Background: Contrast-enhanced ultrasound (CEUS) can provide angiogenesis information about breast lesions; however, its diagnostic performance in comparison with that of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) has not been systematically investigated. This study aimed to evaluate the diagnostic efficacy of CEUS and DCE-MRI in mass-like and non-mass-like enhancement types of breast lesions.
Material and Methods: A retrospective study was conducted on 252 patients with breast lesions who underwent CEUS and DCE-MRI before surgery between January 2016 and February 2020. Histopathological results were used as reference standards. All patients were classified into mass-like and non-mass-like enhancement lesion groups. The mass-like lesion group was further divided into three categories according to different sizes (group 1: < 10 mm, group 2: 10– 20 mm, and group 3: > 20 mm). Sensitivity, specificity, positive predictive value, negative predictive value, and receiver operating characteristic curve were analyzed to assess the diagnostic performance of these two modalities.
Results: For mass-like breast lesions, DCE-MRI (Az =0.981) manifested better diagnostic performance than CEUS (Az =0.940) in medium-sized (10– 20 mm) tumors (Z =2.018, P =0.043), but both had similar diagnostic performance in smaller (< 10 mm) and larger (> 20 mm) tumors (P =0.717, P =0.394). For non-mass-like enhancement lesions, CEUS and DCE-MRI showed no significant difference (Z =1.590, P =0.119) and revealed good diagnostic performance (Az =0.859, Az =0.947) in differentiating the two groups.
Conclusion: For mass-like breast lesions, DCE-MRI showed better diagnostic performance than CEUS in differentiating benign and malignant tumors of medium-sizes (10– 20mm) but not of smaller (< 10mm) and larger (> 20 mm) sizes. For non-mass-like lesions, both modalities showed similar diagnostic performance.
Keywords: contrast-enhanced ultrasound, dynamic contrast-enhanced MRI, mass-like breast lesion, non-mass-like breast lesion, breast cancer