An observational study of contrast-enhanced ultrasound in diagnosing malignant breast masses

To study the diagnostic role of contrast-enhanced ultrasound (CEUS) in terms of sensitivity, specificity, and its comparison with grey-scale ultrasound with colour Doppler in characterising malignant breast masses.

An observational study was done for duration of 18 months, including 64 adult females with breast masses. Patients underwent various investigations in the form of conventional ultrasound with colour Doppler and CEUS. Patients underwent surgery, and a histopathological examination was performed on a surgical specimen for confirmation of a benign or malignant lesion. Outcome measures were the proportion of benign and malignant lesions of the breast and the diagnostic accuracy of CEUS in characterising malignant lesions in the breast.

On analysis, CEUS showed very good agreement with histopathological diagnosis with κ 0.967 (p < 0.0001); while good agreement was found between histopathological diagnosis and diagnosis by B mode + colour Doppler with κ 0.772 (p < 0.0001). CEUS demonstrated sensitivity of 100%, specificity of 96.15%, and AUC of 0.98, while diagnosis B mode + colour Doppler yielded sensitivity of 92.11%, specificity of 84.62%, and diagnostic accuracy of 89.06%.

CEUS was found to have a better diagnostic accuracy for differentiation of benign and malignant breast masses (using histopathology as a gold standard). The overall sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of CEUS was found to be 99%, 96%, 97.4%, 99%, and 98.4% respectively.