The value of color-map virtual touch tissue imaging (CMV) in the differential diagnosis of benign and malignant breast lesions

BACKGROUND: Researchers have evaluated the VTI value in the diagnosis of breast lesions, mostly based on gray-scale. PURPOSE: This study aimed to evaluate the value of color-map virtual touch tissue imaging (CMV) in the diagnosis of breast lesions. METHODS: We retrospectively analyzed the virtual touch tissue imaging (VTI) images of 55 breast lesions in 49 female patients who underwent an examination of breast lesions in our hospital from January 2019 to December 2019. The pathological results were taken as the gold standard. The receiver operating characteristic (ROC) curve of CMV was analyzed, and its diagnostic performance was evaluated. Weighted Kappa (k) statistics were used to assess the inter-observer agreement for CMV. RESULTS: A total of 55 breast lesions were included, including 19 malignant lesions and 36 benign lesions. Multivariate analysis showed that patients with higher CMV scores (P = 0.014, odds ratio [OR] = 13.667, 95% CI = 1.702–109.773) were independent predictors of breast cancer. The sensitivity, specificity, and the area under curve (AUC) of CMV were 94.47%, 72.22%, and 0.912. The CMV’s inter-observer agreement was almost perfect among radiologists with different work experience (k = 0.854, standard error = 0.049, 95% confidence interval = 0.758–0.950). CONCLUSIOS: CMV has high accuracy and repeatability in the diagnosis of malignant breast lesions.

The value of virtual touch tissue imaging quantification in the differential diagnosis between benign and malignant breast lesions

Journal of Medical Ultrasonics ◽

10.1007/s10396-019-00948-0 ◽

2019 ◽

Vol 46 (4) ◽

pp. 459-466 ◽

Author(s):

Wen-tao Kong ◽

Wei-jun Zhou ◽

Yin Wang ◽

Xiao-min Zhuang ◽

Min Wu

Keyword(s):

Differential Diagnosis ◽

Tissue Imaging ◽

Breast Lesions ◽

Malignant Breast ◽

Combining Virtual Touch Tissue Imaging and BI-RADS May Improve Solid Breast Lesion Evaluation

Breast Care ◽

10.1159/000456026 ◽

2017 ◽

Vol 12 (2) ◽

pp. 97-100 ◽

Author(s):

Size Wu ◽

Xiaojing Cui ◽

Li Huang ◽

Xuefei Bai

Keyword(s):

Predictive Value ◽

Area Under The Curve ◽

Ultrasound Elastography ◽

Tissue Imaging ◽

Imaging Method ◽

Breast Lesions ◽

Combined Use ◽

Sensitivity Specificity ◽

Solid Lesions ◽

Background: Ultrasound elastography (UE) is a novel imaging method. The purpose of this study was to determine the utility of Virtual Touch tissue imaging in the evaluation of solid breast lesions. Patients and Methods: 209 breast solid lesions in 192 patients that had been evaluated using ultrasound (US) and UE were reviewed and analyzed. Results: The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value for UE, US, and US plus UE in the differentiation of malignant from benign breast lesions were 80.8, 75.6, 77.9, 73.1, and 82.8% for UE, 87.2, 86.1, 86.6, 83.7, and 89.2% for US, and 92.5, 86.9, 89.5, 85.3, and 93.4% for US plus UE. There were significant differences between UE and US plus UE (all p < 0.05). Except for accuracy, there were no significant differences between UE and US or US and US plus UE (all p > 0.05). The area under the curve obtained from the ROC curve for UE, US, and US plus UE in differentiating malignant from benign lesions was 0.845, 0.884, and 0.922, respectively. Conclusion: The UE scoring system is not superior to BI-RADS in the sonographic evaluation of solid breast lesions. Combined use may improve the performance.

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

Acta Radiologica ◽

10.1177/0284185118773510 ◽

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.

Brightness Mode and Color Doppler Ultrasound in Differential Diagnosis of Breast Lesions in Saudi Females

Journal of Clinical Imaging Science ◽

10.25259/jcis_51_2019 ◽

2019 ◽

Vol 9 ◽

pp. 36

Author(s):

Hashim A. Hashim ◽

Mustafa Z. Mahmoud ◽

Batil Alonazi ◽

Hassan Aldosary ◽

Jameelah S. Alrashdi ◽

...

Keyword(s):

Differential Diagnosis ◽

Data Collection ◽

Doppler Ultrasound ◽

Color Doppler ◽

Color Doppler Ultrasound ◽

Breast Lesions ◽

Doppler Us ◽

Malignant Breast ◽

Color Doppler Us ◽

Sensitivity Specificity

Objective: The aim of the study was to identify the pathological characteristics of benign and malignant breast lesions among Saudi females using brightness mode (B-mode) and color Doppler ultrasound (US). Materials and Methods: This study was retrospectively carried out in a single center in the Radiology and Medical Imaging Department, King Fahad Medical City, Riyadh, Saudi Arabia. A convenient method of sampling was used to include all patients referred for different diagnosis during the period of January 2016 and December 2018. A sample size of 100 cases was selected with 50% of the cases being benign breast lesions, while the rest were malignant. The data collection instruments comprised data collection sheets, while a Philips US system with a 9 MHz linear probe was used to give the differential results. The results were considered significant when P < 0.05. The statistical diagnostic test was used to detect sensitivity, specificity, and accuracy of US in the differential diagnosis of breast lesions in Saudi females. Results: B-mode and color Doppler US findings of breast mass measurements, shape, echotexture, and the presence and absence of vascularity present a sensitivity, specificity, and accuracy of 97.09%, 80.65%, and 93.28% in the diagnosis of benign and malignant breast masses. Conclusion: In Saudi females with dense breasts, the risk of breast cancer development is increased. Moreover, B-mode in combination with color Doppler US was highly determined the results of differential diagnosis for any breast lesions.

