Diagnostic Accuracy of Ultrasonographic Strain Elastography in Differentiating 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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Comparison of qualitative and semiquantitative strain elastography in breast lesions for diagnostic accuracy

Cancer Imaging ◽

10.1186/s40644-016-0070-8 ◽

2016 ◽

Vol 16 (1) ◽

Cited By ~ 7

Author(s):

Timothy Musila Mutala ◽

Purity Ndaiga ◽

Angeline Aywak

Keyword(s):

Diagnostic Accuracy ◽

Breast Lesions ◽

Strain Elastography

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ROLE OF ULTRASOUND STRAIN ELASTOGRAPHY FOR THE EVALUATION OF BREAST LESIONS

10.36106/gjra/2105109 ◽

2020 ◽

pp. 4-6

Author(s):

Deoyani S Sarjare ◽

Arti Anand ◽

Soumya Agrawal ◽

Shanas K. P. ◽

Sandhya Yeshwante

Keyword(s):

Predictive Value ◽

Breast Biopsy ◽

Mammographic Screening ◽

P Value ◽

Breast Lesions ◽

Chi Square ◽

Cross Sectional ◽

Strain Elastography ◽

Malignant Breast ◽

Breast Lumps

Introduction: Ultrasound (US) elastography is an emerging technique that can be used during breast US examination. Guidelines recommend mammographic screening and US for diagnosis of breast cancer. The specificity of these techniques is not high enough to prevent unnecessary biopsies. Hence there is need for a more specific technique to overcome this problem. This study aimed to evaluate the value of strain elastography (SE) for breast lesions. Materials and Methods: In this cross sectional observational study over 18 months, 60 women with palpable breast lumps were evaluated with conventional US and SE. Results obtained were correlated with histopathological findings for statistical analysis. Result: A statistically significant correlation was found between SE and histopathological outcome with a p value of 0.03(<0.05). The positive predictive value (PPV) was 76.92% and the negative predictive value (NPV) was 76.47% with Chi square= 8.4. Conclusion: Ultrasound with SE can substantially improve the possibility of differentiating benign from malignant breast lesions thereby limiting recourse to biopsy and considerably reducing the number of benign breast biopsy diagnoses.

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A PILOT STUDY FOR EVALUATION OF ROLE OF B-MODE ULTRASOUND AND STRAIN ELASTOGRAPHY IN DIFFERENTIATING BENIGN AND MALIGNANT BREAST MASSES

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2021.v14i7.42378 ◽

2021 ◽

pp. 153-163

Author(s):

SARYU GUPTA ◽

MANPREET KAUR ◽

AMARJIT KAUR ◽

KULDEEP BHATIA

Keyword(s):

Pilot Study ◽

Diagnostic Accuracy ◽

Ductal Carcinoma ◽

Strain Ratio ◽

Breast Lump ◽

Breast Masses ◽

Strain Elastography ◽

Malignant Breast ◽

Palpable Breast ◽

Sensitivity Specificity

Background: Early detection of malignant lesions is critical key stone for the successful management of breast cancer. Conventional B-mode ultrasound although could not replace the histopathology which is still gold standard, plays an important role in the diagnostic pathways by using the Breast Imaging Reporting and Data System (BIRADS) lexicon (standardized by American College of Radiology [ACR]). Although characterization of solid breast masses by sonography has improved greatly since the early 1990s, specificity remains low and a large number of biopsies result in benign diagnosis. Strain elastography and strain ratio (SR) are recent techniques which may help in increasing the specificity of ultrasound. Methods: The present study was a pilot study aimed to establish a correlation between B-mode ultrasound and strain elastography in differentiating benign and malignant breast masses and to compare the results of B- mode ultrasound and Strain Elastography with fine-needle aspiration cytology/ biopsy findings. It was a prospective study conducted in the Department of Radio-diagnosis of Rajindra Hospital, Patiala. A total of 40 patients who presented with the complaint of palpable breast lump were evaluated with B-Mode Ultrasonography (USG) and Strain elastography (using elastography score [ES] and SR). Results: The study group (40 patients with breast lumps) comprised 38 (95%) female patients and 2 (5%) male patients. Among the group 29 were benign and 11 were malignant. Fibroadenoma followed by fibrocystic disease was the most common benign pathologies and invasive ductal carcinoma followed by Ductal Carcinoma in situ was the most common malignant pathologies. Sensitivity, specificity, and diagnostic accuracy of B-Mode USG in diagnosing palpable breast lump are 72.7%, 86.2%, and 82.5%, respectively, while that of strain elastography in diagnosing palpable breast lump are 81.8%, 93.10%, and 90.0%, respectively. Using strain ratio (SR) only the sensitivity, specificity, and diagnostic accuracy was found to be 93.1%, 100%, and 95% better than B-Mode USG and shear elastography alone separately and combined. The mean SR for a benign mass is 2.00±0.97 and for a malignant mass is 5.40±1.55. Conclusion: Ultrasound elastography (using ES) has a higher sensitivity, specificity and diagnostic accuracy in differentiating benign and malignant breast masses then B mode USG (using BIRADS). Using SR alone has shown better sensitivity, specificity, and diagnostic accuracy but its standalone or in combination diagnostic application has to be followed up with further studies.

