Ultrasonographic Detection of Vascularity of Focal Breast Lesions: Microvascular Imaging Versus Conventional Color and Power Doppler Imaging

Alberto Firenze, Tommaso Vincenzo Bartolotta, Domenica Matranga, Alessia Angela Maria Orlando, Luigi Spatafora, Mariangela Di Marco, Maria Ilenia Schillaci, Alberto Firenze, Raffaele Ienzi, Alessandra Cirino, Tommaso Vincenzo Bartolotta, Domenica Matranga, Alessandra Cirino, Alessia Angela Maria Orlando, Luigi Spatafora, Maria Ilenia Schillaci

Risultato della ricerca: Articlepeer review

Abstract

To compare microvascular flow imaging (MVFI) to conventional Color-Doppler (CDI) and Power-Doppler (PDI) imaging in the detection of vascularity of Focal Breast Lesions (FBLs). A total of 180 solid FBLs (size: 3.5–45.2 mm) detected in 180 women (age: 21–87 years) were evaluated by means of CDI, PDI, and MVFI. Two blinded reviewers categorized lesion vascularity in absent or present, and vascularity pattern as (a) internal; (b) vessels in rim; (c) combined. The presence of a “penetrating vessel” was assessed separately. Differences in vascularization patterns (chi2 test) and intra- and inter-observer agreement (Fleiss method) were calculated. ROC analysis was performed to assess performance of each technique in differentiating benign from malignant lesions. About 103/180 (57.2%) FBLs were benign and 77/180 (42.8%) were malignant. A statistically significant (p <.001) increase in blood flow detection was observed for both readers with MVFI in comparison to either CDI or PDI. Benign FBLs showed mainly absence of vascularity (p =.02 and p =.01 for each reader, respectively), rim pattern (p <.001 for both readers) or combined pattern (p =.01 and p =.04). Malignant lesions showed a statistically significant higher prevalence of internal flow pattern (p <.001 for both readers). The prevalence of penetrating vessels was significantly higher with MVFI in comparison to either CDI or PDI (p <.001 for both readers) and in the malignant FBLs (p <.001). ROC analysis showed MVFI (AUC = 0.70, 95%CI = [0.64–0.77]) more accurate than CDI (AUC = 0.67, 95%CI = [0.60–0.74]) and PDI (AUC = 0.67, 95%CI = [0.60–0.74]) though not significantly (p =.5436). Sensitivity/Specificity values for MVFI, PDI, and CDI were 76.6%/64.1%, 59.7%/73.8% and 58.4%/74.8%, respectively. Inter-reader agreement with MVFI was always very good (k-score 0.85–0.96), whereas with CDI and PDI evaluation ranged from good to very good. No differences in intra-observer agreement were noted. MVFI showed a statistically significant increase in the detection of the vascularization of FBLs in comparison to Color and Power-Doppler.
Lingua originaleEnglish
pagine (da-a)273-281
Numero di pagine9
RivistaUltrasonic Imaging
Volume43
Stato di pubblicazionePublished - 2021

All Science Journal Classification (ASJC) codes

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  • ???subjectarea.asjc.2700.2741???

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