Diagnostic performance and inter-observer concordance in lesion detection with the automated breast volume scanner (ABVS)

BMC Medical Imaging

Friedrich Degenhardt¹  Peter Hillemanns²  Philipp Soergel²  André Farrokh¹  Samuel Gyapong¹  Sebastian Wojcinski² 

[1] Department of OB/GYN, Franziskus Hospital, Bielefeld, Germany;Department of OB/GYN, Hannover Medical School, OE 6410, Carl-Neuberg-Straße 1, 30625 Hannover, Germany

关键词: Screening;    Inter-observer concordance;    ABVS;    Automated breast volume scanner;    Automated breast ultrasound;    Breast cancer;   

Others  :  1090441
DOI  :  10.1186/1471-2342-13-36

 received in 2012-09-02, accepted in 2013-11-08,  发布年份 2013

【 摘 要 】

Background

Automated whole breast ultrasound scanners of the latest generation have reached a level of comfortable application and high quality volume acquisition. Nevertheless, there is a lack of data concerning this technology. We investigated the diagnostic performance and inter-observer concordance of the Automated Breast Volume Scanner (ABVS) ACUSON S2000™ and questioned its implications in breast cancer diagnostics.

Methods

We collected 100 volume data sets and created a database containing 52 scans with no detectable lesions in conventional ultrasound (BI-RADS®-US 1), 30 scans with benign lesions (BI-RADS®-US 2) and 18 scans with breast cancer (BI-RADS®-US 5).

Two independent examiners evaluated the ABVS data on a separate workstation without any prior knowledge of the patients’ histories.

Results

The inter-rater reliability reached fair agreement (κ=0.36; 95% confidence interval (CI): 0.19-0.53). With respect to the true category, the conditional inter-rater validity coefficient was κ=0.18 (95% CI: 0.00-0.26) for the benign cases and κ=0.80 (95% CI: 0.61-1.00) for the malignant cases.

Combining the assessments of examiner 1 and examiner 2, the diagnostic accuracy (AC), sensitivity (SE) and specificity (SP) for the experimental ABVS were AC = 79.0% (95% CI: 67.3-86.1), SE = 83.3% (95% CI: 57.7-95.6) and SP = 78.1% (% CI: 67.3-86.1), respectively.

However, after the ABVS examination, there were a high number of requests for second-look ultrasounds in up to 48.8% of the healthy women due to assumed suspicious findings in the volume data.

In an exploratory analysis, we estimated that an ABVS examination in addition to mammography alone could detect a relevant number of previously occult breast cancers (about 1 cancer in 300 screened and otherwise healthy women).

Conclusions

The ABVS is a reliable imaging method for the evaluation of the breast with high sensitivity and a fair inter-observer concordance. However, we have to overcome the problem of the high number of false-positive results. Therefore, further prospective studies in larger collectives are necessary to define standard procedures in image acquisition and interpretation. Nevertheless, we consider the ABVS as being suitable for integration into breast diagnostics as a beneficial and reliable imaging method.

【 授权许可】

   
2013 Wojcinski et al.; licensee BioMed Central Ltd.

【 图 表 】

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