Breast multiparametric ultrasound: a single-center experience

Area of Science:

• Radiology
• Medical Imaging
• Breast Imaging

Background:

• Accurate characterization of focal breast lesions (FBLs) is crucial for timely diagnosis and appropriate management.
• Multiparametric ultrasound (mpUS) integrates various imaging techniques to enhance lesion assessment.
• Traditional ultrasound features can sometimes be ambiguous, necessitating advanced methods.

Purpose of the Study:

• To evaluate the diagnostic role of multiparametric ultrasound (mpUS) in characterizing focal breast lesions (FBLs).
• To compare the performance of different mpUS parameters, including Doppler, strain elastography (SE), and 2D shear wave elastography (2D-SWE).

Main Methods:

• Prospective study involving 139 patients with FBLs undergoing mpUS.
• Assessment of US BI-RADS category, vascularization patterns, strain ratio (SR), Tsukuba score (TS), and 2D-SWE parameters (Emax, Emean, Emin, Eratio).
• Standard of reference established through core biopsy for BI-RADS 4-5 lesions and 24-month follow-up for BI-RADS 2-3 lesions.

Main Results:

• Significant differences in vascularization, penetrating vessels, TS, and all 2D-SWE parameters were found between benign and malignant FBLs (p<0.001).
• US BI-RADS achieved an AUC of 0.876 for malignancy diagnosis.
• 2D-SWE parameters, particularly Emax (AUC=0.915) and Emean (AUC=0.908), showed excellent diagnostic performance.

Conclusions:

• Multiparametric ultrasound, especially 2D-SWE, significantly improves the specificity of focal breast lesion characterization.
• Established cut-off values for mpUS parameters can aid in differentiating benign from malignant FBLs.
• mpUS offers a valuable non-invasive tool for enhancing breast lesion assessment.