Objective: To describe the sonographic characteristics of the focal breasst lesions using Acoustic Radiation Force Impulse Imaging (ARFI), and to evaluate the role of ARFI technique in combination with 2D Ultrasound in diagnosing focal breast lesions.
Methods: 2D Ultrasound and ARFI Elastography were caried out in 52 patients who have focal lesions of breast. Images of 2D Ultrasound were classified according to ACR 2013. ARFI Elastography was performed by 2 techniques: “Virtual Touch HD tissue imaging” in order to image of strain distribution and “Virtual Touch HD Tissue quantification imaging” to measure the shear wave velocity (SWV) in the tissue. Strain distribution was classified according to Ako Itoh scale. SWV were measured in 4 positions: internal the lesion (SWVi), boundary zone (SWVb), glandular tissue and fatty tissue next to lesion (SWg and SWf). According to the results of pathology, we determine and compare the value between 2D Ultrasound plus ARFI elastography and 2D Ultrasound alone.
Results: 52 patients with breast focal lesions: 22 malignant tumors and 30 benign tumors. Mean Ako Itoh scale of benign tumors were 2.19 ± 1.13 and malignant tumors were 4.72 ± 0.55; the cut-off value was between E3 và E4. SWVi, SWVb, SWVf, SWVg of benign tumors were lower than malignant tumors with cut-off values were 3.32 m/s; 6.01m/s; 1.08m/s; 2.37m/s, respectively. 2D Ultrasound plus ARFI Elastography: Se 100%, Sp 90%, PPV 88%, NPV 100%, Acc 94.2% (p<0.001, K = 0.884).
Conclutions: In addition to the morphologic characteristics of breast lesions, ARFI provides information about lesion’s tissue elasticity, which can be a useful tool to differentitate malignant lesions from benign ones.
Key words: elastography, focal breast lesions, Acoustic Radiation Force Impulse Imaging