The diagnostic performance of shear wave velocity ratio for the differential diagnosis of benign and malignant breast lesions: Compared with VTQ, and mammography

Clinical Hemorheology and Microcirculation ◽

10.3233/ch-200813 ◽

2020 ◽

pp. 1-9

Author(s):

Li-Chang Zhong ◽

Tian Yang ◽

Li-Ping Gu ◽

Fang Ma

Keyword(s):

Differential Diagnosis ◽

Shear Wave ◽

Wave Velocity ◽

Shear Wave Velocity ◽

Diagnostic Performance ◽

Breast Lesions ◽

Color Flow ◽

Malignant Breast ◽

Sensitivity Specificity ◽

Surrounding Parenchyma

PURPOSE: To evaluate the diagnostic value of shear wave velocity (SWV) ratio for the differential diagnosis of benign and malignant breast lesions. MATERIAL AND METHODS: Our retrospective study included 151 breast lesions that were diagnosed by biopsy and surgical pathology. All of the breast lesions were detected by conventional ultrasound and Virtual Touch tissue quantification (VTQ) and mammography. The sonographic characteristics of the breast lesion, such as the internal echo, shape, margin, color flow, and calcification so on, were also observed. The SWV in lesions and surrounding parenchyma were measured and the SWV ratio between the lesion and surrounding parenchyma was calculated. Pathological results were used as a diagnosis standard to compare the value of SWV ratio, VTQ, and mammography in the diagnosis of benign and malignant breast lesions. RESULTS: The 151 breast lesions included 96 benign lesions and 55 malignant lesions. The cutoff value of VTQ in the diagnosis of benign and malignant breast lesions was 5.01 m/s, of SWV ratio was 2.43, and mammography was BI-RADS 4B. The sensitivity, specificity, accuracy and the area under the ROC curve (AUC) of the SWV ratio were 78.2%, 86.5%, 83.4%, and 0.83 respectively. While of SWV ratio with mammography was 86.4%, 89.4%, 88.3% and 0.87, respectively. The sensitivity, specificity, accuracy, and AUC of SWV ratio and SWV ratio with mammography were statistically higher than those of mammography, no statistically higher than VTQ and VTQ with mammography. CONCLUSION: The SWV ratio can improve the sensitivity without sacrificing diagnostic specificity in the process of breast cancer diagnostic, provide a better diagnostic performance, and avoid unnecessary biopsy or surgery.

Combination of conventional ultrasonography and virtual touch tissue imaging quantification for differential diagnosis of breast lesions smaller than 10 mm

Clinical Hemorheology and Microcirculation ◽

10.3233/ch-170249 ◽

2017 ◽

Vol 67 (1) ◽

pp. 59-68 ◽

Cited By ~ 4

Author(s):

Shu-Pin Zhang ◽

Zeng Zeng ◽

Hui Liu ◽

Ming-Hua Yao ◽

Guang Xu ◽

...

Keyword(s):

Differential Diagnosis ◽

Tissue Imaging ◽

Breast Lesions ◽

Qualitative and quantitative strain and shear wave elastography paradigm in differentiation of breast lesions

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-022-00697-0 ◽

2022 ◽

Vol 53 (1) ◽

Author(s):

Roaa M. A. Shehata ◽

Mostafa A. M. El-Sharkawy ◽

Omar M. Mahmoud ◽

Hosam M. Kamel

Keyword(s):

Shear Wave ◽

Diagnostic Performance ◽

Strain Ratio ◽

Breast Lesions ◽

Breast Masses ◽

Significant Difference ◽

Malignant Breast ◽

Malignant Lesions ◽

The Mean ◽

Sensitivity Specificity

Abstract Background Breast cancer is the most common life-threatening cancer in women worldwide. A high number of women are going through biopsy procedures for characterization of breast masses every day and yet 75% of the pathological results prove these masses to be benign. Ultrasound (US) elastography is a non-invasive technique that measures tissue stiffness. It is convenient for differentiating benign from malignant breast tumors. Our study aims to evaluate the role of qualitative ultrasound elastography scoring (ES), quantitative mass strain ratio (SR), and shear wave elasticity ratio (SWER) in differentiation between benign and malignant breast lesions. Results Among 51 female patients with 77 histopathologically proved breast lesions, 57 breast masses were malignant and 20 were benign. All patients were examined by B-mode ultrasound then strain and shear wave elastographic examinations using ultrasound machine (Logiq E9, GE Medical Systems) with 8.5–12 MHz high-frequency probes. Our study showed that ES best cut-off point > 3 with sensitivity, specificity, PPV, NPP, accuracy was 94.7%, 85%, 94.7%, 85%, 90.9%, respectively, and AUC = 0.926 at P < 0.001, mass SR the best cut-off point > 4.6 with sensitivity, specificity, PPV, NPP, accuracy was 96.5%, 80%, 93.2%, 88.9%, 92.2%, respectively, and AUC = 0.860 at P < 0.001, SWER the best cut-off value > 4.9 with sensitivity, specificity, PPV, NPP and accuracy was 91.2%, 80%, 92.9%, 76.2%, 93.5%, respectively, and AUC = 0.890 at P < 0.001. The mean mass strain ratio for malignant lesions is 10.1 ± 3.7 SD and for solid benign lesions 4.7 ± 4.3 SD (p value 0.001). The mean shear wave elasticity ratio for malignant lesions is 10.6 ± 5.4 SD and for benign (solid and cystic) lesions 3.6 ± 4.2 SD. