自动乳腺超声诊断系统测量乳腺癌大小及预估乳腺癌T分期
Automated breast ultrasound system for assessing tumor size and predicting T stage in breast cancer

摘要：目的 比较常用的超声影像学方法常规超声检查及乳腺全容积自动扫描系统ABUS测量乳腺癌大小的准确性，并评估两种方法对乳腺癌T分期的预测价值。方法 回顾性地筛选经术后病理证实为乳腺癌、同时行常规超声(US)和自动乳腺超声诊断系统(ABUS)检查的患者共60例。肿瘤最大直径为肿瘤大小的测量指标。以术后所测肿瘤实际大小为标准，采用Bland-Altman法及组内一致性相关系数(ICC)比较常规US及ABUS对相同病灶的测值，并初步探究这两种方法预测乳腺癌T分期的准确率。结果 US和ABUS在测量肿瘤大小方面有很好的一致性，但ABUS比US更接近术后病理[(差值平均值(－1.09±3.61)mm vs. (－1.57±4.99)mm]，ABUS与术后所测的病灶实际大小的一致性相关系数ICC高于US(0.93 vs. 0.86)，尤其对于>2cm的病灶。US和ABUS对乳腺癌的T分期预测都有较高的准确率(82.1% vs. 87.5%)。结论 ABUS和US对肿瘤大小的测量均与术后病理有较好的一致性，尤其对于>2cm的病灶，ABUS测量肿瘤大小的准确性相对更高；ABUS可以代替US进行临床乳腺癌的T分期。
ABSTRACT: Objective To compare the feasibility of automated breast volume scanner automated breast ultrasound system (ABUS) and the traditional ultrasound (US) in measuring breast cancer size so as to evaluate their value in predicting breast cancer T staging. Methods We retrospectively recruited 60 women with breast cancer who had received US and ABUS. The maximal tumor diameter was measured as tumor size. Based on the actual postoperative tumor size in pathology, Bland-Altman analysis and intraclass correlation coefficient (ICC) were used to compare the values measured by US and ABUS. Then we made a preliminary study of the accuracy of US and ABUS in predicting breast cancer T staging. Results The best absolute agreement was shown between US and ABUS in measuring tumor size. Moreover, ABUS showed better agreement with histology than US [average difference (－1.09±3.61)mm vs. (－1.57±4.99)mm] with a higher ICC (0.93 vs. 0.86), especially for tumors which were more than 2cm. In addition, both US and ABUS could predict breast cancer T staging relatively accurately (82.1% vs. 87.5%). Conclusion Both US and ABUS showed good agreement with pathology in measuring tumor size. ABUS even outperformed US in assessing tumor size for tumors beyond 2 cm. Therefore, ABUS can be considered as an alternative to US in T staging of breast cancer