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Elastography by acoustic radiation force impulse technology for differentiation of benign and malignant breast lesions: a meta-analysis

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Abstract

Purpose

To perform a meta-analysis assessing the ability of elastography by acoustic radiation force impulse (ARFI) technology to differentiate benign and malignant breast lesions.

Methods

PubMed, the Cochrane Library, and the Web of Knowledge before September 24, 2014 were searched. Published studies that evaluated the diagnostic performance of ARFI for characterization of focal breast lesions were included.

Results

A total of fifteen studies, including 1720 patients with 1873 breast lesions (743 cancers, 1130 benign lesions), was analyzed. Among the included studies, virtual touch tissue imaging (VTI) was used in six studies, virtual touch tissue quantification (VTQ) in eight, combined VTI and VTQ in four, and virtual touch tissue imaging quantification (VTIQ) in three. Summary sensitivity and summary specificity for distinguishing malignant from benign breast lesions were 0.913 [95 % confidence interval (CI), 0.779–0.969] and 0.871 (95 % CI 0.773–0.930) for VTI, 0.849 (95 % CI 0.805–0.884) and 0.889 (95 % CI 0.771–0.950) for VTQ, and 0.935 (95 % CI 0.892–0.961) and 0.881 (95 % CI 0.818–0.924) for combined VTI and VTQ, respectively. The area under summary receiver operating characteristic (sROC) curve of VTI, VTQ, and combined VTI and VTQ were 0.95, 0.88, and 0.96, respectively. Significant publication bias was found only in the VTQ assessment (p = 0.025). The obtained sensitivity of VTIQ ranged from 80.4 to 90.3 %, while the specificity ranged from 73.0 to 93.0 %. The summary diagnostic value of VTIQ could not be evaluated due to insufficient data.

Conclusion

Elastography by ARFI technology could be used as a good identification tool for differentiating benign and malignant breast lesions.

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Author notes

    Authors and Affiliations

    1. Division of Interventional Ultrasound, Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-sen University, Sun Yat-Sen University, 58 Zhong Shan Road 2, Guangzhou, 510080, China

      BaoXian Liu, YanLing Zheng, QuanYuan Shan, Ying Lu, ManXia Lin, WenShuo Tian & XiaoYan Xie

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    1. BaoXian Liu
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    2. YanLing Zheng
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    Correspondence to XiaoYan Xie.

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    Conflict of interest

    There are no financial or other relations that could lead to a conflict of interest.

    Ethical standards

    All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5). Informed consent was obtained from all patients for being included in the study.

    Additional information

    BaoXian Liu and YanLing Zheng contributed equally to this work.

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    Cite this article

    Liu, B., Zheng, Y., Shan, Q. et al. Elastography by acoustic radiation force impulse technology for differentiation of benign and malignant breast lesions: a meta-analysis. J Med Ultrasonics 43, 47–55 (2016). https://doi.org/10.1007/s10396-015-0658-9

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    • DOI: https://doi.org/10.1007/s10396-015-0658-9

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