Automated Breast Ultrasound vs. Handheld Ultrasound: BI-RADS Classification, Duration of the Examination and Patient Comfort

Purpose: Automated breast ultrasound (ABUS) is a potentially valuable adjunct to mammography in breast cancer screening. The reliability and the inter-observer variability in the BI-RADS classification, compared to handheld ultrasound (US), as well as the duration of the examination and patient comfort have only been investigated in a limited number of papers to date. Materials and Methods: In a prospective study, we examined 148 breasts of 76 patients with handheld US and ABUS. The ABUS data were evaluated separately by two investigators. Patient comfort was assessed using a standardized questionnaire. Results: The inter-observer agreement for the BI-RADS classification among the two observers using ABUS was high (K =0,750), the agreement with handheld US was moderate. The sensitivity in the detection of breast cancer was 87.5% for handheld US and 75% for the ABUS evaluation by observer 1. The sensitivity was 87.5% for the ABUS evaluation and 83% for mammography by observer 2. The ABUS examination was rated as completely painless by 64% of the patients. 25% of the patients indicated minor pain, and 10% indicated moderate pain. Handheld US was rated as completely painless by 66% of the patients. 26% of the patients indicated minor pain, and 8% indicated moderate pain. Conclusion: ABUS examinations focusing on the BIRADS classification have low inter-observer variability, compared to handheld US. The sensitivity of ABUS did not differ significantly from handheld US.