rentradВестник рентгенологии и радиологииJournal of radiology and nuclear medicine0042-46762619-0478Limited Liability Company "LUCHEVAYA DIAGNOSTIKA", Russian Association of Radiologists10.20862/0042-4676-2024-105-3-130-142rentrad-875Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL RESEARCHДополнение маммографического скрининга автоматизированным 3D-ультразвуковым исследованием у женщин с молочной железой высокой плотностиComplementing Mammography Screening with Automated 3D Ultrasound in Women with High-Density Breastshttps://orcid.org/0009-0001-8193-6657ГаранинаА. Э.GaraninaА. E.

Гаранина Анна Эдуардовна, аспирант кафедры лучевой диагностики; врач ультразвуковой диагностики

ул. Кирочная, 41, Санкт-Петербург, 191015

Московский пр-т, 22, лит. А, Санкт-Петербург, 190013

Anna E. Garanina, Postgraduate, Chair of Radiation Diagnostics; Ultrasound Diagnostician

Moscovskiy prospekt, 22, lit. А, Saint Petersburg, 190013

ul. Kirochnaya, 41, Saint Petersburg, 191015

anna.garanina.90@mail.ruhttps://orcid.org/0000-0001-8227-1530ХолинА. В.KholinA. V.

Холин Александр Васильевич, д. м. н., профессор, заведующий кафедрой лучевой диагностики

ул. Кирочная, 41, Санкт-Петербург, 191015

Alexander V. Kholin, Dr. Med. Sc., Professor, Chief of Chair of Radiation Diagnostics

ul. Kirochnaya, 41, Saint Petersburg, 191015

ФГБОУ ВО «Северо-Западный государственный медицинский университет им. И.И. Мечникова» Минздрава России; Клиника «Современные медицинские технологии» АО «Поликлинический комплекс»РоссияMechnikov North-Western State Medical University; Modern Medical Technologies Clinic, Polyclinic Complex JSCRussian FederationФГБОУ ВО «Северо-Западный государственный медицинский университет им. И.И. Мечникова» Минздрава РоссииРоссияMechnikov North-Western State Medical UniversityRussian Federation2024081020241053130142Copyright © Гаранина А.Э., Холин А.В., 20242024Гаранина А.Э., Холин А.В.Garanina А.E., Kholin A.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.russianradiology.ru/jour/article/view/875

Актуальность. В структуре раннего скрининга молочной железы (МЖ) большое значение имеет проблематика ее плотности. У женщин с плотностью МЖ типов C и D по классификации Американской коллегии радиологов (American College of Radiology, ACR) риск развития рака повышается в 4–6 раз по сравнению с женщинами с плотностью МЖ типа А. При таком типе плотности эффективность диагностической маммографии (МГ) значительно снижается. На сегодняшний день можно рассмотреть технологию автоматизированного трехмерного ультразвукового исследования (3D-УЗИ) МЖ в качестве дополнительного метода скрининга у женщин с типами C и D строения МЖ по ACR.Цель: провести сравнительный анализ диагностической эффективности 2D- и 3D-УЗИ у женщин в возрастной группе 40 лет и старше с высокой плотностью тканей МЖ.Материал и методы. Проведено ретро-проспективное наблюдательное одноцентровое исследование. С февраля 2019 г. по май 2023 г. исследованы 1283 пациентки в возрасте 40 лет и старше, которые были разделены на две группы. В группе А женщины проходили 2D-УЗИ и МГ, в группе B дополнительно к этим методам выполнялось 3D-УЗИ. В обеих группах результаты оценивали по системе отчетности о риске развития рака МЖ (Breast Imaging-Reporting and Data System, BI-RADS). По итогам исследования определяли положительную (ППЦ) и отрицательную (ОПЦ) прогностическую ценность, чувствительность, специфичность и точность методов, а также вычисляли площадь под кривой (area under curve, AUC) рабочей характеристики приемника (receiver operating characteristic, ROC) предсказательной модели для 2D- и 3D-УЗИ.Результаты. Метод МГ продемонстрировал ППЦ 0,89, ОПЦ 0,93, чувствительность 0,53, специфичность 0,99, отбалансированную точность 0,76. Показатели для 2D-УЗИ составили: ППЦ 0,8, ОПЦ 0,98, чувствительность 0,9, специфичность 0,97, отбалансированная точность 0,93, AUC ROC предсказательной модели 0,968. Результаты для 3D-УЗИ следующие: ППЦ 0,97, ОПЦ 0,97, чувствительность 0,9, специфичность 0,99, отбалансированная точность 0,94, AUC ROC предсказательной модели 0,98.Заключение. Диагностическая эффективность автоматизированного 3D-УЗИ МЖ у пациенток 40 лет и старше сопоставима с 2D-УЗИ по показателю чувствительности и лучше по показателям точности и специфичности. Прогностическая модель метода 3D-УЗИ также лучше по сравнению с 2D-УЗИ.

Background. In early breast screening structure, an important factor is breast density. Women with types C and D breast density according to American College of Radiology (ACR) classification have 4–6-fold increased risk of cancer compared to women with type A breast density. With this type of density, the effectiveness of diagnostic mammography (MG) is significantly decreased. Today, automated breast 3D ultrasound can be considered as an additional screening method in women with breast structure types C and D according to ACR.Objective: to perform a comparative analysis of the diagnostic efficacy of 2D and 3D ultrasound in women aged 40 years and older with high breast tissue density.Material and methods. Retro-prospective, observational, single-center study was conducted. From February 2019 to May 2023, 1283 patients aged 40 years and older were examined. The patients were divided into two groups. In group A, women underwent 2D ultrasound and MG. In group B, additionally to these methods, 3D ultrasound was performed. In both groups, the results were evaluated according to Breast Imaging-Reporting and Data System (BI-RADS). Based on the obtained data, the following indicators were determined: positive (PPV) and negative (NPV) predictive values, sensitivity, specificity and accuracy of all methods. For 2D and 3D ultrasound, the predictive model areas under curve (AUC) of receiver operating characteristic (ROC) were calculated.Results. MG method showed PPV 0.89, NPV 0.93, sensitivity 0.53, specificity 0.99, and balanced accuracy 0.76. Indicators for 2D ultrasound demonstrated PPV 0.8, NPV 0.98, sensitivity 0.9, specificity 0.97, balanced accuracy 0.93, AUC ROC 0.968. The results for 3D ultrasound were as follows: PPV 0.97, NPV 0.97, sensitivity 0.9, specificity 0.99, balanced accuracy 0.94, AUC ROC 0.98.Conclusion. The diagnostic efficiency of breast automated 3D ultrasound in patients aged 40 years and older is comparable to 2D ultrasound in terms of sensitivity, and it’s better in terms of accuracy, specificity. The prognostic model of 3D ultrasound is also better compared to 2D ultrasound.

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The authors declare that there are no conflicts of interest present.