3차원 유방 초음파의 관찰자 일치도 및 진단적 정확성 = The Interobserver Variability and Diagnostic Performance of 3-Dimensional Breast Ultrasound

다국어 초록 (Multilingual Abstract)

Purpose: We wanted to evaluate the interobserver variability and diagnostic performance of 3-dimensional (3D) breast ultrasound (US) as compared with that of 2-dimensional (2D) US.
Materials and Methods: We included 150 patients who received US-guided core biopsy and 3D US between June 2009 and April 2010. Three breast imaging radiologists analyzed the 2D and 3D US images using the Breast Imaging Reporting and Data System (BI-RADS) lexicon. The intra-observer agreement and inter-observer agreement were calculated. The sensitivity and specificity of 2D and 3D US were evaluated.
Results: The intra-observer agreement between 2D and 3D US was mostly slight or fair agreement. However, in terms of the final category, there was substantial agreement for all three radiologists. The inter-observer agreement of 3D US was similar to that of 2D US (moderate agreement for shape, orientation, circumscribed margin and boundary; fair agreement for indistinct margin, angular margin, microlobulated margin, echo pattern and final category). The sensitivity of 3D US for breast cancer was higher than that of 2D US for two radiologists (2D vs. 3D for reader 2: 55.8% vs.
61.5%, 2D vs. 3D for reader 3: 59.6% vs. 63.5%), and the specificity of 3D US was lower than that of 2D US for all the readers (2D vs. 3D for reader 1: 90.8% vs. 86.7%,2D vs. 3D for reader 2: 90.8% vs. 87.8%, 2D vs. 3D for reader 3: 94.9% vs. 90.8%),but the difference was not significant (p ≥ 0.05).
Conclusion: The interobserver variability and diagnostic performance of 3D breast US were similar to those of 2D US.

국문 초록 (Abstract)

목적: 유방 병변에 대한 3차원 초음파의 관찰자 일치도와 진단적 정확성을 기존의 2차원 초음파와 비교해 보고자한다.
대상 및 방법: 2009년 6월부터 2010년 4월까지 초음파유도 하 조직 생검과 3차원 초음파를 모두 시행한 환자 중종괴성 병변을 가진 150명의 환자를 대상으로 하였다. 초음파 소견은 유방영상의 판독과 자료체계 (Breast Imaging Reporting and Data System: BI-RADS) 지침을 기준으로, 3명의 유방 영상 전문의가 분석하였다. 관찰자 내 일치도와 관찰자 간 일치도, 각 초음파 진단법의 민감도와 특이도를 측정하였다.
결과: 각 판독의별 2차원과 3차원 초음파 분석 소견은대부분 불량 또는 보통의 일치도(관찰자 내 일치도)를 보였으나, 최종 카테고리에서는 3명의 판독의 모두 우수한일치도를 보였다. 초음파 소견의 각 항목에 대한 판독의들간의 일치도 (관찰자 간 일치도)는 2차원 초음파와 3차원초음파에서 비슷한 정도를 보였다 (불분명한 변연, 각진변연, 미세소엽형 변연, 에코양상, 최종 카테고리에서는 2차원과 3차원 모두 보통의 일치도; 모양, 방향성, 국한성변연, 병변 가장자리에서는 모두 중증도 일치도). 민감도는 판독의 두 명에서 2차원 보다 3차원 초음파가 더 높았고 (판독의2: 55.8%와 61.5%, 판독의3: 59.6%와63.5%), 특이도는 모두 2차원이 3차원 보다 높았으나 (판독의1: 90.8%와 86.7%, 판독의2: 90.8%와 87.8%, 판독의3: 94.9%와 90.8%), 통계적인 유의성은 없었다 (p ≥0.05).
결론: 3차원 초음파 영상은 2차원 초음파 영상과 비슷한수준의 관찰자 간 일치도와 진단적 정확성을 보였다.

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