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?

Background The maximum value of the strain ratio (SR) is a newly developed measure in strain-elastography. Purpose To prospectively compare the diagnostic performance of three different measures of strain-elastography, the maximum value of the SR (SRmax), the average value of the SR (SRave), and the color map, for differentiating benign and malignant breast lesions. Material and Methods We obtained the SRmax and SRave of 314 lesions from 290 patients with the tissue to nodule SR and color map using a five-degree scoring system. The diagnostic performances of the SRmax, SRave, and color map were compared after obtaining the area under the receiver operating characteristic (ROC) curves (AUCs) of each parameter. Results The AUC of the SRmax (0.7674) was larger than the AUCs of the SRave (0.7138) and color map (0.6324), with statistical significance ( P = 0.0383 for SRmax vs. SRave, P = 0.0000 for SRmax vs. color map). The AUC of the SRave was larger than that of the color map; however, there was no significant difference. The optimal cut-off point of the SRmax that balanced the sensitivity (91.12%) and specificity (50.81%) was 5.16. Conclusion The SRmax is a more reliable diagnostic tool than the SRave and color map for differentiating benign and malignant breast lesions.

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Diagnostic Values of Breast Imaging Reporting and Data System and ultrasound Elastography in Benign and Malignant Breast Tumor

Journal of Computational and Theoretical Nanoscience ◽

10.1166/jctn.2016.5594 ◽

2016 ◽

Vol 13 (10) ◽

pp. 6509-6513

Author(s):

Xin-Hua Lu

Keyword(s):

Breast Cancer ◽

Roc Curve ◽

Predictive Value ◽

Breast Tumor ◽

Breast Imaging ◽

Data System ◽

Ultrasound Elastography ◽

Malignant Breast Tumor ◽

Diagnostic Values ◽

Malignant Breast

Objective: To evaluate the diagnostic values of Breast Imaging Reporting and Data System (BI-RADS), ultrasound elastography (UE) and the combination in differentiating benign and malignant breast tumor. Methods: The BI-RADS and UE image features of 248 breast cancer patients (a total of 260 lesions) proved by surgery and pathology from February 2013 to March 2015 were retrospectively analyzed. With the pathologic results as the gold standard, the sensitivity, specificity, positive and negative predictive values, and accuracy were calculated for BI-RADS, UE and the combination. On the basis of the sensitivity and specificity, they were analyzed by receiver operating characteristic (ROC) curve. Results: In all 260 lesions, 71 lesions were benign and 189 were malignant according to UE diagnosis; 50 lesions were benign and 210 were malignant proved by BI-RADS; 55 lesions were benign and 205 were malignant diagnosed by the combination. The sensitivity (86.09%), specificity (61.64%), positive predictive value (85.19%), negative predictive value (63.38%), and accuracy (79.23%) of ultrasound elastography were all less than that of BI-RADS (98.39%, 64.38%, 88.85%, 87.62%, 94.00%) and the combination (99.47%, 73.97%, 92.31%, 90.73%, 98.18%). The areas under the ROC curve for UE, BI-RADS and the combination were respectively 0.746[95%CI(0.673–0.818)], 0.814[95%CI(0.744–0.884)] and 0.867[95%CI(0.805–0.929)]. Conclusion: Ultrasonic BI-RADS can be the first choice for diagnosing breast cancer, with UE as the auxiliary method. The combined application can further improve the diagnosis rate of benign and malignant breast tumor.

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