Downgrading and upgrading gray-scale ultrasound BI-RADS categories of benign and malignant masses with optoacoustics

A pilot study

Erin I. Neuschler, Philip T. Lavin, F. Lee Tucker, Lora D. Barke, Margaret L. Bertrand, Marcela Böhm-Vélez, Stamatia Destounis, Basak E. Dogan, Stephen R. Grobmyer, Janine Katzen, Kenneth A Kist, Erini V. Makariou, Tchaiko M. Parris, Catherine A. Young, Reni Butler

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

OBJECTIVE. False-positive findings remain challenging in breast imaging. This study investigates the incremental value of optoacoustic imaging in improving BI-RADS categorization of breast masses at ultrasound. SUBJECTS AND METHODS. The study device is an optoacoustic breast imaging device with a handheld duplex laser and internal gray-scale ultrasound probe, fusing functional and morphologic information (optoacoustic ultrasound). In this prospective multisite study, breast masses assessed as BI-RADS category 3, 4A, 4B, 4C, or 5 by site radiologists underwent both gray-scale ultrasound and optoacoustic imaging with the study device. Independent reader radiologists assessed internal gray-scale ultrasound and optoacoustic ultrasound features for each mass and assigned a BI-RADS category. The percentage of mass reads for which optoacoustic ultrasound resulted in a downgrade or upgrade of BI-RADS category relative to internal gray-scale ultrasound was determined. RESULTS. Of 94 total masses, 39 were biopsy-proven malignant, 44 were biopsy-proven benign, and 11 BI-RADS category 3 masses were stable at 12-month follow-up. The sensitivity of both optoacoustic ultrasound and internal gray-scale ultrasound was 97.1%. The specificity was 44.3% for optoacoustic ultrasound and 36.4% for internal gray-scale ultrasound. Using optoacoustic ultrasound, 41.7% of benign masses or BI-RADS category 3 masses that were stable at 12-month follow-up were downgraded to BI-RADS category 2 by independent readers; 36.6% of masses assigned BI-RADS category 4A were downgraded to BI-RADS category 3 or 2, and 10.1% assigned BI-RADS category 4B were downgraded to BI-RADS category 3 or 2. Using optoacoustic ultrasound, independent readers upgraded 75.0% of the malignant masses classified as category 4A, 4B, 4C, or 5, and 49.4% of the malignant masses were classified as category 4B, 4C, or 5. CONCLUSION. Optoacoustic ultrasound resulted in BI-RADS category downgrading of benign masses and upgrading of malignant masses compared with gray-scale ultrasound.

Original languageEnglish (US)
Pages (from-to)689-700
Number of pages12
JournalAmerican Journal of Roentgenology
Volume211
Issue number3
DOIs
StatePublished - Sep 1 2018

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Breast
Equipment and Supplies
Biopsy
Ultrasonography
Lasers
Prospective Studies
Radiologists

Keywords

  • BI-RADS
  • Breast cancer
  • Breast ultrasound
  • Optoacoustic imaging
  • Photoacoustic imaging

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Neuschler, E. I., Lavin, P. T., Lee Tucker, F., Barke, L. D., Bertrand, M. L., Böhm-Vélez, M., ... Butler, R. (2018). Downgrading and upgrading gray-scale ultrasound BI-RADS categories of benign and malignant masses with optoacoustics: A pilot study. American Journal of Roentgenology, 211(3), 689-700. https://doi.org/10.2214/AJR.17.18436

Downgrading and upgrading gray-scale ultrasound BI-RADS categories of benign and malignant masses with optoacoustics : A pilot study. / Neuschler, Erin I.; Lavin, Philip T.; Lee Tucker, F.; Barke, Lora D.; Bertrand, Margaret L.; Böhm-Vélez, Marcela; Destounis, Stamatia; Dogan, Basak E.; Grobmyer, Stephen R.; Katzen, Janine; Kist, Kenneth A; Makariou, Erini V.; Parris, Tchaiko M.; Young, Catherine A.; Butler, Reni.

In: American Journal of Roentgenology, Vol. 211, No. 3, 01.09.2018, p. 689-700.

