{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T14:19:50Z","timestamp":1788013190865,"version":"build-2784847793"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T00:00:00Z","timestamp":1787961600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T00:00:00Z","timestamp":1787961600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100019084","name":"Kobe University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100019084","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Med Ultrasonics"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This study aimed to determine whether the addition of contrast-enhanced ultrasonography (CEUS) to B-mode ultrasonography improves diagnostic accuracy in differentiating benign from malignant breast lesions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A comprehensive literature search was performed using PubMed (MEDLINE), Ichushi, and the Cochrane Library up to July 2025. Eligible studies assessed the diagnostic performance of CEUS for suspected breast cancer, with histopathology as the reference standard. Pooled sensitivity, specificity, diagnostic odds ratio (DOR), and positive and negative likelihood ratios were calculated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Eleven studies comprising 1987 patients with 2051 lesions were included. The pooled sensitivity and specificity of B-mode ultrasonography alone were 86.1% (95% confidence interval [CI] 81.5\u201389.7) and 70.8% (95%CI 60.7\u201379.2), respectively. For B-mode alone, the pooled DOR was 15.0 (95%CI 9.7\u201323.3), with an LR\u2009+\u2009of 2.95 (95% CI 2.18\u20133.99) and an LR\u2009\u2212\u2009of 0.20 (95% CI 0.15\u20130.26). In contrast, CEUS was associated with improved pooled estimates of diagnostic performance, yielding a pooled sensitivity of 93.4% (95%CI 89.0\u201396.2) and a specificity of 85.8% (95%CI 80.9\u201389.6). The pooled DOR for CEUS was 86.3 (95%CI 48.0\u2013155.4), with an LR\u2009+\u2009of 6.59 (95%CI 4.89\u20138.87) and an LR\u2009\u2212\u2009of 0.08 (95%CI 0.05\u20130.13).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Pooled diagnostic estimates were higher in studies evaluating CEUS combined with B-mode ultrasonography than in studies evaluating B-mode ultrasonography alone, particularly by increasing specificity in differentiating benign from malignant breast lesions. However, these findings are based on indirect comparisons and should be interpreted with caution.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10396-026-01682-0","type":"journal-article","created":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T14:06:57Z","timestamp":1788012417000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Does the addition of contrast-enhanced ultrasonography to B-mode ultrasonography improve diagnostic accuracy for breast cancer? 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Outside of the submitted work, he reports the following financial activities: Grants or contracts: I&H Co., Ltd.; Cocokarafine Group Co., Ltd.; Konica Minolta, Inc.; NTT DATA; Takeda Pharmaceutical Co.; and CancerScan. Consulting fees: Ohtsuka Pharmaceutical Co.; Takeda Pharmaceutical Co.; Johnson & Johnson K.K.; and AstraZeneca plc. Payment or honoraria for lectures, manuscript writing, or educational events: Pfizer Japan Inc.; MSD K.K.; Chugai Pharmaceutical Co.; Takeda Pharmaceutical Co.; Janssen Pharmaceutical K.K.; Boehringer Ingelheim International GmbH; Eli Lilly Japan K.K.; Maruho Co., Ltd.; Mitsubishi Tanabe Pharma Co.; Novartis Pharma K.K.; Allergan Japan K.K.; Novo Nordisk Pharma Ltd.; TOA EIYO Ltd.; AbbVie Inc.; ONO Pharmaceutical Co., Ltd.; GSK plc; Alexion Pharmaceuticals, Inc.; Canon Medical Systems Co.; Kowa Company, Limited; Araya; Merck & Co.; Amicus Therapeutics, Inc.; CSL Behring; Amgen Inc.; Sanofi S.A.; and BeOne Medicines I GmbH. Stock or stock options: BonBon Inc. Other financial interests: TN has received donations from JMDC Inc. and Yuyama Manufacturing Co., Ltd. for his department. Leadership or fiduciary roles: TN serves as a member of the Social Security Council at the Ministry of Health, Labor and Welfare, and as a member of the Council for Promotion of Cancer Control at the National Cancer Center.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This article does not contain any studies with human or animal subjects performed by any of the authors.","order":2,"name":"Ethics","label":"Ethical approval","group":{"name":"EthicsHeading","label":"Declarations"}}]}}