Differential diagnosis of breast lesions using ultrasound elastography

Gheonea, Ioana Andreea; Stoica, Zoia; Bondari, Simona

doi:10.4103/0971-3026.90697

Cited by 49 publications

(19 citation statements)

References 15 publications

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“…With this value, we found that the mean elasticity score was significantly higher in malignant masses than in benign masses. Our findings are concordant with other previous studies using 5-point scoring systems [ 10 , 23 , 25 ]. In VTQ mode, each breast lesion was differentiated as a benign or malignant lesion using SWV measurements; malignant lesions showed significantly higher SWV values than benign lesions.…”

Section: Discussionsupporting

confidence: 94%

Diagnostic Value of Elastography Using Acoustic Radiation Force Impulse Imaging and Strain Ratio for Breast Tumors

et al. 2014

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PurposeThe aim of this study was to determine whether the combination of B-mode ultrasonography (BUS), acoustic radiation force impulse (ARFI) elastography, and strain ratio (SR) provides better diagnostic performance of breast lesion differentiation than BUS alone.MethodsARFI elastography and SR evaluations were performed on patients with 157 breast lesions diagnosed by BUS from June to September 2013. BUS images were classified according to the Breast Imaging-Reporting and Data System. ARFI elastography was performed using Virtual Touch™ tissue imaging (VTI) and Virtual Touch™ tissue quantification (VTQ). In VTI mode, we evaluated the color-mapped patterns of the breast lesion and surrounding tissue. The lesions were classified into five categories by elasticity score. In VTQ mode, each lesion was assessed using shear wave velocity (SWV) measurements. SR was calculated from the lesion and comparable lateral fatty tissue. We compared the diagnostic performance of BUS alone and the combination of BUS, ARFI elastography, and SR evaluations.ResultsAmong the 157 lesions, 40 were malignant and 117 were benign. The mean elasticity score (3.7±1.0 vs. 1.6±0.8, p<0.01), SWV (4.23±1.09 m/sec vs. 2.22±0.88 m/sec, p<0.01), and SR (5.69±1.63 vs. 2.69±1.40, p<0.01) were significantly higher for malignant lesions than benign lesions. The results for BUS combined with ARFI elastography and SR values were 97.5% sensitivity, 92.3% specificity, 93.6% accuracy, a 79.6% positive predictive value (PPV), and a 99.1% negative predictive value. The combination of the 3 radiologic examinations yielded superior specificity, accuracy, and PPV compared to BUS alone (p<0.01 for each).ConclusionARFI elastography and SR evaluations showed significantly different mean values for benign and malignant lesions. Moreover, these two modalities complemented BUS and improved the diagnostic performance of breast lesion detection. Therefore, ARFI elastography and SR evaluations can be used as complementary modalities to make more accurate breast lesion diagnoses.

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Section: Discussionsupporting

confidence: 94%

Diagnostic Value of Elastography Using Acoustic Radiation Force Impulse Imaging and Strain Ratio for Breast Tumors

et al. 2014

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“…In some studies, a combination of elastography with CU improved differentiation between benign and malignant breast masse. [3,4] However, this result was not observed in the present study. ROC curve analyses showed that the diagnostic efficiencies of CU, SR + CU, and PHC + CU were not significant, yet the accuracy of each was significant according to the McNemar test.…”

Section: Discussioncontrasting

confidence: 91%

“…Previous studies have reported that elastography has the potential to improve differentiation of benign and malignant masses. [3,4] There are 2 widely employed strain elastography evaluation methods: a scoring system and evaluation of strain ratio (SR). Regarding the former, there are different standards that have been used to score lesions.…”

Section: Introductionmentioning

confidence: 99%

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Strain histograms used for differential diagnosis of breast masses according to hardness percentage

