Can strain US-elastography with strain ratio (SRE) improve the diagnostic accuracy in the assessment of breast lesions? Preliminary results

2020 ◽  
Author(s):  
Daniela Elia ◽  
Daniele Fresilli ◽  
Patrizia Pacini ◽  
Sara Cardaccio ◽  
Giorgia Polti ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Strain Ratio ◽  
Breast Lesions ◽  
Preliminary Results ◽  
Us Elastography

A qualitative and quantitative assessment of simultaneous strain, shear wave, and point shear wave elastography to distinguish malignant and benign breast lesions

2020 ◽  
pp. 028418512096142
Author(s):  
Yasemin Altıntas ◽  
Mehmet Bayrak ◽  
Ömer Alabaz ◽  
Medih Celiktas
Keyword(s):  
Shear Wave ◽  
Diagnostic Performance ◽  
Area Under The Curve ◽  
Shear Wave Elastography ◽  
Strain Ratio ◽  
Breast Lesions ◽  
Breast Masses ◽  
Malignant Breast ◽  
The Mean ◽  
Us Elastography

Background Ultrasound (US) elastography has become a routine instrument in ultrasonographic diagnosis that measures the consistency and stiffness of tissues. Purpose To distinguish benign and malignant breast masses using a single US system by comparing the diagnostic parameters of three kinds of breast elastography simultaneously added to B-mode ultrasonography. Material and Methods A total of 163 breast lesions in 159 consecutive women who underwent US-guided core needle biopsy were included in this prospective study. Before the biopsy, the lesions were examined with B-mode ultrasonography and strain (SE), shear wave (SWE), and point shear wave (STQ) elastography. The strain ratio was computed and the Tsukuba score determined. The mean elasticity values using SWE and STQ were computed and converted to Young’s modulus E (kPa). Results All SE, SWE, and STQ parameters showed similar diagnostic performance. The SE score, SE ratio, SWEmean, SWEmax, STQmean, and STQmax yielded higher specificity than B-mode US alone to differentiate benign and malignant masses. The sensitivity of B-mode US, SWE, and STQ was slightly higher than that of the SE score and SE ratio. The SE score, SE ratio, SWEmean, SWEmax, STQmean, and STQmax had significantly higher positive predictive value and diagnostic accuracy than B-mode US alone. The area under the curve for each of these elastography methods in differentiating benign and malignant breast lesions was 0.93, 0.93, 0.98, 0.97, 0.98, and 0.96, respectively; P<0.001 for all measurements. Conclusion SE (ratio and score), SWE, and STQ had higher diagnostic performance individually than B-mode US alone in distinguishing between malignant and benign breast masses.

Accuracy of Breast Fine-Needle Aspiration Biopsy Using the International Academy of Cytology Yokohama System in Clinico-Radiologically Indeterminate Lesions: Initial Findings Demonstrating Value in Lesions of Low Suspicion of Malignancy

2021 ◽  
pp. 1-7
Author(s):  
Shruti Agrawal ◽  
Michael Leonard Anthony ◽  
Pranoy Paul ◽  
Divya Singh ◽  
Akansha Agarwal ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Biopsy ◽  
Needle Aspiration ◽  
Aspiration Biopsy ◽  
Breast Lesions ◽  
Fine Needle ◽  
Malignant Lesions ◽  
Needle Aspiration Biopsy ◽  
International Academy

<b><i>Background:</i></b> Fine-needle aspiration biopsy (FNAB) in breast lesions offers accurate results in differentiating benign and malignant lesions. However, its role is unclear when core-needle biopsy (CNB) is available, the latter providing additional information regarding tumor grade, invasion, and hormone receptor status in malignant lesions. In benign breast lesions, especially in BIRADS category 4a and 4b, FNAB, and CNB provide similar pathological information, whereby FNAB may serve as a more rapid and cost-effective investigation. The study was planned to reevaluate the diagnostic accuracy of FNAB in BIRADS category 4a, 4b, and 4c lesions. <b><i>Materials and Methods:</i></b> FNAB and biopsy reports of all patients with breast lesions sent between September 1, 2018, and November 30, 2020, were collected and the International Academy of Cytology (IAC) Yokohama category and BIRADS score were recorded for each case. The rate of malignancy and the accuracy of FNAB in diagnosing malignancy were calculated for each BIRADS 4a, 4b, and 4c subgroup. <b><i>Results:</i></b> A total of 249 cases of BIRADS 4 lesions had corresponding cytology and histopathology diagnoses. FNAB showed high diagnostic accuracy in all BIRADS groups. A benign categorization was associated with a very low number of false-negative diagnoses, especially in BIRADS 4a lesions. <b><i>Conclusion:</i></b> The study reconfirms the excellent accuracy of breast FNAB using the IAC Yokohama system in diagnosing breast malignancies. Furthermore, BIRADS 4a lesions found to be belonging to the cytological benign category may be excluded from CRB and kept on clinical follow-up.

scholarly journals Strain Elastography: A Valuable Additional Method to BI-RADS?

