Application of Multimodal Ultrasound Combined With BI‐RADS in Classification and Diagnosis of Non‐Mass Breast Lesions

ABSTRACT Introduction The primary objective of this study is to assess the diagnostic accuracy of multimodal ultrasound, including microvascular flow imaging (MVFI), shear wave elastography (SWE), and contrast‐enhanced ultrasound (CEUS), in conjunction with the breast imaging reporting and data system (BI‐RADS) for non‐mass breast lesions (NMLs). Methods A total of 100 patients who received treatment in our hospital from April 2021 to June 2024 were retrospectively collected. All patients had complete pre‐operative ultrasound BI‐RADS, MVFI, SWE, and CEUS. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated; the diagnostic efficacy of the methods was compared, and the diagnostic performance of the subjects was plotted. Results The agreement between the BI‐RADS‐MVFI‐SWE‐CEUS alone and the pathological results was very high, with a Kappa value of 0.806. The area under the curve (AUC) of the combined diagnosis of MVFI‐SWE‐CEUS and BI‐RADS‐MVFI‐SWE‐CEUS was 0.885 ( p < 0.001) and 0.922 ( p < 0.001). The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of BI‐RADS‐MVFI‐SWE‐CEUS for the diagnosis of NMLs were higher than those of the diagnosis alone ( p < 0.05), with 95.24%, 89.19%, 93.75%, 91.67%, and 93%, respectively. Conclusion The combination of multimodal ultrasound and BI‐RADS provides a significant improvement in the diagnostic accuracy and sensitivity for NMLs, offering a more comprehensive and reliable diagnostic tool for evaluating NMLs.