Can strain elastography combined with ultrasound breast imaging reporting and data system be a more effective method in the differentiation of benign and malignant breast lesions?

• Published in: Journal of medical ultrasonics (2001) 2017-10, Vol.44 (4), p.289-296
• Main Authors: Arslan, Serdar, Uslu, Nihal, Ozturk, Funda Ulu, Akcay, Eda Yilmaz, Tezcaner, Tugan, Agildere, Ahmet Muhtesem
• Format: Article
• Language: English
• Subjects: Accuracy; Adult; Aged; Aged, 80 and over; Biopsy; Breast; Breast - diagnostic imaging; Breast - pathology; Breast cancer; Breast Neoplasms - diagnostic imaging; Breast Neoplasms - pathology; Breast Neoplasms, Male - diagnostic imaging; Breast Neoplasms, Male - pathology; Data systems; Diagnosis, Differential; Diagnostic imaging; Diagnostic systems; Differentiation; Elasticity Imaging Techniques; Female; Humans; Imaging; Lesions; Male; Medical imaging; Medicine; Medicine & Public Health; Methods; Middle Aged; Necrosis; Original Article; Prospective Studies; Radiology; Radiology Information Systems; Sensitivity; Ultrasonic imaging; Ultrasonography, Mammary; Ultrasound; Ultrasound imaging; Variance analysis; Young Adult
• ISSN: 1346-4523; 1613-2254
• DOI: 10.1007/s10396-017-0772-y

Purpose To investigate whether a novel method that combines breast imaging reporting and data system (BI-RADS) with strain elastography contributes to diagnostic performance in differentiation of malignant and benign breast lesions. Methods In 81 patients, 81 breast lesions were prospectively investigated. Breast lesions were separately evaluated with ultrasonography and strain elastography. While evaluations with ultrasonography were based on 2003 BI-RADS-US, strain elastography evaluations were based on a 5-point scale and strain ratio. Diagnostic performances of ultrasonography, strain elastography, and the combined method were compared. Results Among 81 lesions, 43 (53.1%) were benign and 38 (46.9%) were malignant. When a cutoff point of category 3 was used, sensitivity, specificity, positive and negative predictive values, and accuracy for BI-RADS were 100, 11.6, 50, 100, and 53%, respectively. When BI-RADS and strain ratio were combined, sensitivity, specificity, positive and negative predictive values, and accuracy were 89.5, 93, 91.9, 90.9, and 91.3%, respectively. When BI-RADS and elastography scores were combined, sensitivity, specificity, positive and negative predictive values, and accuracy were 86.8, 97.7, 97.1, 89.4, and 92.5%, respectively. Conclusions The combination of strain elastography and BI-RADS was found to have better diagnostic performances to diagnose breast lesions than BI-RADS alone.