ArticleBreast cancer (Dove Medical Press)2026
Differentiation of Benign and Malignant BI-RADS 4-5 Breast Lesions Using Ultrasound Localization Microscopy-Derived Microvascular Biomarkers: A Prospective Study.
Article in Breast cancer (Dove Medical Press), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: To investigate qualitative and quantitative microvascular biomarkers derived from ultrasound localization microscopy (ULM) for differentiating benign and malignant breast lesions, and to evaluate their added value in improving BI-RADS-based diagnosis. Methods: In this prospective study, 295 patients with 301 breast lesions classified as BI-RADS category 4-5 on conventional ultrasound (US) underwent contrast-enhanced ultrasound and ULM prior to surgery or biopsy. Qualitative vascular biomarkers and quantitative parameters were derived from ULM images. Diagnostic performance was evaluated using receiver operating characteristic (ROC) analysis. BI-RADS categories were further re-evaluated by integrating ULM-derived biomarkers. Results: ULM qualitative vascular biomarkers classified microvascular morphology into five patterns: avascular, dot-strip, circular, chaotic, and radial. Benign lesions predominantly exhibited avascular, dot-strip, and circular patterns (5.6%, 23.4%, and 48.6%, respectively), whereas malignant lesions were mainly characterized by chaotic and radial patterns (56.7% and 28.4%, respectively; Conclusion: ULM-derived qualitative and quantitative microvascular biomarkers provide complementary information beyond conventional ultrasound and may improve diagnostic performance and risk stratification in BI-RADS 4-5 breast lesions, but their role in safely reducing unnecessary biopsies requires further clinical validation.
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