How effective are ultrasound (ultrasound) machines for cancer diagnostics?

From the Guidelines

Ultrasound machines are moderately effective for cancer diagnostics, particularly in detecting liver metastases with an accuracy range of 87% to 91% when using contrast-enhanced ultrasound (CEUS) 1.

Key Points to Consider

• Ultrasound is the most widely available technique for liver imaging worldwide and is useful for detecting liver lesions, especially when CEUS is used.
• The accuracy of CEUS in characterizing and detecting liver lesions is high, but it has limitations, such as the need for operator skill and the limited availability of US contrast agents in some countries.
• CEUS has a complementary role to CT or MRI for lesions that are indeterminate with these modalities, and it is useful for guiding percutaneous biopsy of liver lesions suspicious for malignancy.
• Ultrasound guidance is preferred for biopsies if the lesion is easily visible or accessible on US, and intraoperative US is the most accurate imaging technique for detecting liver metastases at the time of primary tumor resection or resection of previously identified hepatic metastases.

Limitations and Considerations

• Ultrasound has important limitations in cancer detection, including the inability to reliably distinguish between benign and malignant lesions, limited penetration in deep tissues or through bone, and high operator dependence.
• For these reasons, ultrasound findings typically require confirmation through other diagnostic methods such as MRI, CT scans, or tissue biopsies for definitive cancer diagnosis.
• The effectiveness of ultrasound in cancer diagnostics varies significantly depending on the cancer type, location, and stage, and it is most effective when used as part of a comprehensive diagnostic approach rather than as a standalone cancer detection method.

Additional Context

While other studies discuss the use of ultrasound in breast cancer screening and diagnosis 1, the most relevant and recent evidence for the effectiveness of ultrasound machines in cancer diagnostics, particularly for liver metastases, is found in the study published in the Journal of the American College of Radiology 1.

From the Research

Effectiveness of Ultrasound Machines for Cancer Diagnostics

The effectiveness of ultrasound machines for cancer diagnostics can be evaluated based on various studies.

• Ultrasound imaging is a commonly used modality for breast cancer detection and diagnosis, with technologies such as ultrasound elastography, contrast-enhanced ultrasound, and 3-D ultrasound providing important tools for the management of breast patients 2.
• A review comparing the diagnostic performance of Magnetic Resonance Imaging (MRI), ultrasound, and mammography for detection of breast cancer found that ultrasound had an overall sensitivity of 67.2% and specificity of 76.8% 3.
• A systematic review and meta-analysis assessing the diagnostic performance of ultrasound as a primary tool for early detection of breast cancer found that ultrasound had an overall pooled sensitivity and specificity of 80.1% and 88.4%, respectively 4.
• Ultrasound has progressed beyond anatomical imaging and monitoring blood flow in large vessels, with the use of modern ultrasound pulse sequences and microbubbles allowing for tissue perfusion studies, superresolution imaging, and molecular ultrasound imaging 5.
• The role of ultrasound in breast cancer screening has been expanding, with supplemental screening for breast cancer with ultrasound and magnetic resonance imaging being considered due to the limitations of mammography, especially in dense breasts 6.

Diagnostic Performance of Ultrasound

The diagnostic performance of ultrasound can be affected by various factors, including:

• Tumor type: The sensitivity and specificity of ultrasound may vary depending on the type of breast cancer 3.
• Breast density: Ultrasound may be more effective in detecting breast cancer in dense breasts, where mammography may be less effective 3, 4.
• Patient's history: The sensitivity and specificity of ultrasound may be affected by the patient's history, including previous breast cancer or breast density 3.

Comparison with Other Imaging Modalities

Ultrasound can be compared with other imaging modalities, such as MRI and mammography, in terms of diagnostic performance.

• A review found that MRI had the highest sensitivity and specificity for breast cancer detection, while mammography had the lowest sensitivity 3.
• Combining ultrasound with other imaging modalities, such as MRI or mammography, may increase diagnostic ability compared with using modalities alone 3, 4.