Akademik Veri Yönetim Sistemi
Academic Radiology, 2026 (SCI-Expanded, Scopus)
Rationale and Objectives To compare the efficacy of automatic breast ultrasound (ABUS) with handheld ultrasound (HHUS) as second-look US techniques in the identification of lesions that are detected on breast MRI, and to determine factors that affect lesion detection on second-look US examinations. Material and methods This single-center prospective study included 54 patients with 66 MRI-detected breast lesions referred for MRI-guided biopsy. All patients underwent second-look evaluation with both HHUS and ABUS. Histopathology or imaging follow-up served as the reference standard.US-guided biopsy or preoperative surgical localization was performed for lesions detected by US; while the rest of the patients underwent MRI-guided biopsy or localization procedures. Patients who refused to undergo MRI-guided procedures were followed-up with MRI for at least 2 year. ABUS and HHUS examinations were performed by different radiologists and evaluated based on BI-RADS lexicon. Results Out of the 66 lesions detected on MRI examinations, 30 (45.5%) were benign, 16 (24.2%) were high-risk lesions, and 20 (30.3%) were malignant. HHUS demonstrated 56/66 (84.9%), while ABUS demonstrated 46/66 (69.7%) of them; and the difference was statistically significant (p=0.010). Two out of 13 (15.4%) lesions detected only by HHUS, and 2/3 (66.7%) lesions detected only by ABUS were malignant. None of the 7 lesions (10.6%), that could not be detected by either method, were malignant. There was no statistically significant difference between the number of lesions detected on HHUS and ABUS in terms of lesion size, depth, lesion type (mass/non-mass), lesion localization, parenchymal density, kinetic features or morphological findings (p>0.05). Sensitivity was similar for HHUS and ABUS (90% for both). However, the positive predictive value (PPV) was higher for ABUS (39.1%) than for HHUS (32.1%) (notably due to a higher proportion of malignant lesions among ABUS-only detected findings). Conclusion HHUS was superior to ABUS in detecting lesions in second-look US evaluation. However, cancer detection rates were similar, resulting in a higher positive predictive value for ABUS. Our results show that the two methods are complementary to each other and have the potential to increase lesion detection rate when used together in clinics where both methods are available.