Breast ultrasound elastography—Results of 193 breast lesions in a prospective study with histopathologic correlation

Schaefer, Fritz; Heer, I. M.; Schaefer, Philipp J.; Mundhenke, Christoph; Osterholz, S.; Order, B.; Hofheinz, N.; Hedderich, J.; Heller, Martin; Jonat, W.; Schreer, Ingrid

doi:10.1016/j.ejrad.2009.08.026

Cited by 113 publications

(84 citation statements)

References 8 publications

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“…The results from the present study are different from those reported by Lee et al (14) , with the area under the ROC curve for Bmode US (0.616) lower than that from sonoelastography (0.784), with a weak and reasonable performance, respectively for the two methods. The results reported by Schaefer et al (12) are also different from the results from the present study, with an area under the ROC curve for B-mode US (0.820) lower than that for sonoelastography (0.884), with both methods presenting a good performance.…”

Section: Discussioncontrasting

confidence: 57%

Screening of breast lesions: a comparative study between mammography, B-mode ultrasonography, sonoelastography and histological results

et al. 2013

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Objective: To compare the capacity of mammography, sonoelastography, B-mode ultrasonography and histological analysis to differentiate benign from malignant breast lesions. Materials and Methods: A total of 12 histopathologically confirmed breast lesions were documented. The lesions were assessed by means of mammography, B-mode ultrasonography and sonoelastography, and histopathological analysis was utilized as a gold standard. Sensitivity and specificity were calculated. A receiver operating characteristic (ROC) curve was constructed to evaluate the diagnostic performance of the mentioned techniques. Results: Sensitivity and specificity in the differentiation between benign and malignant lesions were respectively 100% and 50% for mammography, 100% and 71% for B-mode ultrasonography, and 67% and 83% for sonoelastography. The area under the ROC curve was calculated for the three imaging modalities and corresponded to 0.792 for mammography, 0.847 for B-mode ultrasonography, and 0.806 for sonoelastography. Conclusion: Sonoelastography demonstrated higher specificity and lower sensitivity as compared with mammography and B-mode ultrasonography. On the other hand, B-mode ultrasonography had the largest area under the ROC curve. Sonoelastography has demonstrated to be a promising technique to detect and evaluate breast lesions, and could potentially reduce the number of unnecessary biopsies. Keywords: Breast B-mode ultrasonography; Breast lesions; Mammography; Sensitivity; Specificity; Sonoelastography.Objetivo: Comparar a capacidade de diferenciação de lesões benignas versus malignas por parte da mamografia, ultrassonografia modo-B e elastografia. Materiais e Métodos: Um total de 12 lesões mamárias confirmadas histologicamente foi documentado. A avaliação das lesões foi realizada por meio da mamografia, ultrassonografia modo-B e elastografia. Os resultados histopatológicos foram utilizados como técnica padrão ouro. As sensibilidades e as especificidades foram calculadas. A curva receiver operating characteristic (ROC) foi realizada para avaliar o desempenho diagnóstico das técnicas utilizadas. Resultados: A sensibilidade e a especificidade na diferenciação entre lesões mamárias benignas e malignas foram 100% e 50%, respectivamente, para a mamografia, e 100% e 71% para a ultrassonografia modo-B. A elastografia obteve sensibilidade de 67% e especificidade de 83%. A área abaixo da curva ROC foi calculada para as três técnicas imaginológicas, sendo 0,792 para a mamografia, 0,847 para a ultrassonografia modo-B e 0,806 para a elastografia. Conclusão: A elastografia mostrou ter maior especificidade e menor sensibilidade comparativamente à mamografia e à ultrassonografia modo-B. A ultrassonografia modo-B foi a técnica que demonstrou maior área abaixo da curva ROC. A elastografia mostra-se uma técnica promissora na detecção de doença mamária e, potencialmente, poderá reduzir biópsias desnecessárias. Unitermos: Elastografia; Especificidade; Lesões mamárias; Mamografia; Sensibilidade; US modo-B mamária. Abstract

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Section: Discussioncontrasting

confidence: 57%

Screening of breast lesions: a comparative study between mammography, B-mode ultrasonography, sonoelastography and histological results

et al. 2013

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“…In most cases, compression to the area of interest is manually applied, with some scanners relying on internal patient movement such as respiratory or cardiac motion. [10][11][12][13] The commercially-available intravascular ultrasound (IVUS) system (EndoSonics, USA) investigates the morphology of the coronary wall and plaque by observing the induced strain in the vascular tissue via different levels of the intraluminal pressure.…”

