The diagnostic value of contrast-enhanced ultrasound and superb microvascular imaging in differentiating benign from malignant solid breast lesions: A systematic review and meta-analysis

Article type: Research Article

Authors: Zhang, Yi^{; 1} | Sun, Xiaofeng^{; 1} | Li, Jingjing | Gao, Qian | Guo, Xiaofei | Liu, Jian-xin | Gan, Wenyuan | Yang, Shunshi^{; *}

Affiliations: Department of Ultrasound, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China

Correspondence: [*] Corresponding author: Shunshi Yang, Department of Ultrasound The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014 Hubei, China. E-mail: zhangyi-zoe@163.com.

Note: [1] Yi Zhang and Xiaofeng Sun contributed equally to this work.

Abstract: OBJECTIVE:To investigate the added value of contrast-enhanced ultrasound (CEUS) and superb microvascular imaging (SMI) to the conventional ultrasound (US) in the diagnosis of breast lesions. METHODS:PubMed, EMBASE, Web of Science, Chinese national knowledge infrastructure databases, Chinese biomedical literature databases, and Wanfang were searched for relevant studies from November 2015 to November 2021. The quality of the included studies was evaluated using the Quality Assessment of Diagnostic Studies (QUADAS) tool. Meta-Disc version 1.4 was used to calculate sensitivity (SEN), specificity (SPE), positive likelihood ratio (LR+), negative likelihood ratio (LR–), area under curve (AUC), and diagnostic odds ratio (DOR). Meta-regression analysis was performed using STATA 16.0 software to compare the diagnostic accuracy of the two techniques. RESULTS:In the five studies included, 530 patients were eligible for this meta-analysis. For SMI, the pooled SEN and SPE were 0.75 (95% confidence interval [CI]: 0.69–0.91) and 0.88 (95% CI: 0.83–0.91), respectively, LR+ was 5.75 (95% CI: 4.26–7.78), LR– was 0.29 (95% CI: 0.23–0.36), DOR was 21.42 (95% CI, 13.61–33.73), and AUC was 0.8871. For CEUS, the pooled SEN and SPE were 0.87 (95% CI: 0.82–0.91) and 0.86 (95% CI: 0.82–0.89), respectively, LR+ was 5.92 (95% CI: 4.21–8.33), LR– was 0.16 (95% CI: 0.11–0.25), DOR was 38.27 (95% CI: 18.73–78.17), and AUC was 0.9210. CONCLUSIONS:Adding CEUS and (or) SMI to conventional US could improve its diagnostic performance in differentiating benign from malignant solid breast lesions.

Keywords: Contrast-enhanced ultrasound, superb microvascular imaging, breast lesions, BI-RADS

DOI: 10.3233/CH-211367

Journal: Clinical Hemorheology and Microcirculation, vol. 81, no. 2, pp. 109-121, 2022