Combination of Virtual Touch Tissue Imaging and Virtual Touch Tissue Quantification for Differential Diagnosis of Breast Lesions

• Published in: Journal of ultrasound in medicine 2015-07, Vol.34 (7), p.1201-1208
• Main Authors: Teke, Memik, Göya, Cemil, Teke, Fatma, Uslukaya, Ömer, Hamidi, Cihad, Çetinçakmak, Mehmet Guli, Hattapoğlu, Salih, Alan, Bircan, Tekbaş, Güven
• Format: Article
• Language: English
• Subjects: acoustic radiation force impulse imaging; Adult; Aged; Aged, 80 and over; breast cancer; Breast Neoplasms - diagnostic imaging; breast ultrasound; Diagnosis, Differential; Elasticity Imaging Techniques; Female; Humans; Middle Aged; Prospective Studies; Reproducibility of Results; Sensitivity and Specificity; shear wave velocity; Touch; Ultrasonography, Mammary - instrumentation; User-Computer Interface; Virtual Touch tissue imaging; Virtual Touch tissue quantification
• ISSN: 0278-4297; 1550-9613
• DOI: 10.7863/ultra.34.7.1201

Objectives Breast cancer is the second leading cause of death from cancer in women, and early detection is the key to successful treatment. Unfortunately, even with technological advances, the specificity of imaging modalities is still low. Therefore, we evaluated the value of a newly developed noninvasive technique, acoustic radiation force impulse imaging, for differentiating benign versus malignant breast lesions. Methods We prospectively examined 141 breast lesions in 122 patients. All lesions were classified according to the American College of Radiology Breast Imaging Reporting and Data System (BI‐RADS) for mammography, BI‐RADS for sonography, and Virtual Touch tissue imaging (VTI; Siemens Medical Solutions, Mountain View, CA) pattern. Internal and marginal shear wave velocity (SWV) values for the lesions were noted. The sensitivity, specificity, accuracy, and positive and negative predictive values for VTI and Virtual Touch tissue quantification (VTQ; Siemens Medical Solutions) were calculated. Results The marginal SWV values were statistically higher in malignant lesions (mean ± SD, 5.41 ± 1.37 m/s) than benign lesions (2.91 ± 0.88 m/s; P < .001). When the SWV cutoff level was set at 4.07 m/s, and the higher of the internal and marginal values was adopted, the combination of VTI and VTQ showed 95.1% sensitivity, 99.0% specificity, and 97.8% accuracy. Conclusions Breast Imaging Reporting and Data System category 4 lesions are the main focus of research for early detection of breast cancer. Unfortunately, BI‐RADS category 4 assessment covers a wide range of likelihood of malignancy (2%–95%). This wide range reflects the necessity for a more specific imaging modality. The combination of VTI and VTQ could increase the diagnostic performance of conventional sonography.