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Sonoelastography for 1786 non-palpable breast masses: diagnostic value in the decision to biopsy

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Abstract

Objectives

To evaluate the diagnostic value of sonoelastography by correlation with histopathology compared with conventional ultrasound on the decision to biopsy.

Methods

Prospectively determined BI-RADS categories of conventional ultrasound and elasticity scores from strain sonoelastography of 1786 non-palpable breast masses (1,523 benign and 263 malignant) in 1,538 women were correlated with histopathology. The sensitivity and specificity of two imaging techniques were compared regarding the decision to biopsy. We also investigated whether there was a subset of benign masses that were recommended for biopsy by B-mode ultrasound but that had a less than 2% malignancy rate with the addition of sonoelastography.

Results

The mean elasticity score of malignant lesions was higher than that of benign lesions (2.94 ± 1.10 vs. 1.78 ± 0.81) (P < 0.001). In the decision to biopsy, B-mode ultrasound had higher sensitivity than sonoelastography (98.5% vs. 93.2%) (P < 0.001), whereas sonoelastography had higher specificity than B-mode ultrasound (42.6% vs. 16.3%) (P < 0.001). BI-RADS category 4a lesions with an elasticity score of 1 had a malignancy rate of 0.8%.

Conclusions

Sonoelastography has higher specificity than B-mode ultrasound in the differentiation between benign and malignant masses and has the potential to reduce biopsies with benign results.

Key Points

Sonoelastography has higher specificity than B-mode ultrasound in distinguishing benign from malignant masses.

Sonoelastography could potentially help reduce the number of biopsies with benign results.

Lesion stiffness on sonoelastography correlated with the malignant potential of the lesion.

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References

  1. Krouskop TA, Wheeler TM, Kallel F et al (1998) Elastic moduli of breast and prostate tissues under compression. Ultrason Imaging 20:260–274

    PubMed  CAS  Google Scholar 

  2. Itoh A, Ueno E, Tohno E et al (2006) Breast disease: clinical application of US elastography for diagnosis. Radiology 239:341–350

    Article  PubMed  Google Scholar 

  3. Zhi H, Ou B, Luo BM et al (2007) Comparison of ultrasound elastography, mammography, and sonography in the diagnosis of solid breast lesions. J Ultrasound Med 26:807–815

    PubMed  Google Scholar 

  4. Cho N, Moon WK, Park JS et al (2008) Nonpalpable breast masses: evaluation by US elastography. Korean J Radiol 9:111–118

    Article  PubMed  Google Scholar 

  5. Tardivon A, El Khoury C, Thibault F et al (2007) Elastography of the breast: a prospective study of 122 lesions [in French]. J Radiol 88:657–662

    Article  PubMed  CAS  Google Scholar 

  6. Thomas A, Fischer T, Frey H et al (2006) Real-time Elastography—an advanced method of ultrasound: first results in 108 patients with breast lesions. Ultrasound Obstet Gynecol 28:335–340

    Article  PubMed  CAS  Google Scholar 

  7. Zhu QL, Jiang YX, Liu JB et al (2008) Real-time ultrasound elastography: its potential role in assessment of breast lesions. Ultrasound Med Biol 34:1232–1238

    Article  PubMed  Google Scholar 

  8. Tan SM, Teh HS, Mancer JF et al (2008) Improving B mode ultrasound evaluation of breast lesions with real-time ultrasound elastography – a clinical approach. Breast 17:252–257

    Article  PubMed  CAS  Google Scholar 

  9. Sohn YM, Kim MJ, Kim EK et al (2009) Sonographic elastography combined with conventional sonography how much is it helpful for diagnostic performance? J Ultrasound Med 26:807–815

    Google Scholar 

  10. Raza S, Odulate A, Ong EM et al (2010) Using real-time tissue elastography for breast lesion evaluation: our initial experience. J Ultrasound Med 29:551–563

    PubMed  Google Scholar 

  11. Yerli H, Yilmaz T, Kaskati T et al (2011) Qualitative and semiquantitative evaluations of solid breast lesions by sonoelastography. J Ultrasound Med 30:179–186

    PubMed  Google Scholar 

  12. Berg WA, Blume JD, Cormack JB et al (2008) Combined screening with ultrasound and mammography vs mammography alone in women at elevated risk of breast cancer. JAMA 299:2151–2163

    Article  PubMed  CAS  Google Scholar 

  13. Feig SA (2005) Current status of screening US. In: Feig SA (ed) 2005 Syllabus: categorical course in diagnostic radiology-breast imaging. Radiological Society of North America, Oak Brook, pp 143–154

    Google Scholar 

  14. American College of Radiology (2003) Breast imaging reporting and data system-Ultrasound (BI-RADS™). American College of Radiology, Reston

    Google Scholar 

  15. Athanasiou A, Tardivon A, Tanter M et al (2010) Breast lesions: quantitative elastography with supersonic shear imaging – preliminary results. Radiology 256:297

    Article  PubMed  Google Scholar 

  16. Varas X, Leborgne JH, Leborgne F et al (2002) Revisiting the mammographic follow-up of BI-RADS category 3 lesions. AJR Am J Roentgenol 179:691–695

    PubMed  Google Scholar 

  17. Cho N, Moon WK, Chang JM et al (2011) Sonoelastographic lesion stiffness: preoperative predictor of the presence of an invasive focus in nonpalpable DCIS diagnosed at US-guided needle biopsy. Eur Radiol 21:1618–1627

    Article  PubMed  Google Scholar 

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Correspondence to Nariya Cho.

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Yi, A., Cho, N., Chang, J.M. et al. Sonoelastography for 1786 non-palpable breast masses: diagnostic value in the decision to biopsy. Eur Radiol 22, 1033–1040 (2012). https://doi.org/10.1007/s00330-011-2341-x

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  • DOI: https://doi.org/10.1007/s00330-011-2341-x

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