Evaluation Of Three-dimensional Color Power Angiography In The Differential Diagnosis Of Benign And Malignant Breast Tumors

Objective To evaluate the value of three-dimensional color power angiography (3D-CPA) in the differential diagnosis of benign and malignant breast tumors.Methods The whole three-dimensional volume of 3D-CPA were acquired in 121 breast solid lesions in the 114 female patients.we used the virtual organ computer-aided analysis (VOCAL) and selected the manual model with rotation step of 300 to generate six contours for each mass. The VOCAL-image program can calculate volume automatically. The volume of the breast tumor was obtained once a contour was defined in all image planes. The histogram indices VI, FI and VFI were determined after the contour was accepted. We edited the contour shell off (i.e., the contour around the tumor margin) and the shell outside a thickness of 3mm for each 3D-CPA image. The histogram indices of VI, FI, and VFI for the intra-tumor (VI1,FI1 and VFI1) and for shells with a thickness of 3mm surrounding the breast lesion (VI2,FI2 and VFI2) were calculated for each breast tumor.And,the ratio of each parameter (G1:VI2/VI1,G2:FI2/FI1,G3:VFI2/VFI1) was calculated.Then, two groups were distributed according to the Surgicopathological results:benign and malignant groups. Eventually, the diagnostic performances of each parameter were compared by receiver operating characteristic (ROC) cure.Results 121 masses(63 malignant and 58 benign) were analyzed:(1) The parameters of intra-tumor flow index (FI1), flow index of shells with outside thickness of 3mm surrounding the breast tumors(FI2) and the ratio of FI2 and FI1(G2) in malignant group were significantly higher than those in benign group(P<0.05, respectively).(2)Analysis of the areas under ROC curve showed that the areas under FI2 curve was the largest; no significant difference(P>0.05) was found compared the area under both FI2 and FI1 curve to G2 curve; Comparing the area under FI2 curve to that under FI1,there was significant differences(P<0.05).(3)Taking FI2≥27.385 as the critical value,the sensitivity and specificity for the diagnosis of malignant breast tumors were 88.9% and 81.0%,and the positive and negative predictive values were 86.2% and 87.0% respectively.(4)Taking G2≥1.005 as the critical value,the sensitivity and specificity for the diagnosis of malignant breast tumors were 85.7% and 94.8%,and the positive and negative predictive values were 94.7% and 85.9% respectively.Conclusions The sensitivity and specificity of 3D-CPA parameter FI2 and G2 in the diagnosis of malignant breast tumors were higher than others. FI2 with the optimal critical value of≥27.385 and G2 with≥1.005 could help to identify malignant from benign breast tumors.