The Application Value Of Acoustic Radiation Force Impulse For BI-RADS Classification Of Breast Lesions

[Objective]Acoustic radiation force impulse(ARFI)was used to observe the hardness of breast lesions tissues.Quantitative analysis of the value of acoustic radiation force impulse technology for breast imaging reporting and data system(BI-RADS),looking forward to early detect breast cancer patients and improving patients survival and quality of life.[Methods]A total of 179 breast lesions were selected from 175 patients who were diagnosed by biopsy and surgical pathology.Routine ultrasound,virtual touch tissues quantification(VTQ),virtual touch tissue imaging(VTI)examination and BI-RADS classification for these breast lesions,obtained the shear wave velocity(SWV)and average optical density of the tumor by using Image J software on VTI images.The diagnostic value of BI-RADS classification,VTQ,VTI and combined method were compared by statistical method.Finally,the significance of ARFI in BI-RADS classification was analyzed.[Results]1.Confirmed by pathology,all 179 breast lesions included 108 benign lesions and 71 malignant.The area under the ROC curve of VTQ examination was 0.883 and the value is 3.54m/s.Similarly,the AUC of VTI examination mean density was 0.933 and the corresponding boundary value is 202.25.In malignant lesions,there were 55 lesions with VTQ value more than or equal 3.54 and 16 lesions less than 3.54.There were 7 lesions with VTQ value more than or equal 3.54 and 101 lesions less than 3.54(t=11.227,P=0.000).To 202.25 as the critical value,66 lesions more than or equal the value and 5less than the number of all the malignant lesions.In benign nodules,There were 10 lesions more than or equal 202.25 and 98 lesions less than 202.25(t=12.364,P=0.000).The sensitivity,specificity,PPV,NPV and accuracy,Youden index of conventional ultrasound were97.18%(69/71),42.59%(48/108),52.67%(69/131),95.83%(46/48),64.25%(115/179),0.3977,respectively,for ARFI,94.37%(67/718),88.89%(96/108),84.81%(67/79),96%(96/100),91.06%(163/179),0.8326,respectively.2.VTQ examination compared with conventional ultrasound BI-RADS classification:the sensitivity of BI-RADS was higher than that VTQ(P=0.001),and the specificity,positive predictive value and accuracy rate of VTQ examination were higher than that BI-RADS(P=0.000),specificity index better.3.VTQ examination compared with combination method: combination method sensitivity higher than VTQ examination(P=0.004).4.VTI examination compared with conventional ultrasound BI-RADS classification:the specificity,positive predictive value and accuracy rate of VTI examination were higher than that BI-RADS(P=0.000),specificity index better.5.Combination method compared with conventional ultrasound BI-RADS classification: the specificity,positive predictive value and accuracy rate of combination method were higher than that BI-RADS(P=0.000),specificity index better.[Conclusion]1.Two methods of VTQ examination and VTI examination are of great significance in the diagnosis of benign and malignant breast lesions.2.Comparison of VTQ examination and VTI examination parameters in the diagnosis of benign and malignant breast lesions,there are no significant difference.3.Acoustic radiation force impulse can make up for the lack of conventional ultrasound.The combined method can detect small lesions in the early stage,which can accurately judge the benign and malignant breast lesions and improves the diagnostic accuracy.