Real-time US elastography in the differentiation of suspicious microcalcifications on mammography

Abstract

The purpose of this study was to retrospectively evaluate the use of US elastography in the differentiation of mammographically detected suspicious microcalcifications, using histology as the reference standard. Between May 2006 and April 2007, real-time US elasticity images were obtained in 77 patients (age range, 24-67 years; mean, 46 years) with 77 mammographically detected areas of microcalcifications (42 benign and 35 malignant lesions) prior to needle biopsy. Two experienced radiologists reviewed cine clips of elasticity and B-mode images and assigned an elasticity score of 1 to 3 in consensus, based on the degree of strain in the hypoechoic lesion without information of mammography and histology. For the elasticity score, the mean +/- standard deviation was 1.5 +/- 0.7 for benign and 2.7 +/- 0.7 for malignant lesions (P < 0.001). When a cutoff point between elasticity scores of 1 and 2 was used, US elastography showed 97% (34/35) sensitivity, 62% (26/42) specificity, 68% (34/50) PPV, and 96% (26/27) NPV with an Az value of 0.852 (0.753-0.923, 95% confidence interval) in the differentiation of benign and malignant microcalcifications. Our results suggest that US elastography has the potential to differentiate benign and malignant lesions associated with microcalcifications detected at screening mammography.

Real-time elastography for the differentiation of benign and malignant breast lesions: a meta-analysis

“…Fleury Ede et al [23] proposed an elastographic classification system (scales 1-4) using the image of the lesion not only before and during compression, but also after parenchymal decompression and its correlation with the respective histological result. Cho [24] used a three-point scale because lesions with microcalcification, in contrast to solid mass lesions, tended to show less strain difference from the surrounding parenchyma. In addition, the cutoff value of the ES fivepoint systems was different in four studies [18,27,33,34], but observer because of the lack of data reported, subgroup analysis was not possible.…”

Assessment of breast cancer tumour size using six different methods

“…Imaging the elasticity of the lesions makes it easier to detect and characterise them, and also to estimate their size [17][18][19]. In the present study, RTE was carried out with colour coding and real-time assessment.…”

“…Most studies advocate using ultrasound as the preferred method of predicting the real histopathological tumour size, although most studies have found that ultrasound underestimates the size of breast lesions [6,8,10]. However, the published studies [6,8,[10][11][12][13][14][15][16] may not reflect current technical standards in mammography and ultrasound, as compound imaging and real-time elastography in particular, as a quite new technique in breast diagnosis, may now allow more accurate tumour size estimation [17][18][19][20][21][22][23][24]. Elastography is able to image the elasticity of soft tissues [21].…”

Sonoelastographic lesion stiffness: preoperative predictor of the presence of an invasive focus in nonpalpable DCIS diagnosed at US-guided needle biopsy

“…And a score of 3 indicated no strain in the entire hypoechoic lesion, i.e., the entire lesion was blue. This scoring system was modified from a five-point scale reported in previous research [16] and was found to be useful in differentiating benign from malignant lesions [24].…”