HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text All Versions of this Article: 2393051069v1 239/3/693    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Berg, W. A. Articles by Madsen, E. L. Search for Related Content PubMed PubMed Citation Articles by Berg, W. A. Articles by Madsen, E. L.

Lesion Detection and Characterization in a Breast US Phantom: Results of the ACRIN 6666 Investigators¹

¹ From American College of Radiology Imaging Network, American Radiology Services, Johns Hopkins Green Spring, 10755 Falls Rd, Lutherville, MD 21093 (W.A.B.); Center for Statistical Sciences, Brown University, Providence, RI (J.D.B., J.B.C.); Department of Radiology, Northwestern University School of Medicine, Chicago, Ill (E.B.M.); and Department of Medical Physics, University of Wisconsin, Madison, Wis (E.L.M.). Received June 25, 2005; revision requested August 16; revision received September 1; final version accepted September 21. Supported by grants from the National Cancer Institute (CA89008) and the Avon Foundation. Address correspondence to W.A.B. (e-mail: wendieberg{at}hotmail.com).

Purpose: To prospectively evaluate ultrasonographic (US) lesion detection and characterization in a breast phantom by potential investigators in a screening US protocol, American College of Radiology Imaging Network (ACRIN) 6666.

Materials and Methods: National Cancer Institute Cancer Experimental Therapeutic Protocol review and ACRIN internal institutional review board approved the protocol; potential investigators were informed of the study purpose prior to participation. Six equivalent anthropomorphic phantoms were prepared with 17 masses (2–10 mm in mean diameter) in different locations at different depths. Sixty-six investigators, experienced in breast US, from 23 institutions scanned a phantom with high-frequency linear-array transducers (12-5 MHz). Lesion location, diameters, echogenicity, shape, and posterior features were recorded. Reader-specific phantom maps were generated and compared with known lesion locations and features. Results from 64 observers could be analyzed and were masked to investigator identity. Agreement on US features was measured with statistics. A generalized linear model generated log relative risks for detection rates as a function of lesion diameter, depth, and features.

Results: Of 17 lesions, a median of 14 (82%) were detected (range, 9–16), and 86% of observers detected at least 12 lesions. Of 1088 potential detections, 861 (79.1%) were made. Among 5–10-mm lesions, 499 (97.5%) of 512 detections were made (excluding a 6-mm "skin" lesion seen by only seven observers [11%]). One 4-mm mass was seen by 53 observers (83%). Among 3-mm lesions, 274 (71.4%) of 384 detections were made. One 2-mm lesion was seen by 28 (44%) observers. Relative risk of detection decreased to 0.55 (95% confidence interval: 0.51, 0.59) for each centimeter increase in lesion depth. Agreement was slight for lesion shape ( = 0.14), substantial for echogenicity ( = 0.61), and moderate for posterior features ( = 0.45). Feature description errors were common for 2–4-mm lesions; only 33% of 3-mm anechoic masses were so characterized. Among eight 6–10-mm lesions, investigators erred in feature description of a median of 1 lesion (mean, 1.3; range, 0–4).

Conclusion: US detection and description of lesions in a breast phantom were highly consistent for lesions 5–10 mm in diameter; those smaller than 5 mm were less reliably identified or characterized by experienced investigators.

© RSNA, 2006

This article has been cited by other articles:

				W. A. Berg, J. D. Blume, J. B. Cormack, E. B. Mendelson, D. Lehrer, M. Bohm-Velez, E. D. Pisano, R. A. Jong, W. P. Evans, M. J. Morton, et al. Combined Screening With Ultrasound and Mammography vs Mammography Alone in Women at Elevated Risk of Breast Cancer JAMA, May 14, 2008; 299(18): 2151 - 2163. [Abstract] [Full Text] [PDF]

				B. Mesurolle, T. Helou, M. El-Khoury, M. Edwardes, E. J. Sutton, and E. Kao Tissue Harmonic Imaging, Frequency Compound Imaging, and Conventional Imaging: Use and Benefit in Breast Sonography J. Ultrasound Med., August 1, 2007; 26(8): 1041 - 1051. [Abstract] [Full Text] [PDF]

				W. A. Berg, J. D. Blume, J. B. Cormack, and E. B. Mendelson Operator Dependence of Physician-performed Whole-Breast US: Lesion Detection and Characterization. Radiology, November 1, 2006; 241(2): 355 - 365. [Abstract] [Full Text] [PDF]

				E. L. Madsen, W. A. Berg, E. B. Mendelson, and G. R. Frank Anthropomorphic Breast Phantoms for Qualification of Investigators for ACRIN Protocol 6666 Radiology, June 1, 2006; 239(3): 869 - 874. [Abstract] [Full Text] [PDF]