Aims and objectives
Ultrasound (US) of the breast is a valuable adjunct to mammography in the characterization of breast lesions.
Using established diagnostic criteria,
as described in the BI-RADS lexicon [1],
it shows a high sensitivity at a variable but in general moderate specificity [2-5].
Since B-mode US only provides morphological information,
elastography is one of the techniques that have been introduced in breast imaging,
in order to provide additional functional information about breast lesions.
Elastography evaluates the mechanical properties of tissue.
Several approaches have been investigated,
such...
Methods and materials
Patients
Institutional Review Board approval was obtained for this retrospective,
cross-sectional study.
All diagnostic US examinations of the breast,
which included ARFI imaging with VTIQ,
performed at our institution between June 2013 and June 2015,
were retrospectively reviewed by searching the local PACS system.
In order to be eligible for inclusion in the study,
an examination had to meet following criteria: an abnormality visible at breast B-mode US with at least 4 mm in size (BI-RADS 2-5); no previous biopsy or neoadjuvant chemotherapy; color coded...
Results
84 lesions were malignant and 112 benign.
The mean lesion size was 17.52 ± 10.27 (SD) mm (range 4-54 mm).
Malignant lesions included 67 invasive ductal carcinomas (IDC),
7 invasive lobular carcinomas (ILC),
5 ductal carcinomas in situ (DCIS),
3 mucinous carcinomas,
1 medullary carcinoma and 1 angiosarcoma.
Benign lesions comprised of 44 fibroadenomas,
14 fibrocystic changes,
9 liponecrosis,
7 fibroadenomatoid hyperplasia,
6 papillomas,
5 inflammatory changes/abscess,
4 apocrine metaplasia and 23 other benign lesions.
Mean SWV values were 2.91 ± 1.61 m/s for benign...
Conclusion
Several studies have already shown [7; 8; 10] that ARFI imaging with VTIQ can aid in the differentiation of malignant from benign breast lesions.
Our study assessed the added value of ARFI imaging to B-mode breast US and demonstrated a tendency towards higher diagnostic accuracy for most of the examiners.
Moreover,
all examiners reported a higher diagnostic confidence through the combined B-mode and ARFI reading.
Several SWV cut-off values have been proposed in literature.
In concordance to previous work from our group [10],
ROC curve...
References
1 Mendelson EB,
Böhm-Vélez M,
Berg WA,
al.
e (2013) ACR BI-RADS® Ultrasound ACR BI-RADS® Atlas,
Breast Imaging Reporting and Data System.
American College of Radiology,
Reston,
VA
2 Thomas A,
Kummel S,
Fritzsche F et al (2006) Real-time sonoelastography performed in addition to B-mode ultrasound and mammography: improved differentiation of breast lesions? Acad Radiol 13:1496-1504
3 Cho N,
Jang M,
Lyou CY,
Park JS,
Choi HY,
Moon WK (2012) Distinguishing benign from malignant masses at breast US: combined US elastography and color doppler US--influence...