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...