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European Radiology
Published in: European Radiology 8/2018

01-08-2018 | Breast

Breast-density assessment with hand-held ultrasound: A novel biomarker to assess breast cancer risk and to tailor screening?

Authors: Sergio J. Sanabria, Orcun Goksel, Katharina Martini, Serafino Forte, Thomas Frauenfelder, Rahel A. Kubik-Huch, Marga B. Rominger

Published in: European Radiology | Issue 8/2018

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Abstract

Objectives

To assess feasibility and diagnostic accuracy of a novel hand-held ultrasound (US) method for breast density assessment that measures the speed of sound (SoS), in comparison to the ACR mammographic (MG) categories.

Methods

ACR-MG density (a=fatty to d=extremely dense) and SoS-US were assessed in the retromamillary, inner and outer segments of 106 women by two radiographers. A conventional US system was used for SoS-US. A reflector served as timing reference for US signals transmitted through the breasts. Four blinded readers assessed average SoS (m/s), ΔSoS (segment-variation SoS; m/s) and the ACR-MG density. The highest SoS and ΔSoS values of the three segments were used for MG-ACR whole breast comparison.

Results

SoS-US breasts were examined in <2 min. Mean SoS values of densities a-d were 1,421 m/s (SD 14), 1,432 m/s (SD 17), 1,448 m/s (SD 20) and 1,500 m/s (SD 31), with significant differences between all groups (p<0.001). The SoS-US comfort scores and inter-reader agreement were significantly better than those for MG (1.05 vs. 2.05 and 0.982 vs. 0.774; respectively). A strong segment correlation between SoS and ACR-MG breast density was evident (rs=0.622, p=<0.001) and increased for full breast classification (rs=0.746, p=<0.001). SoS-US allowed diagnosis of dense breasts (ACR c and d) with sensitivity 86.2 %, specificity 85.2 % and AUC 0.887.

Conclusions

Using hand-held SoS-US, radiographers measured breast density without discomfort, readers evaluated measurements with high inter-reader agreement, and SoS-US correlated significantly with ACR-MG breast-density categories.

Key Points

• The novel speed-of-sound ultrasound correlated significantly with mammographic ACR breast density categories.
• Radiographers measured breast density without women discomfort or radiation.
• SoS-US can be implemented on a standard US machine.
• SoS-US shows potential for a quantifiable, cost-effective assessment of breast density.
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Metadata
Title
Breast-density assessment with hand-held ultrasound: A novel biomarker to assess breast cancer risk and to tailor screening?
Authors
Sergio J. Sanabria
Orcun Goksel
Katharina Martini
Serafino Forte
Thomas Frauenfelder
Rahel A. Kubik-Huch
Marga B. Rominger
Publication date
01-08-2018
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 8/2018
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-017-5287-9

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