Coherence-Based Beamforming Increases the Diagnostic Certainty of Distinguishing Fluid from Solid Masses in Breast Ultrasound Exams

Ultrasound is often used as a supplement for mammography to detect breast cancer. However, one known limitation is the high false-positive rates associated with breast ultrasound. We investigated the use of coherence-based beamforming (which directly displays spatial coherence) as a supplement to standard ultrasound B-mode images in 25 patients recommended for biopsy (26 masses in total), with the eventual goal of decreasing false-positive rates. Because of the coherent signal present within solid masses, coherence-based beamforming methods allow solid and fluid-filled masses to appear significantly different (p < 0.001). When presented to five board-certified radiologists, the inclusion of robust short-lag spatial coherence (R-SLSC) images in the diagnostic pipeline reduced the uncertainty of fluid-filled mass contents from 47.5% to 15.8% and reduced the percentage of fluid-filled masses unnecessarily recommended for biopsy from 43.3% to 13.3%. These results are promising for the potential introduction of R-SLSC (and related coherence-based beamforming methods) into the breast clinic to improve diagnostic certainty and reduce the number of unnecessary biopsies.