In a new trial, medical students who were trained for two hours or less in an ultrasound “volume sweep” imaging (VSI) protocol obtained diagnostic-quality imaging of palpable breast lesions.
Interpreting the images, an attending breast radiologist diagnosed the findings with 97% sensitivity, 100% specificity and 97.6% agreement with standard-of-care imaging obtained by experienced sonographers using conventional protocols.
What’s more, the ultrasound machine used in the study was a portable handheld unit that retails for around $2,000.
Noting the numbers, the study authors comment:
[F]or a small investment, communities could be equipped with an acceptable quality and potentially life-saving means to evaluate palpable breast abnormalities. As breast cancer rates and mortality continue to increase worldwide, this [VSI technique] could represent a simple cost-effective means to improve outcomes and bring potentially life-saving imaging where it is needed most in the world.”
The study was conducted at The University of Rochester Medical Center in New York and published online July 8 in the Journal of Ultrasound in Medicine [1].
Corresponding author Thomas Marini, MD, senior author Avice O’Connell, MD, and colleagues explain that ultrasound volume sweep imaging (VSI) allows an inexperienced operator to obtain video loops of target region going only by external body landmarks.
For the study, they taught ultrasound VSI to medical students who had no previous experience operating ultrasound equipment. Instructors kept the training under two hours for each student.
The students then imaged 160 patients using a commercially available handheld scanner from Butterfly iQ+ connected to an Apple iPad. The patient cohort had a total of 170 palpable lumps.
The researchers sent the images to a breast-specialized radiologist who had previously interpreted same-day, standard-of-care ultrasound scans of the same lesions.
Along with the excellent sensitivity and specificity, the researchers recorded high agreement on lesion size and features between VSI and standard of care, including 87% agreement on BI-RADS assessments.
The latter finding suggests breast ultrasound VSI “has potential to distinguish between benign, indeterminate and malignant entities,” Marini and co-authors write in their discussion. “While simply identifying the presence or absence of a mass is a potentially life-saving outcome, the ability to effectively characterize lesions offers even more potential value to patients.”
The study is available in full for free.
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