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Keywords:
Breast, Ultrasound, Elastography, Biopsy, Cancer
Authors:
P. Kapetas1, P. Clauser1, M. A. Marino1, R. Woitek1, S. Viganò2, M. Bernathova1, K. Pinker-Domenig1, T. H. Helbich1, P. A. T. Baltzer1; 1Vienna/AT, 2Milan/IT
DOI:
10.1594/ecr2016/C-2369
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 and 5.98 ± 2.67 m/s for malignant lesions.
The difference in SWV between benign and malignant lesions proved statistically significant (p=0.0001).
Typical examples from the study population are shown in Figures 2 and 3.
ROC curve analysis showed a high accuracy for the B-mode reading of all four readers,
with the area under the ROC curve (AUC) ranging between 0.851 and 0.900.
The combined B-mode and ARFI imaging reading showed a tendency towards a higher AUC for three readers and a slightly lower AUC for the fourth one (AUC 0.873-0.914) (Table 1).
There was no statistical difference between the AUC of the two readings for none of the readers (Fig.
1).
All readers though,
reported a higher diagnostic confidence through the combined reading.
By varying the SWV cut-off value “rule-in” and “rule-out” thresholds were specified.
A high SWV cut-off value of 6.5 m/s suggested a probability of malignancy of >95%.
On the contrary,
a low cut-off value of 1.9 m/s led to a sensitivity of 99%.
Details of the threshold values and their diagnostic parameters are shown in Table 2.