Diagnostic Value of ARFI (Acoustic Radiation Force Impulse) in Differentiating Benign From Malignant Breast Lesions

Magalhães, Mariana; Belo-Oliveira, P; Casalta-Lopes, J.; Costa, Yessica; Gonçalo, Manuela; Gomes, Paula; Caseiro-Alves, Filipe

doi:10.1016/j.acra.2016.09.001

Cited by 10 publications

(5 citation statements)

References 18 publications

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“…Recently, this new imaging technique has been widely applied to evaluate the cervical LNs as well as the liver, breast, thyroid, and musculoskeletal system. Several studies have reported ARFI to be effective for differentiating malignant and benign lesions in the breast and thyroid [15,16].…”

Section: Introductionmentioning

confidence: 99%

Acoustic radiation force impulse imaging of biopsy-proven Kikuchi disease: initial experiences for evaluating feasibility in pediatric patients

et al. 2019

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Purpose This study evaluated the feasibility of acoustic radiation force impulse (ARFI) elastography and characterized the sonographic features of lymph nodes (LNs) with Kikuchi disease in pediatric patients. Methods Seventy-six cervical LN biopsies were performed for the diagnosis of cervical lymphadenopathy. ARFI imaging was performed, and the characteristic ultrasound features of the biopsied LNs and the contralateral LNs were analyzed. We also reviewed clinical and conventional ultrasonographic findings. Results On histology, 56 patients were diagnosed with Kikuchi disease. These LNs were large and elongated, with increased perinodal echogenicity and capsular thickening. In 38 of them, ARFI elastography was performed, and the median shear wave velocity (SWV) of the biopsied LNs with Kikuchi disease (2.19 m/sec; range, 1.45 to 4.57 m/sec) was higher than of the contralateral LNs (1.72 m/sec; range, 0.95 to 2.65 m/sec; P<0.001). In patients with reactive hyperplasia, the mean SWV of the biopsied LNs (2.00 m/sec; range, 1.49 to 2.26 m/sec) was higher than that of the contralateral LNs (1.55 m/sec; range, 1.21 to 2.32 m/sec; P=0.031). Conclusion The SWV of LNs with Kikuchi disease was significantly higher than that of the contralateral LNs. Morphologically, LNs with Kikuchi disease showed an enlarged, elongated, and oval shape, increased perinodal echogenicity, and capsular thickening. In addition to the conventional ultrasonographic findings, the application of ARFI is feasible even in pediatric patients for the evaluation of cervical lymphadenopathy.

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Section: Introductionmentioning

confidence: 99%

Acoustic radiation force impulse imaging of biopsy-proven Kikuchi disease: initial experiences for evaluating feasibility in pediatric patients

et al. 2019

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“…In concordance to previous work from our group 11 , ROC curve analysis in our present study suggested an optimal threshold of 3.23 m/s with a sensitivity of 85.7% (95% CI: 76.4–92.4%) and a specificity of 76.8% (95% CI: 67.9–84.2%). Other studies have proposed similar (3.31–3.68 m/s) 10 , 18 or quite divergent (5.18–6.593 m/s) 19 , 20 threshold values, with sensitivities ranging between 80.4% and 98% and specificities between 62.6% and 96.5%. However, at these threshold values there is usually a considerable overlap between benign and malignant lesions, which precludes unequivocal diagnosis and does not allow for a lesion to be classified as either benign or malignant with certainty.…”

Section: Discussionmentioning

confidence: 86%

Virtual Touch IQ elastography reduces unnecessary breast biopsies by applying quantitative “rule-in” and “rule-out” threshold values