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Diagnostic Accuracy of Magnetic Resonance Spectroscopy (MRS) in Diagnosing Malignant Breast Lesions Taking Histopathology as Gold Standard

10.53350/pjmhs211571847 ◽

2021 ◽

Vol 15 (7) ◽

pp. 1847-1849

Author(s):

Adnan Ahmed ◽

Jawad Ali Memon ◽

Muhammad Sibtain Shah ◽

Hafeez ur Rehman ◽

Tahir Baig ◽

...

Keyword(s):

Breast Cancer ◽

Magnetic Resonance ◽

Magnetic Resonance Spectroscopy ◽

Diagnostic Accuracy ◽

Predictive Value ◽

Gold Standard ◽

Resonance Spectroscopy ◽

Breast Lesions ◽

Female Patients ◽

Malignant Breast

Background and Aims: Breast cancer is the prime cause of mortality among women of both developing and developed world. Out of 34.6% of female cancer patients, malignant breast cancer being the most common cancer found in Pakistan. The current study aims to evaluate the diagnostic accuracy of magnetic resonance spectroscopy in diagnosing malignant breast lesions taking histopathology as a gold standard. Materials and Methods: This cross-sectional study was carried out on 135 female patients with suspicious palpable lesions for malignancy referred from surgical OPD of Liaquat University of Medical and Health Sciences, Jamshoro during the period from October 2020 to March 2021. Magnetic resonance spectroscopy (MRS) dynamic enhanced images taken with contrast on 1.5 Tesla MRI machines were assessed based on kinetic and morphology. Malignancy biomarker was assessed with choline peak (Cho) allowed by MRS. The Single-voxel technique was utilized in order to evaluate the diagnostic performance of MRS in breast lesions malignancy. A comparison was made between MRS and biopsy findings. Results: Out of 135 female patients, 118 (87.40%) were malignant lesions patients assessed by MRS while histopathologically proven patients were 104 (77.33%). The calculated mean age of all the malignant patients was 48.3 ± 14.5 years with a range of 40-79 years. The diagnostic parameters of MRS such as specificity, accuracy, sensitivity, negative predictive value (NPV), and positive predictive value (PPV) was 74%, 88.2%, 93%, 77.8%, and 93.1% respectively while taking histopathology as a gold standard. Conclusion: MRS must be utilized as a primary imaging technique for the diagnosis of breast lesions malignancy due to its higher specificity, sensitivity, and accuracy in breast lumps characterization. MRS was found to be specific 74%, sensitive 88.2%, and accurate 93% in malignant breast cancer diagnosis. Keywords: MRS, Malignant breast lesions, Histopathology

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Advantages of b-mode ultrasound combined with strain elastography in differentiation of idiopathic granulomatous mastitis from malignant breast lesions

TURKISH JOURNAL OF MEDICAL SCIENCES ◽

10.3906/sag-1708-34 ◽

2018 ◽

Vol 48 ◽

pp. 16-23 ◽

Cited By ~ 2

Author(s):

Serdar ARSLAN ◽

Fatih ÖNCÜ ◽

Mehmet Ali ERYILMAZ ◽

Mehmet Sedat DURMAZ ◽

Ayşegül ALTUNKESER ◽

...

Keyword(s):

Breast Lesions ◽

Granulomatous Mastitis ◽

Idiopathic Granulomatous Mastitis ◽

Strain Elastography ◽

Malignant Breast

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Added value of strain elastography in the characterisation of breast lesions: A prospective study

Ultrasound ◽

10.1177/1742271x20912762 ◽

2020 ◽

Vol 28 (3) ◽

pp. 164-173

Author(s):

Dimpi Sinha ◽

Sukrity Sharma ◽

Nischal G Kundaragi ◽

Sudhir Kumar Kale

Keyword(s):

Negative Predictive Value ◽

Predictive Value ◽

Histopathological Examination ◽

Area Under The Curve ◽

Added Value ◽

Breast Lesions ◽

Strain Elastography ◽

Combined Use ◽

Significant Difference ◽

Malignant Breast

Background Elastography is a new promising ultrasonographic technique which is used to differentiate benign and malignant breast lesions based on the stiffness of the lesion. Purpose To determine the role of strain elastography in characterisation of breast lesions and to compare the diagnostic performances of strain elastography and conventional ultrasound (US). Methods In total, 113 breast lesions in 100 women were prospectively evaluated by US and strain elastography followed by the histopathological examination. Elastography score based on the Tsukuba colour scale and strain ratio were determined for each lesion. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value were calculated for each modality and the diagnostic performances were compared. The best cut-off point was calculated for each of the elastography parameters using the receiver operator curve analysis. Results Out of the 113 lesions, 40 were malignant (35.4%) and 73 were benign (64.6%). The area under the curve for elastography score showed significant difference with that of US: 0.98 versus 0.90 (Difference = 0.08, p =0.02). The elastography parameters were more specific as compared to US (ES-95 and SR-93% vs. 63%, p < 0.05) with a high negative predictive value. The combined use of elastography and US gave better results with 95% sensitivity, 94% specificity, 94% accuracy and negative predictive value reaching 97%. Conclusion Strain elastography is a useful adjunct to conventional ultrasonography. The combined use of strain elastography and ultrasound improves the characterisation of breast lesions and helps in down-staging of assigned BI-RADS category, thereby avoiding unnecessary biopsies. ES is the most useful elastography parameter to differentiate between benign and malignant breast lesions.

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