) Doppler examination for distinguishing intraductal papilloma (IDP) from duct ectasia with secretion in lesions smaller than 1 cm compared to color Doppler imaging (CDI) and power Doppler imaging (PDI).
Methods:
Fifty-nine lesions were evaluated by grayscale ultrasound, CDI, PDI, and SMI. Biopsied tissue samples were analyzed. Ultrasound evaluations and Doppler examinations were performed with a Toshiba Aplio 500 device. The lesions were divided into 2 groups, secretion and IDP, according to the pathologic results. Color Doppler imaging, PDI, and SMI data were compared statistically to investigate their diagnostic values.
Results:
Of the 59 lesions, 22 were secretion, and 37 were IDP. The mean diameters ± SDs were 4.7 ± 0.6 mm in the secretion group and 4.9 ± 0.8 mm in the IDP group (P = .315). There was no significant difference in grayscale ultrasound features such as shape or margin between the groups (P > .05). No significant difference was found between the groups in CDI or PDI characteristics (P > .999; P = .702, respectively). The color SMI evaluation results showed no vascularity in 18 (81.8%) lesions in the secretion group. Vascularity was detected in 32 patients (86.5%) in the IDP group. In the receiver operating characteristic analysis, the areas under the curve were calculated as 0.842 (95% confidence interval [CI], 0.728-0.925) for SMI, 0.522 (95% CI, 0.388-0.654) for PDI, and 0.518 (95% CI, 0.384-0.650) for CDI.
Conclusions:
Superb Microvascular Imaging is more accurate and has more diagnostic ability than CDI or PDI in distinguishing small IDPs from duct ectasia with secretion because of its ability to visualize slow flow speeds of vascular structures.
Insights
Superb Microvascular Imaging (SMI) demonstrates superior accuracy in differentiating small intraductal papillomas (IDPs) from duct ectasia with secretion. SMI
Area of Science:
- Radiology
- Medical Imaging
- Diagnostic Ultrasound
Background:
- Distinguishing intraductal papilloma (IDP) from duct ectasia with secretion can be challenging using conventional ultrasound.
- Small lesions (<1 cm) require advanced imaging techniques for accurate diagnosis.
Purpose of the Study:
- To evaluate the diagnostic performance of Superb Microvascular Imaging (SMI) Doppler in differentiating small IDPs from duct ectasia with secretion.
- To compare SMI with conventional color Doppler imaging (CDI) and power Doppler imaging (PDI).
Main Methods:
- Fifty-nine breast lesions (<1 cm) were assessed using grayscale ultrasound, CDI, PDI, and SMI.
- Pathological analysis of biopsied tissue confirmed the diagnosis for each lesion.
- Statistical comparison of Doppler imaging modalities was performed.
Main Results:
- SMI identified vascularity in 86.5% of IDPs versus 18.2% of secretion-associated duct ectasia.
- Receiver operating characteristic analysis showed a significantly higher area under the curve for SMI (0.842) compared to PDI (0.522) and CDI (0.518).
- No significant differences were observed in grayscale ultrasound features or conventional Doppler characteristics between the groups.
Conclusions:
- Superb Microvascular Imaging (SMI) offers superior diagnostic accuracy for small intraductal papillomas compared to CDI and PDI.
- SMI's ability to visualize slow blood flow enhances its utility in differentiating these breast lesions.
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