Kapetas

Clauser

Woitek

et al. 2018

Sci Rep

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Our purpose was to evaluate Virtual Touch IQ (VTIQ) elastography and identify quantitative “rule-in” and “rule-out” thresholds for the probability of malignancy, which can help avoid unnecessary breast biopsies. 189 patients with 196 sonographically evident lesions were included in this retrospective, IRB-approved study. Quantitative VTIQ images of each lesion measuring the respective maximum Shear Wave Velocity (SWV) were obtained. Paired and unpaired, non-parametric statistics were applied for comparisons as appropriate. ROC-curve analysis was used to analyse the diagnostic performance of VTIQ and to specify “rule-in” and “rule-out” thresholds for the probability of malignancy. The standard of reference was either histopathology or follow-up stability for >24 months. 84 lesions were malignant and 112 benign. Median SWV of benign lesions was significantly lower than that of malignant lesions (p < 0.001). The application of a “rule-out” threshold of 1.9 m/s lead to a sensitivity of >98% with a concomitant significant (p = 0.032) reduction in false positive cases of almost 15%, whereas a “rule-in” threshold of 6.5 m/s suggested a probability of malignancy of >95%. In conclusion, VTIQ elastography accurately differentiates malignant from benign breast lesions. The application of quantitative “rule-in” and “rule-out” thresholds is feasible and allows reduction of unnecessary benign breast biopsies by almost 15%.

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“…In the literature, studies have reported using the VTIQ method of SWE for the evaluation of breast lesions [2,[23][24][25][26][27][28][29]. Ianculescu et al [2] reported the sensitivity and specificity values of the VTIQ method as 80.4% and 73%, respectively, when the cutoff SWV was 3.31 m/s.…”

Section: Discussionmentioning

confidence: 99%

“…Comparison of discrepant findings on SWE and SE is shown. Magalhaes et al[26] measured SWV of the lesions from the stiffest part seen on the elastography color map, which may explain the high cutoff value of their study. In our study, the maximum SWV of the malignant lesions was 4.90 ± 1.48 m/s and the maximum SWV of the benign lesions was 2.58 ± 0.83 m/s.…”

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confidence: 96%

Shear wave versus strain elastography in the differentiation of benign and malignant breast lesions

Gürüf¹,

Öztürk²,

Bayrak³

et al. 2019

Turk J Med Sci

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Background/aim: To evaluate and compare the diagnostic performances of shear wave elastography (SWE) and strain elastography (SE) in the differentiation of benign and malignant breast lesions. Materials and methods:The current study included 87 breast lesions in 84 patients. The Breast Imaging Reporting and Data System (BIRADS) categories were determined with ultrasound features. The maximum shear wave velocity (SWV), mean SWV, maximum SWV to fat SWV ratio, and mean SWV to fat SWV ratio were measured using SWE. The strain ratio (SR) was calculated as the ratio of lesion strain to the adjacent fat strain using SE. Receiver operating characteristic (ROC) curves were constructed to assess and compare the diagnostic performances of each parameter.Results: Forty-five benign and 42 malignant lesions were diagnosed. The sensitivity and specificity of the BIRADS classification was 100% and 35.6%, respectively. Selecting a cutoff SR value of 3.22 led to an 88.1% sensitivity and an 88.4% specificity (AUC: 0.913 [95% CI: 0.854-0.971], P < 0.001). Selecting cutoff maximum SWV value of 3.41 m/s led to an 88.1% sensitivity and an 86.7% specificity (AUC: 0.918 [95% CI: 0.858-0.978], P < 0.001). The diagnostic performance of the maximum SWV, mean SWV, and maximum SWV to fat SWV ratio were similar to the diagnostic performance of the SR (P = 1.00, P = 1.00, P = 0.629, respectively).Conclusion: SE and SWE are both feasible imaging modalities in the differentiation of malignant and benign breast lesions with similar diagnostic performances.

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Diagnostic Value of ARFI (Acoustic Radiation Force Impulse) in Differentiating Benign From Malignant Breast Lesions

Cited by 10 publications

References 18 publications

Acoustic radiation force impulse imaging of biopsy-proven Kikuchi disease: initial experiences for evaluating feasibility in pediatric patients

Acoustic radiation force impulse imaging of biopsy-proven Kikuchi disease: initial experiences for evaluating feasibility in pediatric patients

Virtual Touch IQ elastography reduces unnecessary breast biopsies by applying quantitative “rule-in” and “rule-out” threshold values

Shear wave versus strain elastography in the differentiation of benign and malignant breast lesions

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