Section: Static Elastographymentioning

confidence: 99%

“…Table 2 presents a list of suggested tissue mimicking properties matched to specific clinical applications, based on measured mechanical properties reported in a number of clinical studies. 11,[38][39][40][41][42][43][44][45][46][47][48] The background properties are usually representative of the approximate stiffness values of the healthy tissue in the respective clinical application, while the range of the target stiffness usually represents the typical values of malignant lesions. The minimum target dimensions seem to reflect the minimum lesion dimensions detected in the studies, while the elastic contrast is the ratio of the stiffness of the target to that of the background material.…”

Section: Relevant Standards and Design Criteriamentioning

confidence: 99%

Review of ultrasound elastography quality control and training test phantoms

Cournane

Fagan

Browne³

2011

Ultrasound

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While the rapid development of ultrasound elastography techniques in recent decades has sparked its prompt implementation in the clinical setting adding new diagnostic information to conventional imaging techniques, questions still remain as to its full potential and efficacy in the hospital environment. A limited number of technical studies have objectively assessed the full capabilities of the different elastography approaches, perhaps due, in part, to the scarcity of suitable tissue-mimicking materials (TMMs) and appropriately designed phantoms available. Few commercially available elastography phantoms possess the necessary test target characteristics or mechanical properties observed clinically, or indeed reflect the lesion-to-background elasticity ratio encountered during clinical scanning. Thus, while some phantoms may prove useful, they may not fully challenge the capabilities of the different elastography techniques, proving limited when it comes to quality control (QC) and/or training purposes. Although a variety of elastography TMMs, such as agar and gelatine dispersions, co-polymer in oil and poly(vinyl) alcohol cryogel, have been developed for specific research purposes, such work is yet to produce appropriately designed phantoms to adequately challenge the variety of current commercially available elastography applications. Accordingly, there is a clear need for the further development of elastography TMMs and phantoms to keep pace with the rapid developments in elastography technology, to ensure that the performance of these new diagnostic approaches are validated, and for clinical training purposes.

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“…The hardness of tissues or lesions is visually and qualitatively assessed on the basis of the strain distribution and pattern of elastographic images. 1,[6][7][8][9][10]12,[15][16][17][19][20][21][22][23][24] Semi-quantitative analysis, in which strain is represented in numerical values, has recently been used as a more objective method. [1][2][3][4][5][9][10][11]13,17 However, whether these values can be effectively used for clinical assessment remains unclear because the image quality of strain elastography, which is performed manually, depends strongly on the imaging procedure.…”

Section: Introductionmentioning

confidence: 99%

“…The technique has been used to assess the hardness of various normal and abnormal tissues, [1][2][3][4][5][6] and to differentiate malignant from benign lesions in the breast, prostate, thyroid, lymph nodes and salivary glands. [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] Ultrasound elastography uses either strain or shear wave velocity. 25,26 In strain elastography, tissue strain induced by compression with the probe is used as an indicator of hardness.…”

Section: Introductionmentioning

confidence: 99%

Effects of compression force on elasticity index and elasticity ratio in ultrasound elastography

Imaizumi¹,

Sasaki²,

Sakamoto³

et al. 2014

Dentomaxillofacial Radiology

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Objectives: The purpose of this study was to investigate the relationship between compression force and hardness values in ultrasound elastography. Methods: Ultrasound elastography was performed using an elastography phantom, comprising inclusions with different elasticities and echogenicities. The compression force was set to approximately 100 gw (light force) and approximately 500 gw (heavy force). The elasticity index (EI) of the inclusion was measured. The EI was a relative hardness value of a structure within an elastographic image. Similarly, the EI of the background was measured as a reference. The elasticity ratio (ER) was calculated as the EI of the inclusion divided by the EI of the reference. Results: The hardness of the phantom could be discerned with both the EI and ER, regardless of the compression force. The EI and ER with heavy force tended to be higher than those with light force, but the difference was not significant. A strong correlation was observed between the EI and ER of soft structures, whereas the correlation between the EI and ER of hard structures was weak, and the ER values varied widely.

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Breast ultrasound elastography—Results of 193 breast lesions in a prospective study with histopathologic correlation

Cited by 113 publications

References 8 publications

Screening of breast lesions: a comparative study between mammography, B-mode ultrasonography, sonoelastography and histological results

Screening of breast lesions: a comparative study between mammography, B-mode ultrasonography, sonoelastography and histological results

Review of ultrasound elastography quality control and training test phantoms

Effects of compression force on elasticity index and elasticity ratio in ultrasound elastography

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