2018 ◽  
Vol 39 (05) ◽  
pp. 526-534 ◽  
Author(s):  
Xin-Bao Zhao ◽  
Ji-Yi Yao ◽  
Xin Zhou ◽  
Shao-Yun Hao ◽  
Wen Mu ◽  
...  
Keyword(s):  
Classification System ◽  
Diagnostic Performance ◽  
Final Analysis ◽  
Daily Practice ◽  
Strain Ratio ◽  
Final Diagnosis ◽  
Ratio Method ◽  
Breast Lesions ◽  
Sensitivity Specificity ◽  
Histological Results

Abstract Background Breast lesions classified as BI-RADS-US 3 are probably benign and observation was recommended, while a considerable number of BI-RADS-US 4 lesions were benign, resulting in excessive biopsies. We focus exclusively on BI-RADS-US 3 and 4 lesions and hypothesize that improved diagnostic performance can be achieved by integrating real-time elastography (strain ratio) into the BI-RADS-US classification system. Method From April 2010 to September 2015, 1071 lesions were included in the final analysis. After the conventional ultrasound examination, the BI-RADS-US (2013) classification was used to evaluate the lesions. Then the strain ratios were calculated, and the final diagnosis was made on the basis of histological results. The sensitivity, specificity, accuracy, PPV and NPV were calculated and the AUCs were compared. Additionally, an analysis of the diagnostic performance expressed by the pretest and posttest probability of disease (POD) was performed in BI-RADS-US 3 and 4A lesions. Results With the cutoff point of 2.98, the sensitivity, specificity and accuracy of the strain ratio method were 86.9 %, 86.6 % and 82.6 %, respectively. In BI-RADS-US 3 lesions, a suspicious strain ratio significantly modified the POD from 1.3 % to a posttest POD of 29.8 %. In BI-RADS-US 4A lesions, a suspicious strain ratio significantly modified the POD from 8.5 % to a posttest POD of 48.7 %. Conclusion Ultrasonographic elastography (strain ratio) yields additional diagnostic information in the evaluation of BI-RADS-US 3 and 4 breast lesions. The strain ratios should be integrated into the BI-RADS-US classification system and into daily practice.

scholarly journals Comparison of the SRmax, SRave, and color map of strain-elastography in differentiating malignant from benign breast lesions

2018 ◽  
Vol 60 (1) ◽  
pp. 28-34
Author(s):  
Jin Hee Moon ◽  
Sung Hye Koh ◽  
Sun-Young Park ◽  
Ji-Young Hwang ◽  
Ji Young Woo
Keyword(s):  
Statistical Significance ◽  
Roc Curves ◽  
Strain Ratio ◽  
Breast Lesions ◽  
Strain Elastography ◽  
Average Value ◽  
Maximum Value ◽  
Significant Difference ◽  
Malignant Breast ◽  
Color Map

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.

Mammographic Fine Needle Biopsy of Non-Palpable Breast Lesions

1984 ◽  
Vol 25 (4) ◽  
pp. 273-276 ◽  
Author(s):  
M. Kehler ◽  
U. Albrechtsson
Keyword(s):  
Diagnostic Accuracy ◽  
Needle Biopsy ◽  
Fine Needle Biopsy ◽  
Breast Lesions ◽  
Malignant Cells ◽  
Fine Needle ◽  
The Past ◽  
Palpable Breast ◽  
Short Time ◽  
Observation Period

Results with a previously described device for fine needle biopsies of non-palpable breast lesions are reported. During the past 5 years 182 biopsies were performed and 133 of these yielded diagnostic cell material. In the series, 41 carcinomas were found and fine needle biopsy in all demonstrated malignant or probably malignant cells. In the biopsies evaluated as benign or probably benign, malignancy has not been found during the observation period of 4 to 59 months (mean 21.5 months). The device described is cheap and biopsy is easily performed and, if necessary, repeated in a short time. The diagnostic accuracy is high and carcinomas as small as 3 mm in diameter have been diagnosed.

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