RSNA: ABUS may trump hand-held US devices for breast lesion detection

The skin line sub-millimeter image shows the coronal view of the breast. Image Source: Siemens Healthcare

CHICAGO--Automated breast ultrasound systems (ABUS) may be a good alternative to hand-held breast ultrasound (HHUS) devices and better detect breast lesions, according to a study presented Dec. 1 at the annual Radiological Society of North America (RSNA) meeting.

The researchers sought to evaluate inter-observer agreement of breast lesion detection, description and interpretation via ABUS.

“Several previous studies have shown that ABUS allows detecting and classifying solid and cystic lesions with a high sensitivity," said Hee Jung Shin MD, of the department of radiology and research Institute of radiology at the University of Ulsan College of Medicine, Asan Medical Center in Seoul, Korea, who presented the study.  Between August 2009 and October 2009, 55 women underwent bilateral whole breast ultrasound with ABUS (Acuson S2000 ABVS, Siemens Healthcare) technology and diagnostic HHUS (IU-22, Philips Healthcare).

According to Shin, acquisition time was less than five minutes per breast and a total of 121 lesions were found. Patients had a mean age of 48 years.

The 3D ABUS data was evaluated by five radiologists and if the lesion was detected via ABUS, clockface direction, distance from nipple, diameter, lesion type and BIRADS final assessment categories were assessed.

The results showed that three patients reportedly had high-risk lesions (all papilloma). Of the 725 possible detections, 81 percent of detections were made by radiologists. There were 31 cysts and 89 solid masses. Lesion detections on ABUS were between 119 and 127 across five readers. “Mean detection rate of malignant masses in patients with known breast cancer was 95 percent,” the researchers said.

Shin said that 12 of the 121 lesions were detected by the hand-held device. Thirty-six lesions were detected by ABUS only—20 were considered consensus masses and 16 were consensus cysts.

“By using standardized scanning protocol and interpretation criteria, for the ABUS, detection of lesions larger than 1.2 cm in the largest diameter and the method was reliable,” the authors wrote.

“ABUS would provide an alternative tool to HHUS in the diagnostic setting because inter-observer agreement of lesion detection and characterization was substantial,” Shin concluded.