Comparison between combined ultrasounds and magnetic resonance imaging in the differentiation of benign and malignant breast lesions: a cross-sectional study

Aim: To explore the performance of single or combined ultrasound (US) in diagnosing malignant breast lesions, and then compare the results with a magnetic resonance imaging (MRI) aspect. Material and methods: Patients' demographics, tumor markers, and imaging examination were collected. Diagnostic models based on B-mode, color Doppler ultrasounds (CDU), strain elastography (SE), MRI, B-mode US + CDU, B-mode US + SE, and B-mode US + CDU + SE were developed using logistic regression analysis. The performance was assessed using the area under the curve (AUC) with 95% confidence intervals (CIs). Performance of MRI and B-mode US + CDU was compared using DeLong analysis. Results: For single imaging modality, MRI showed the best performance, with AUC of 0.938 (95%CI: 0.888-0.988). For combined US modalities, combination of B-mode US and CDU had the best performance, with AUC of 0.948 (95%CI: 0.877-1.000). There was no significant difference in the diagnostic performance between the combination of B-mode US and CDU and MRI (p>0.05). Conclusions: Our study found the performance of B-mode + CDU was comparable to MRI. Our findings suggested that the combination of B-mode US and CDU was recommended to diagnose malignant breast lesions in order to save time and expense and provide guidance to make decisions for a biopsy.