Objective:

To investigate the differential diagnosis ability of automated breast volume scanning (ABVS) and acoustic radiation force impulse (ARFI) in the diagnosis of suspicious breast mass by conventional ultrasound.

Methods:

A total of 118 patients with breast masses classified as Breast Imaging Reporting And Data System (BI-RADS) class 4 or above by conventional ultrasound evaluation were analyzed using ABVS and ARFI. ABVS was to determine whether the masses had coronal imaging features (convergence sign and microcalcification)

then ARFI was to examine the area ratio of masses in elastic and two-dimensional images in virtual touch tissue imaging (VTI)

as well as the average shear wave velocity of masses (V

mean

) in virtual touch tissue imaging quantification (VTIQ). The benign and malignant images of breast masses were classified according to whether there was convergence sign or microcalcification in the coronal plane

and any of the above or more were recorded as positive. The area ratio of tumor in VTI greater than 1.65 was considered positive. The V

mean

greater than 4.14 m/s was positive. The sensitivity

specificity

accuracy

positive predictive value and negative predictive value of ABVS and ARFI alone or combined in the diagnosis of BI-RADS 4 breast masses were calculated and compared.

Results:

In the examination of breast mass in ARFI

mass area ratio of malignant tumor in VTI (1.76±0.61) was higher than that of benign tumor (1.14±0.48)

and V

mean

of malignant tumor ［(6.38±1.76) m/s］ was higher than that of benign tumor ［(4.17±1.43) m/s］

the differences were statistically significant (

P

＜0.01). There were significant differences in VTI and VTIQ between the two groups (

P

＜0.01). In BI-RADS 4 breast masses

the sensitivity

specificity

accuracy

posi

tive predictive value

and negative predictive value were 92%

78.3%

84.5%

78.0%

and 92.2%

respectively for the detection of malignant breast mass in ABVS. The sensitivity

specificity

accuracy

positive predictive value

and negative predictive value of VTI in diagnosis of malignant breast masses were 70.0%

81.7%

76.4%

76.1%

and 76.6%

respectively. The sensitivity

specificity

accuracy

positive predictive value

and negative predictive value of VTIQ in diagnosis of malignant breast masses were 96.0%

58.3%

75.5%

65.8%

and 94.6%

respectively. The sensitivity

specificity

accuracy

positive predictive value

and negative predictive value of the combined diagnosis of ABVS and ARFI were 100.0%

50.0%

72.7%

62.5%

and 100.0%

respectively.

Conclusion:

ABVS and ARFI can supplement the information of breast mass that cannot be obtained by conventional two-dimensional ultrasound

enrich the basis of diagnosis of breast mass

and expand the idea of differential diagnosis of disease. The combination of the two can achieve the effect of complementary advantages

and help to improve the accuracy of diagnosis.