Role of sonoelastography in characterising breast nodules. Preliminary experience with 120 lesions

Regini, E.; Bagnera, Silvia; Tota, Donatella; Campanino, Pier Paolo; Luparia, A.; Barisone, Francesca; Durando, Manuela; Mariscotti, Giovanna; Gandini, Giovanni

doi:10.1007/s11547-010-0518-z

Cited by 49 publications

(34 citation statements)

References 21 publications

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“…In this study, the au- thors have concluded that elastography can increase the specificity of conventional ultrasonography up to 88.7%, especially in non-palpable lesions. Although some studies did not detect an improvement in specificity with the addition of US elastography (14,17), a number of other studies showed an increase in specificity (6-13). Cho et al (10) studied 100 non-palpable breast lesions and found the sensitivity as 82% and the specificity as 84%, and concluded that there were no significant differences between conventional US and elastography in the evaluation of solid breast masses.…”

Section: Discussionmentioning

confidence: 97%

Value of Strain Elastography Ultrasound in Differentiation of Breast Masses and Histopathologic Correlation

Atabey¹,

Arıbal

Ergelen

et al. 2014

J Breasth Health

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Objective: US elastography is an emerging technique that can be used during breast US examination. The increasing awareness of breast cancer led to an increase in mammography and breast US examinations. The specificity of these techniques is not high enough to prevent unnecessary biopsies. There is still a need for a more specific technique that can overcome this problem. This study aimed to evaluate the value of strain elastography in breast lesions. Materials and Methods:In this study, 110 lesions of 96 patients were evaluated with strain elastography. Five score system was used for lesion scoring. The histopathologic results of lesions were obtained and were accepted as gold standard. The sensitivity, specificity, PPV and NPV of the technique were calculated. Histopathologic and strain elastography results were correlated. Results:The sensitivity of US strain elastography was calculated as 83%, the specificity as 89%, the positive predictive value as 79% and the negative predictive value as 91%.There were no score 1 lesions. All score 2 lesions were benign. Score 5 had the highest true positivity rate. Conclusion:We believe that ultrasound elastography is an effective imaging technique that can be used as an adjunct for differential diagnosis, prior to the decision to biopsy a lesion in certain cases.Key words: Elastography, breast elastography, breast lesions, sonoelastography IntroductionBreast screening and diagnostic breast imaging provides early diagnosis of breast cancer. Although breast imaging modalities have high sensitivity rates, there is still need for a higher specificity in imaging to rule out malignancy in incidentally found breast lesions. Especially ultrasonography (US) examination can detect more malign masses with lower specificity, which leads to a high number of unnecessary biopsies (1, 2). US elastography, which shows the stiffness of the lesion, is being widely used in recent years. It determines the change of the size of the lesion in neutral position and under pressure. Generally, breast cancers are hard due to fibrous desmo-plastic reaction and are expected to remain stable during pressure application. There are 2 different types of techniques widely used for determination of the rigidity of the lesion with US; strain elastography and shear wave elastography techniques. In strain elastography, the observer or the patient produces the pressure either with the probe or by breathing whereas in the shear wave technique that pressure is formed by the US probe by a special sound wave, which is called shear wave (3). In this study, we aimed to evaluate the value of strain elastography technique in breast lesions by correlation of elastographic features with histopathological results. Materials and Methods PatientsIn this study, 110 lesions of 96 patients, who were admitted for biopsy of a breast lesion, were evaluated prospectively between December 2009 and September 2010. The mean age of patients was 50 (range 19-87) years. An ethical committee approval was obtained from Medical Re...

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Section: Discussionmentioning

confidence: 97%

Value of Strain Elastography Ultrasound in Differentiation of Breast Masses and Histopathologic Correlation

Atabey¹,

Arıbal

Ergelen

et al. 2014

J Breasth Health

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“…The diagnostic accuracy of elasticity scoring has already been investigated in several previous studies [2,3,5, and a previous meta-analysis [37]. Our prior meta-analysis has shown a sensitivity of 79% and a specificity of 89% for use of ES in differentiating benign and malignant lesions [38].…”

Section: Introductionmentioning

confidence: 86%

“…Elasticity is the tendency of a tissue to resume the original size and shape; while strain is the level of change in size or shape in response to external compression (stress) [4]. Each pixel of the image is assigned one of 256 specific colors and demonstrates the magnitude of tissue strain depending on physiological and pathological changes in breast structure [3,5]. Harder tissues such as malignancy may result in decreased strain and are shown in blue, while softer tissues will reflect increased strain and are shown in red [3].…”

Section: Introductionmentioning

confidence: 99%

Ultrasonographic differentiation of malignant from benign breast lesions: a meta-analytic comparison of elasticity and BIRADS scoring

