TY - JOUR
T1 - Optoacoustic breast imaging
T2 - Imaging-pathology correlation of optoacoustic features in benign and malignant breast masses
AU - Butler, Reni
AU - Lavin, Philip T.
AU - Tucker, F. Lee
AU - Barke, Lora D.
AU - Bohm-Velez, Marcela
AU - Destounis, Stamatia
AU - Grobmyer, Stephen R.
AU - Katzen, Janine
AU - Kist, Kenneth A.
AU - Makariou, Erini V.
AU - Schilling, Kathy J.
AU - Young, Catherine A.
AU - Dogan, Basak
AU - Neuschler, Erin I.
N1 - Funding Information:
Yale University School of Medicine, Radiologic Imaging Associates, P.C., Weinstein Imaging Associates, Elizabeth Wende Breast Care, Cleveland Clinic, Weill Cornell Medicine, University of Texas Health Science Center at San Antonio, MedStar Georgetown University Hospital, Boca Raton Regional Hospital, Austin Radiological Association, MD Anderson Cancer Center, and Northwestern University Feinberg School of Medicine received research grants from Seno Medical Instruments, Inc. Boston Biostatistics Research Foundation has a research contract with Seno Medical Instruments, Inc. to provide study design and analysis services. F. L. Tucker has a research contract with Seno Medical Instruments, Inc. to provide central pathology review and histopathology analysis services. S. R. Grobmyer has received research grants from Provista Diagnostics and Mitaka US. B. E. Dogan has received a research grant from GE Healthcare. R. Butler. P. T. Lavin, F. L. Tucker, L. D. Barke, M. Böhm-Vélez, S. Destounis, S. R. Grobmyer, J. Katzen, K. A. Kist, E. V. Makariou, K. J. Schilling, C. A. Young, B. E. Dogan, and E. I. Neuschler had travel expenses related to training and research meetings reimbursed by Seno Medical Instruments, Inc.
Publisher Copyright:
© 2018 American Roentgen Ray Society.
PY - 2018/11
Y1 - 2018/11
N2 - OBJECTIVE. Optoacoustic ultrasound breast imaging is a fused anatomic and functional modality that shows morphologic features, as well as hemoglobin amount and relative oxygenation within and around breast masses. The purpose of this study is to investigate the positive predictive value (PPV) of optoacoustic ultrasound features in benign and malignant masses. SUBJECTS AND METHODS. In this study, 92 masses assessed as BI-RADS category 3, 4, or 5 in 94 subjects were imaged with optoacoustic ultrasound. Each mass was scored by seven blinded independent readers according to three internal features in the tumor interior and two external features in its boundary zone and periphery. Mean and median optoacoustic ultrasound scores were compared with histologic findings for biopsied masses and nonbiopsied BI-RADS category 3 masses, which were considered benign if they were stable at 12-month follow-up. Statistical significance was analyzed using a two-sided Wilcoxon rank sum test with a 0.05 significance level. RESULTS. Mean and median optoacoustic ultrasound scores for all individual internal and external features, as well as summed scores, were higher for malignant masses than for benign masses (p < 0.0001). High external scores, indicating increased hemoglobin and deoxygenation and abnormal vessel morphologic features in the tumor boundary zone and periphery, better distinguished benign from malignant masses than did high internal scores reflecting increased hemoglobin and deoxygenation within the tumor interior. CONCLUSION. High optoacoustic ultrasound scores, particularly those based on external features in the boundary zone and periphery of breast masses, have high PPVs for malignancy and, conversely, low optoacoustic ultrasound scores have low PPV for malignancy. The functional component of optoacoustic ultrasound may help to overcome some of the limitations of morphologic overlap in the distinction of benign and malignant masses.
AB - OBJECTIVE. Optoacoustic ultrasound breast imaging is a fused anatomic and functional modality that shows morphologic features, as well as hemoglobin amount and relative oxygenation within and around breast masses. The purpose of this study is to investigate the positive predictive value (PPV) of optoacoustic ultrasound features in benign and malignant masses. SUBJECTS AND METHODS. In this study, 92 masses assessed as BI-RADS category 3, 4, or 5 in 94 subjects were imaged with optoacoustic ultrasound. Each mass was scored by seven blinded independent readers according to three internal features in the tumor interior and two external features in its boundary zone and periphery. Mean and median optoacoustic ultrasound scores were compared with histologic findings for biopsied masses and nonbiopsied BI-RADS category 3 masses, which were considered benign if they were stable at 12-month follow-up. Statistical significance was analyzed using a two-sided Wilcoxon rank sum test with a 0.05 significance level. RESULTS. Mean and median optoacoustic ultrasound scores for all individual internal and external features, as well as summed scores, were higher for malignant masses than for benign masses (p < 0.0001). High external scores, indicating increased hemoglobin and deoxygenation and abnormal vessel morphologic features in the tumor boundary zone and periphery, better distinguished benign from malignant masses than did high internal scores reflecting increased hemoglobin and deoxygenation within the tumor interior. CONCLUSION. High optoacoustic ultrasound scores, particularly those based on external features in the boundary zone and periphery of breast masses, have high PPVs for malignancy and, conversely, low optoacoustic ultrasound scores have low PPV for malignancy. The functional component of optoacoustic ultrasound may help to overcome some of the limitations of morphologic overlap in the distinction of benign and malignant masses.
KW - breast cancer
KW - breast ultrasound
KW - imaging-pathology correlation
KW - optoacoustic imaging
KW - photoacoustic imaging
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U2 - 10.2214/AJR.17.18435
DO - 10.2214/AJR.17.18435
M3 - Article
C2 - 30106610
AN - SCOPUS:85055209461
SN - 0361-803X
VL - 211
SP - 1155
EP - 1170
JO - The American journal of roentgenology and radium therapy
JF - The American journal of roentgenology and radium therapy
IS - 5
ER -