{"doi":"10.1093/radadv/umaf037","title":"Generalized contrast-to-noise ratio applied to short-lag spatial coherence ultrasound differentiates breast cysts from solid masses","abstract":"Abstract Background Benefits of ultrasound in breast cancer detection are often limited by the similar appearance of complicated cysts and solid hypoechoic masses with B-mode imaging, which can lead to false positive diagnoses. Purpose To evaluate the diagnostic performance of generalized contrast-to-noise ratio (gCNR) on short-lag spatial coherence (SLSC) ultrasound images as an objective tool to improve complicated cyst vs solid mass classification. Materials and Methods For this secondary analysis of a prospective recruitment for the Advanced Ultrasound Signal Processing of Suspicious Breast Images (AUSPICIOUS) observational study (NCT07206888), women scheduled for ultrasound-guided procedures or follow-up of at least 1 breast mass were enrolled from March 2018 to October 2023. Raw ultrasound data were acquired with an Alpinion ECUBE12R research scanner, then post-processed with our custom software. The primary evaluation indicator was gCNR applied to SLSC images with regions of interest determined by 6 radiologists. Outcomes were compared to the same radiologists classifying mass contents as solid, fluid, mixed, or uncertain using B-mode images. The reference standard was determined by aspiration, pathology, or characterization of image features. Areas under receiver operating characteristic curves (AUCs) with 95% confidence intervals (CIs) and inter-reader agreement (Fleiss’ κ) were assessed. Results Among 175 cases, 145 breast masses from 115 women (age: 52 ± 17 years) were analyzed, including 16 complicated cysts and 96 solid masses. The mean AUC for complicated cyst vs solid mass characterization was 0.96 (95% CI: 0.94, 0.97) with gCNR applied to SLSC images, relative to a mean lower-bound AUC of 0.67 (range: 0.54-0.76) with readings of B-mode images (P < .05). Inter-reader agreement improved from fair with B-mode (κ = 0.40) to moderate with gCNR applied to SLSC images with a 0.76 threshold (κ = 0.59, P < .00001). Conclusion Applying an objective gCNR metric to SLSC images improved the differentiation of complicated cysts from solid masses when compared to subjective readings of B-mode images.","journal":"Radiology Advances","year":2025,"id":579060,"datarank":0.10397207708399181,"base_score":0.6931471805599453,"endowment":0.6931471805599453,"self_citation_contribution":0.10397207708399181,"citation_network_contribution":0.0,"self_endowment_contribution":0.10397207708399181,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":1,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.961,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":905776,"name":"Eniola Oluyemi","orcid":"0000-0001-8956-4379","position":1,"is_corresponding":false},{"id":1489308,"name":"Madhavi Tripathi","orcid":"0000-0002-4736-9134","position":2,"is_corresponding":false},{"id":355938,"name":"Emily B. Ambinder","orcid":"0000-0001-6282-5858","position":3,"is_corresponding":false},{"id":453318,"name":"Lisa A. Mullen","orcid":"0000-0003-3191-2865","position":4,"is_corresponding":false},{"id":905777,"name":"Babita Panigrahi","orcid":"0000-0002-1329-3549","position":5,"is_corresponding":false},{"id":905778,"name":"Joanna Rossi","orcid":"0000-0002-6954-4669","position":6,"is_corresponding":false},{"id":1284113,"name":"Nethra Venkatayogi","orcid":"0000-0002-9689-5341","position":7,"is_corresponding":false},{"id":517281,"name":"Kelly S. Myers","orcid":"0000-0001-6614-0901","position":8,"is_corresponding":false},{"id":275807,"name":"Muyinatu A. Lediju Bell","orcid":"0000-0002-8394-4482","position":9,"is_corresponding":false},{"id":998391,"name":"Arunima Sharma","orcid":"0000-0001-7219-7509","position":0,"is_corresponding":true}],"reference_count":29,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T02:58:30.282164Z","pmid":"41415217","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}