Research output: Contribution to journalArticle

Neuschler, EI, Lavin, PT, Lee Tucker, F, Barke, LD, Bertrand, ML, Böhm-Vélez, M, Destounis, S, Dogan, BE, Grobmyer, SR, Katzen, J, Kist, KA, Makariou, EV, Parris, TM, Young, CA & Butler, R 2018, 'Downgrading and upgrading gray-scale ultrasound BI-RADS categories of benign and malignant masses with optoacoustics: A pilot study', American Journal of Roentgenology, vol. 211, no. 3, pp. 689-700. https://doi.org/10.2214/AJR.17.18436
Neuschler, Erin I. ; Lavin, Philip T. ; Lee Tucker, F. ; Barke, Lora D. ; Bertrand, Margaret L. ; Böhm-Vélez, Marcela ; Destounis, Stamatia ; Dogan, Basak E. ; Grobmyer, Stephen R. ; Katzen, Janine ; Kist, Kenneth A ; Makariou, Erini V. ; Parris, Tchaiko M. ; Young, Catherine A. ; Butler, Reni. / Downgrading and upgrading gray-scale ultrasound BI-RADS categories of benign and malignant masses with optoacoustics : A pilot study. In: American Journal of Roentgenology. 2018 ; Vol. 211, No. 3. pp. 689-700.
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abstract = "OBJECTIVE. False-positive findings remain challenging in breast imaging. This study investigates the incremental value of optoacoustic imaging in improving BI-RADS categorization of breast masses at ultrasound. SUBJECTS AND METHODS. The study device is an optoacoustic breast imaging device with a handheld duplex laser and internal gray-scale ultrasound probe, fusing functional and morphologic information (optoacoustic ultrasound). In this prospective multisite study, breast masses assessed as BI-RADS category 3, 4A, 4B, 4C, or 5 by site radiologists underwent both gray-scale ultrasound and optoacoustic imaging with the study device. Independent reader radiologists assessed internal gray-scale ultrasound and optoacoustic ultrasound features for each mass and assigned a BI-RADS category. The percentage of mass reads for which optoacoustic ultrasound resulted in a downgrade or upgrade of BI-RADS category relative to internal gray-scale ultrasound was determined. RESULTS. Of 94 total masses, 39 were biopsy-proven malignant, 44 were biopsy-proven benign, and 11 BI-RADS category 3 masses were stable at 12-month follow-up. The sensitivity of both optoacoustic ultrasound and internal gray-scale ultrasound was 97.1{\%}. The specificity was 44.3{\%} for optoacoustic ultrasound and 36.4{\%} for internal gray-scale ultrasound. Using optoacoustic ultrasound, 41.7{\%} of benign masses or BI-RADS category 3 masses that were stable at 12-month follow-up were downgraded to BI-RADS category 2 by independent readers; 36.6{\%} of masses assigned BI-RADS category 4A were downgraded to BI-RADS category 3 or 2, and 10.1{\%} assigned BI-RADS category 4B were downgraded to BI-RADS category 3 or 2. Using optoacoustic ultrasound, independent readers upgraded 75.0{\%} of the malignant masses classified as category 4A, 4B, 4C, or 5, and 49.4{\%} of the malignant masses were classified as category 4B, 4C, or 5. CONCLUSION. Optoacoustic ultrasound resulted in BI-RADS category downgrading of benign masses and upgrading of malignant masses compared with gray-scale ultrasound.",
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T1 - Downgrading and upgrading gray-scale ultrasound BI-RADS categories of benign and malignant masses with optoacoustics

T2 - A pilot study

AU - Neuschler, Erin I.

AU - Lavin, Philip T.

AU - Lee Tucker, F.

AU - Barke, Lora D.

AU - Bertrand, Margaret L.

AU - Böhm-Vélez, Marcela

AU - Destounis, Stamatia

AU - Dogan, Basak E.

AU - Grobmyer, Stephen R.

AU - Katzen, Janine

AU - Kist, Kenneth A

AU - Makariou, Erini V.

AU - Parris, Tchaiko M.

AU - Young, Catherine A.