Sadigh

Carlos

Neal

et al. 2011

Breast Cancer Res Treat

105

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There has been controversy regarding the accuracy of breast ultrasound elastography (USE) compared to conventional B-mode Ultrasound (USB). The purpose of this study was to conduct a direct comparative effectiveness analysis of USB versus USE or their combination in differentiating breast lesions through systematically reviewing recent literature. An extensive literature search of PubMed and other medical and general purpose databases from inception through August 2011 was conducted. Published studies that reported a direct comparison of the diagnostic performance of USE, using elasticity score versus USB, using breast imaging reporting and data system (BIRADS) for characterization of focal breast lesions were included. Summary diagnostic performance measures were assessed for each of the tests and their combination using bivariate generalized linear mixed modeling. The two tests were combined as: (1) conjunctive, where the outcome of the combination of tests is positive only if both test results are positive; (2) disjunctive, where the outcome of a combination of tests is negative only if both tests are negative. Twenty nine studies provided relevant information on 5,511 breast masses (2,065 cancers, 3,446 benign lesions). Sensitivity of USB, USE, and their conjunctive and disjunctive combinations were 96% (95% credible interval (CrI), 93-98%), 79% (95% CrI, 74-83%), 73% (95% CrI, 67-78%), and 99% (95% CrI, 98-99%), respectively. Specificity of USB, USE, and their conjunctive and disjunctive combinations were 70% (95% CrI, 55-83%), 88% (95% CrI, 82-92%), 97% (95% CrI, 95-99%), and 56% (95% CrI, 43-69%), respectively. The application of USE as a single test is not superior to USB alone. However, in low risk patients it is recommended to perform an USE following a positive USB result to decrease the rate of unnecessary biopsies.

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“…In recent years, new radiological imaging methods such as Elastography have been described about diagnosis of malign tissue. In previous studies (about prostate and breast cancer) it has been reported that stiffness grade of tumor tissue higher than in normal tissue by Elastographic examination (6,7,8). Aigner et al (3) performed testicular Elastography for 50 patients who have TLs detected with gray-scale US.…”

Section: Discussionmentioning

confidence: 99%

“…Elastography is a new sonographic method that directly discloses the elasticity features of the tissue and allows examination of changes in tissue hardness (4). Elastography has been proposed with promising results for differentiating benign from malignant lesions in some tissues, such as testis (4,5,6,7,8). Due to increasing stiffness of a mass, the risk of malignancy becomes higher and more sensitive to elasticity evaluation than palpation might obtain with recent sonographic devices (5).…”

Section: Introductionmentioning

confidence: 99%

Should Testis Elastography be Performed in All Patients with Scrotal Swelling? A Case Report

Hamidi¹,

Altınbaş²,

Süer³

et al. 2015

uob

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Some of testicular tumor cases can present with symptoms like epididymo-orchitis and this condition can cause delay in the diagnosis of testis tumor. Even though scrotal Doppler ultrasound has high sensitivity (up to 100%) in the diagnosis of testicular lesions; it alone may not be sufficient in the differential diagnosis of benign and malign lesions. The delay of the diagnosis can cause progression of stage and consequently worsening prognosis. In this case, it was aimed to present a case that is thought to be testicular tumor according to Elastography which applies with clinical features like epididymo-orchitis and cannot be diagnosed with B-mode scrotal Doppler ultrasound. Keywords: Elastography, epididymoorchitis, testicular tumour, tissue stiffness grade Testis tümör olgularının bir kısmı epididimoorşit benzeri şikayetlerle başvurabilir ve bu durum tanının gecikmesine yol açabilir. Skrotal Dopler ultrasonun testiküler lezyon tanısında sensitivitesi %100'e yakın olsa da malign lezyonları benign testiküler lezyonlardan ayırt etmede tek başına yeterli olmayabilir. Tanının gecikmesi evrenin ilerlemesine ve dolayısıyla prognozun daha kötüleşmesine neden olabilir. Bu olguda epididimoorşit benzeri klinikle başvuran ve B-mode skrotal ultrason ile ayırt edilemeyen ancak testis elastografisindeki bulgulara göre tümör olduğu düşünülen bir olguyu sunmayı amaçladık. Anahtar Kelimeler: Elastografi, epididimoorşit, testis tümörü, doku sertlik derecesi Öz SummaryCase Report / Olgu Sunumu

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Role of sonoelastography in characterising breast nodules. Preliminary experience with 120 lesions

Abstract: The use of sonoelastography to complement mammography and ultrasonography could help in the differential diagnosis of nodular breast lesions, especially in Breast Imaging Reporting Data System (BI-RADS) 3 lesions with marked elasticity (S

Cited by 49 publications

References 21 publications

Value of Strain Elastography Ultrasound in Differentiation of Breast Masses and Histopathologic Correlation

Value of Strain Elastography Ultrasound in Differentiation of Breast Masses and Histopathologic Correlation

Ultrasonographic differentiation of malignant from benign breast lesions: a meta-analytic comparison of elasticity and BIRADS scoring

Should Testis Elastography be Performed in All Patients with Scrotal Swelling? A Case Report

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