Download PDF
CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2011; 21(04): 301-305
DOI: 10.4103/0971-3026.90697
Women’s Radiology

Differential diagnosis of breast lesions using ultrasound elastography

Ioana Andreea Gheonea
Department of Radiology and Imaging, University of Medicine and Pharmacy Craiova, Romania
,
Zoia Stoica
Department of Radiology and Imaging, University of Medicine and Pharmacy Craiova, Romania
,
Simona Bondari
Department of Radiology and Imaging, University of Medicine and Pharmacy Craiova, Romania
› Author Affiliations
› Further Information
Also available at
  PDF Download Permissions and Reprints

Abstract

Context: The recent introduction of elastography has increased the specificity of USG and enabled early diagnosis of breast cancer. Quantitative elastography, especially with strain ratio (SR) index, improves diagnostic accuracy and decreased number of biopsies. Aims: The purpose of this study was to assess the role of USG elastography in the differential diagnosis of breast lesions. Settings and Design: This prospective study was conducted in the University of Medicine and Pharmacy Research Centre of Craiova. Materials and Methods: Fifty-eight patients diagnosed with breast lesions between January 2009 and January 2010 were included in this prospective study. All the patients were examined in the supine position, and the B-mode USG image was displayed alongside the elastography strain image. For obtaining the elastography images we used a EUS Hitachi EUB 8500 ultrasound system with a 6.5-MHz linear probe. The elastography strain images were scored according to the Tsukuba elasticity score. Statistical Analysis: We performed receiver operator characteristic (ROC) analysis for assessment of the role of USG elastography in the diagnosis of breast lesions. Results: We obtained a sensitivity of 86.7% and a specificity of 92.9% for elasticity score and a sensitivity of 93.3% and a specificity of 92.9% for SR (when a cutoff point of 3.67 was used). There was very good correlation between SR and elasticity score (Spearman coefficient of 0.911). Conclusions: Elastography is a fast, simple method that can complement conventional USG examination. This method has the lowest cost/efficiency ratio and it is also the most noninvasive and accessible imaging method, with an accuracy comparable to MRI.

Keywords

Breast lesions - receiver operator characteristic analysis - ultrasound elastography


Publication History

Article published online:
30 July 2021

© 2011. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India

 

  • References

  • 1 Krouskop TA, Wheeler TM, Kallel F, Garra BS, Hall T. Elastic moduli of breast and prostate tissues under compression. Ultrason Imaging 1998;20:260-74.
  • 2 Ophir J, Céspedes I, Ponnekanti H, Yazdi Y, Li X. Elastography: A quantitative method for imaging the elasticity of biological tissues. Ultrason Imaging 1991;13:111-34.
  • 3 Klauser AS, Faschingbauer R, Jaschke WR. Is sonoelastography of value in assessing tendons? Semin Musculoskelet Radiol 2010;14:323-33.
  • 4 Itoh A, Ueno E, Tohno E, Kamma H, Takahashi H, Shiina T, et al. Breast disease: Clinical application of US elastography for diagnosis. Radiology 2006;239:341-50.
  • 5 Burnside ES, Hall TJ, Sommer AM, Hesley GK, Sisney GA, Svensson WE, et al. Differentiating benign from malignant solid breast masses with US strain imaging. Radiology 2007;245:401-10.
  • 6 Regner DM, Hesley GK, Hangiandreou NJ, Morton MJ, Nordland MR, Meixner DD, et al. Breast lesions: Evaluation with US strain imaging-clinical experience of multiple observers. Radiology 2006;238:425-37.
  • 7 Garra BS, Cespedes EI, Ophir J, Spratt SR, Zuurbier RA, Magnant CM, et al. Elastography of breast lesions: Initial clinical results. Radiology 1997;202:79-86.
  • 8 Hall TJ, Zhu Y, Spalding CS. In vivo real-time freehand palpation imaging. Ultrasound Med Biol 2003;29:427-35.
  • 9 Amy D. Echographie mammaire: Echoanatomie. Jl mensuel d`echographie: LUS 2000;10:654-62.
  • 10 Rizzatto G. Real-time elastography of the breast in clinical practice - The Italian experience. Medix Hitachi Suppl 2007;1 :12-5.
  • 11 Itoh A. Review of the techniques and diagnostic criteria of breast ultrasound elastography. Medix Hitachi Suppl 2007;1:8-11.
  • 12 Hong AS, Rosen EL, Soo MS, Baker JA. BIRADS for sonography: Positive and negative values of sonographic features. AJR Am J Roentogenol 2005;184:1260-5.
  • 13 Ueno E, Shiina T, Kubota M, Sawai K, editors. Research and Development in Breast Ultrasound. In vivo Breast Examination by Real-Time Freehand Elasticity Imaging System, Tokyo: Springer-Verlag; 2005. p. 7-16.
  • 14 Konofagou EE. Quo Vadis elasticity imaging? Ultrasonics 2004;42:331-6.
  • 15 Thomas A, Fischer T, Frey H, Ohlinger R, Grunwald S, Blohmer JU, et al. Real-time elastography-an advanced method of ultrasound: First results in 108 patients with breast lesions. Ultrasound Obstet Gynecol 2006;28:335-40.
  • 16 Wang Z, Yang T, Wu Z, Tang S, Liang X, Qin A, et al. Correlation between elastography score and strain rate ratio in breast small tumor. Zhong Nan Da Xue Xue Bao Yi Xue Ban 2010;35:928-32.
  • 17 Zhi H, Xiao XY, Yang HY, Wen YL, Ou B, Luo BM, et al. Semi-quantitating stiffness of breast solid lesions in ultrasonic elastography. Acad Radiol 2008;15:1347-53.
  • 18 Stavros AT, Thickman D, Rapp CL, Dennis MA, Parker SH, Sisney GA. Solid breast nodules. Use of sonography to distinguish benign and malignant lesions. Radiology 1995;196:123-34.
  • 19 Thomas A, Kümmel S, Fritzsche F, Warm M, Ebert B, Hamm B, et al. Real-time sonoelastography performed in addition to B-mode ultrasound and mammography: Improved differentiation of breast lesions? Acad Radiol 2006;13:1496-504.
  • 20 Scaperrotta G, Ferranti C, Costa C, Mariani L, Marchesini M, Suman L, et al. Role of sonoelastography in non-palpable breast lesions. Eur Radiol 2008;18:2381-9.
  • 21 Giuseppetti GM, Martegani A, Di Cioccio B, Baldassarre S. Elastosonography in the diagnosis of the nodular breast lesions: Preliminary report. Radiol Med 2005;110:69-76.
  • 22 Lyshchik A, Higashi T, Asato R, Tanaka S, Ito J, Hiraoka M, et al. Cervical lymph node metastases: Diagnosis at sonoelastography--initial experience. Radiology 2007;243:258-67.