AU - Butler, Reni

PY - 2018/9/1

Y1 - 2018/9/1

N2 - OBJECTIVE. False-positive findings remain challenging in breast imaging. This study investigates the incremental value of optoacoustic imaging in improving BI-RADS categorization of breast masses at ultrasound. SUBJECTS AND METHODS. The study device is an optoacoustic breast imaging device with a handheld duplex laser and internal gray-scale ultrasound probe, fusing functional and morphologic information (optoacoustic ultrasound). In this prospective multisite study, breast masses assessed as BI-RADS category 3, 4A, 4B, 4C, or 5 by site radiologists underwent both gray-scale ultrasound and optoacoustic imaging with the study device. Independent reader radiologists assessed internal gray-scale ultrasound and optoacoustic ultrasound features for each mass and assigned a BI-RADS category. The percentage of mass reads for which optoacoustic ultrasound resulted in a downgrade or upgrade of BI-RADS category relative to internal gray-scale ultrasound was determined. RESULTS. Of 94 total masses, 39 were biopsy-proven malignant, 44 were biopsy-proven benign, and 11 BI-RADS category 3 masses were stable at 12-month follow-up. The sensitivity of both optoacoustic ultrasound and internal gray-scale ultrasound was 97.1%. The specificity was 44.3% for optoacoustic ultrasound and 36.4% for internal gray-scale ultrasound. Using optoacoustic ultrasound, 41.7% of benign masses or BI-RADS category 3 masses that were stable at 12-month follow-up were downgraded to BI-RADS category 2 by independent readers; 36.6% of masses assigned BI-RADS category 4A were downgraded to BI-RADS category 3 or 2, and 10.1% assigned BI-RADS category 4B were downgraded to BI-RADS category 3 or 2. Using optoacoustic ultrasound, independent readers upgraded 75.0% of the malignant masses classified as category 4A, 4B, 4C, or 5, and 49.4% of the malignant masses were classified as category 4B, 4C, or 5. CONCLUSION. Optoacoustic ultrasound resulted in BI-RADS category downgrading of benign masses and upgrading of malignant masses compared with gray-scale ultrasound.

AB - OBJECTIVE. False-positive findings remain challenging in breast imaging. This study investigates the incremental value of optoacoustic imaging in improving BI-RADS categorization of breast masses at ultrasound. SUBJECTS AND METHODS. The study device is an optoacoustic breast imaging device with a handheld duplex laser and internal gray-scale ultrasound probe, fusing functional and morphologic information (optoacoustic ultrasound). In this prospective multisite study, breast masses assessed as BI-RADS category 3, 4A, 4B, 4C, or 5 by site radiologists underwent both gray-scale ultrasound and optoacoustic imaging with the study device. Independent reader radiologists assessed internal gray-scale ultrasound and optoacoustic ultrasound features for each mass and assigned a BI-RADS category. The percentage of mass reads for which optoacoustic ultrasound resulted in a downgrade or upgrade of BI-RADS category relative to internal gray-scale ultrasound was determined. RESULTS. Of 94 total masses, 39 were biopsy-proven malignant, 44 were biopsy-proven benign, and 11 BI-RADS category 3 masses were stable at 12-month follow-up. The sensitivity of both optoacoustic ultrasound and internal gray-scale ultrasound was 97.1%. The specificity was 44.3% for optoacoustic ultrasound and 36.4% for internal gray-scale ultrasound. Using optoacoustic ultrasound, 41.7% of benign masses or BI-RADS category 3 masses that were stable at 12-month follow-up were downgraded to BI-RADS category 2 by independent readers; 36.6% of masses assigned BI-RADS category 4A were downgraded to BI-RADS category 3 or 2, and 10.1% assigned BI-RADS category 4B were downgraded to BI-RADS category 3 or 2. Using optoacoustic ultrasound, independent readers upgraded 75.0% of the malignant masses classified as category 4A, 4B, 4C, or 5, and 49.4% of the malignant masses were classified as category 4B, 4C, or 5. CONCLUSION. Optoacoustic ultrasound resulted in BI-RADS category downgrading of benign masses and upgrading of malignant masses compared with gray-scale ultrasound.

KW - BI-RADS

KW - Breast cancer

KW - Breast ultrasound

KW - Optoacoustic imaging

KW - Photoacoustic imaging

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