Xue

Zou

et al. 2019

Medicine

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To evaluate the diagnostic performance of percentage of hard component (PHC) versus strain ratio (SR) in focal breast lesion diagnosis. Ultrasonography and elastography images of 245 malignant and 255 benign breast lesions were obtained and analyzed according to the Breast Imaging-Reporting and Data System of the American College of Radiology. PHC and SR were measured for each lesion and receiver operating characteristic (ROC) curve analysis was performed to evaluate and compare the diagnostic performance of conventional ultrasound (CU) only, PHC with CU, and SR with CU. Mean PHC differed significantly between malignant (90.46 ± 13.29) and benign (62.03 ± 25.61) lesions. Mean SR differed significantly between malignant (4.61 ± 1.75) and benign (2.34 ± 1.80) lesions. ROC curve threshold values were 82.45 for PHC and 2.69 for SR. The area under the curve values for CU, SR with CU, and PHC with CU were 0.956, 0.960, and 0.956, respectively, with no significant differences among them ( P < .05). PHC was comparable to SR for differentiating malignant from benign breast masses and may be an auxiliary tool for breast lesion stiffness evaluation. ROC data for CU, SR with CU, and PHC with CU were statistically similar.

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“…Malignant masses are stiffer than the normal tissues, so measuring the tissue strain by compressing the sonography transducer provides information regarding the strain of breast lesions in relation to the surrounding fatty tissue (strain ratio) and breast lesion elasticity in SE compared to its length in B mode sonography (E/B ratio). 11,12 Moreover, color Doppler US helps to explore vascularity within the tumor and provides information regarding the angiogenesis in breast masses. 13 The current study is conducted to determine the diagnostic yield of conventional US, SE, and color Doppler US and different features of SE, including strain ratio and E/B ratio in differentiating malignant breast lesions.…”

Section: Introductionmentioning

confidence: 99%

<p>Diagnostic Value of Elastography, Strain Ratio, and Elasticity to B-Mode Ratio and Color Doppler Ultrasonography in Breast Lesions</p>

Ranjkesh

Hajibonabi

Seifar

et al. 2020

IJGM

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The aim of this study was to investigate the sensitivity, specificity, and diagnostic accuracy of sonoelastography (SE), strain ratio (SR), elasticity to B-mode (E/B) ratio, and color Doppler ultrasonography (US) in suspected breast lesions. Materials and Methods: This prospective study was conducted on women referred to Alzahra university hospital of Tabriz for annual screening of breast cancer between May 2017 and December 2018. B-mode US, SE, and color Doppler imaging were conducted in females with suspected mammography reports. The lesions in B-mode were classified according to the Breast Imaging Reporting and Data System (B-RADS). The results of SE imaging were graded based on five-grade SE score. SR and E/B ratio of each lesion were also analyzed in SE images. Color Doppler findings were categorized from 0 (no visible vessel) to 2 (> two vessels) based on the vascularity of the tumor. Pathology results were used as the gold standard to measure the area under the receiver operating characteristic curve (AUC), sensitivity, specificity, and diagnostic accuracy of each modality. Results: One-hundred and ten breast lesions of 104 women aged 42.05±10.33 years were included in the study. Seventy-seven of the lesions were benign and 3 were malignant. Sensitivity and specificity of 97.0% and 77.9% for B-mode US, 93.9% and 87.0% for SE score, 81.8% and 66.2% for color Doppler US, 72.7% and 77.6% for E/B ratio (cutoff: 1.05), and 77.3% and 79.6% for SR (cutoff: 1.90) were obtained, respectively. Addition of SE score to B-mode US increased the sensitivity to 93.9%, specificity to 93.5%, and AUC from 0.95 to 0.97. Cumulative color Doppler US with B-mode US did not enhance the diagnostic accuracy of B-mode US. Conclusion: SE was more effective than color Doppler US for distinguishing malignant from benign breast lesion. Among the three different SE features, five-grade SE score was superior to E/B ratio and SR.

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Differential diagnosis of breast lesions using ultrasound elastography

Cited by 49 publications

References 15 publications

Diagnostic Value of Elastography Using Acoustic Radiation Force Impulse Imaging and Strain Ratio for Breast Tumors

Diagnostic Value of Elastography Using Acoustic Radiation Force Impulse Imaging and Strain Ratio for Breast Tumors

Strain histograms used for differential diagnosis of breast masses according to hardness percentage

<p>Diagnostic Value of Elastography, Strain Ratio, and Elasticity to B-Mode Ratio and Color Doppler Ultrasonography in Breast Lesions</p>

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