Diagnostic Value of Virtual Touch Tissue Quantification for Breast Lesions with Different Size

Lin

J of Ultrasound Medicine

et al. 2016

Section: Discussionsupporting

confidence: 76%

mentioning

confidence: 99%

Noninvasive Evaluation of Benign and Malignant Superficial Lymph Nodes by Virtual Touch Tissue Quantification

Lin

J of Ultrasound Medicine

et al. 2016

“…It is well known that malignant masses are usually stiffer than benign masses [ 26 – 29 ], for this reason, different SWE methods have been used to differentiate between benign and malignant masses in different organs. SuperSonic Imagine (SSI) [ 22 , 30 ] and shear wave imaging using Acoustic Radiation Force Impulse (ARFI) [ 31 , 32 ] are two of the most well-known SWE techniques. The advantages of these techniques in the differentiation of breast masses have been well studied [ 31 , 33 – 39 ], but few studies have investigated the effect of breast calcifications on SWE [ 40 – 42 ].…”

Section: Introductionmentioning

confidence: 99%

Effect of Calcifications on Breast Ultrasound Shear Wave Elastography: An Investigational Study

et al. 2015

PurposeTo investigate the effects of macrocalcifications and clustered microcalcifications associated with benign breast masses on shear wave elastography (SWE).MethodsSuperSonic Imagine (SSI) and comb-push ultrasound shear elastography (CUSE) were performed on three sets of phantoms to investigate how calcifications of different sizes and distributions influence measured elasticity. To demonstrate the effect in vivo, three female patients with benign breast masses associated with mammographically-identified calcifications were evaluated by CUSE.ResultsApparent maximum elasticity (Emax) estimates resulting from individual macrocalcifications (with diameters of 2mm, 3mm, 5mm, 6mm, 9mm, 11mm, and 15mm) showed values over 50 kPa for all cases, which represents more than 100% increase over background (~21kPa). We considered a 2cm-diameter circular region of interest for all phantom experiments. Mean elasticity (Emean) values varied from 26 kPa to 73 kPa, depending on the macrocalcification size. Highly dense clusters of microcalcifications showed higher Emax values than clusters of microcalcification with low concentrations, but the difference in Emean values was not significant.ConclusionsOur results demonstrate that the presence of large isolated macrocalcifications and highly concentrated clusters of microcalcifications can introduce areas with apparent high elasticity in SWE. Considering that benign breast masses normally have significantly lower elasticity values than malignant tumors, such areas with high elasticity appearing due to presence of calcification in benign breast masses may lead to misdiagnosis.

“…The measured shear wave speeds are used to calculate the stiffness properties of the tissue [ 21 ]. The diagnostic value of shear wave imaging using ARFI for characterization of B-mode detected breast lesions has been studied [ 23 , 24 , 25 ]. The push method used in SSI relies on generating a supersonic regime moving-source generating shear waves in the tissue using a conventional transducer.…”

Section: Introductionmentioning

confidence: 99%

Comb-Push Ultrasound Shear Elastography of Breast Masses: Initial Results Show Promise

et al. 2015

Purpose or ObjectiveTo evaluate the performance of Comb-push Ultrasound Shear Elastography (CUSE) for classification of breast masses.Materials and MethodsCUSE is an ultrasound-based quantitative two-dimensional shear wave elasticity imaging technique, which utilizes multiple laterally distributed acoustic radiation force (ARF) beams to simultaneously excite the tissue and induce shear waves. Female patients who were categorized as having suspicious breast masses underwent CUSE evaluations prior to biopsy. An elasticity estimate within the breast mass was obtained from the CUSE shear wave speed map. Elasticity estimates of various types of benign and malignant masses were compared with biopsy results.ResultsFifty-four female patients with suspicious breast masses from our ongoing study are presented. Our cohort included 31 malignant and 23 benign breast masses. Our results indicate that the mean shear wave speed was significantly higher in malignant masses (6 ± 1.58 m/s) in comparison to benign masses (3.65 ± 1.36 m/s). Therefore, the stiffness of the mass quantified by the Young’s modulus is significantly higher in malignant masses. According to the receiver operating characteristic curve (ROC), the optimal cut-off value of 83 kPa yields 87.10% sensitivity, 82.61% specificity, and 0.88 for the area under the curve (AUC).ConclusionCUSE has the potential for clinical utility as a quantitative diagnostic imaging tool adjunct to B-mode ultrasound for differentiation of malignant and benign breast masses.