Sunday, November 27 | 12:05 p.m.-12:15 p.m. | SSA21-09 | Room S504AB
In this scientific session, a Japanese research team will discuss its computer-aided detection (CAD) scheme, which is based on histologic classifications of breast ultrasound images.Reducing the number of unnecessary breast biopsies may be possible if decisions to biopsy or follow up breast masses could take into account possible histological classifications on ultrasound images, said presenter Akiyoshi Hizukuri of Mie University.
For example, patients with breast masses associated with invasive carcinomas should be biopsied immediately, while patients with a noninvasive carcinoma type that grows rapidly should undergo biopsy or follow-up within a few months, Hizukuri said. Those with cysts and fibroadenomas can have follow-up at a relatively long interval of six months.
"Computerized analysis for evaluating the likelihood of histological classifications and also the likelihood of malignancy for breast masses would be helpful to clinicians for their decisions on patient management," he said.
The researchers developed a CAD scheme for determining histological classification of masses on ultrasound images and mammograms. In contrast with other traditional CAD methods, the group's CAD algorithm makes use of objective features based on clinicians' subjective impressions of image features.
The end result is a CAD scheme that achieved high classification accuracies, according to the researchers. Learn all the details in their presentation.
![Examples of ultrasound findings and techniques. (A) Images in a 39-year-old male patient with a mass in the left thigh. The mass is heterogeneous on the B-mode US image (compared with the patient in D) and showed increased microvascularity (superb microvascular imaging [SMI]) and shear-wave elastography (SWE) values. Undifferentiated pleomorphic sarcoma was diagnosed at biopsy (with pleomorphic rhabdomyosarcoma in surgical specimen). (B) Images in an 18-year-old male patient with a mass in the left leg. The mass is hypoechoic on the B-mode image, with no other findings suggestive of malignancy. The lesion is in contact with the cortex of the tibia, which is slightly irregular. CT revealed a doubtful anteromedial tibial erosion. The microvascular study demonstrated high vascularization, suggestive of malignancy. Periosteal Ewing sarcoma was diagnosed with both histologic and immunohistochemical confirmation. (C) Images in a 69-year-old female patient with a lump growing on the outside of the left leg. Multiple SWE examinations were performed (please note the high values obtained in the measurements, whereas the color map highlights the stiffness relative to adjacent tissues). SMI showed areas of increased vascularization to target for sampling. Undifferentiated spindle cell sarcoma was diagnosed at biopsy, with residual leiomyosarcoma in the surgical specimen after neoadjuvant therapy. (D) Images in a 56-year-old female patient with a mass in the right thigh. The mass is heterogeneous at both B-mode ultrasound (similar to patient A) and MRI (coronal T2-weighted spectral attenuated inversion recovery [SPAIR]; T1-weighted pre-contrast and postcontrast imaging), which even shows uptake after the administration of paramagnetic contrast material, which is traditionally suggestive of malignancy. Low values at SMI and elastography are suggestive of benignity. Spindle cell lipoma was diagnosed at biopsy, with atypical spindle cell lipomatous tumor in the surgical specimen.](https://img.auntminnie.com/mindful/smg/workspaces/default/uploads/2026/08/images-radiol250278fig2.APCFLSvX6p.jpg?auto=format%2Ccompress&dpr=2&fit=crop&h=167&q=70&w=250)
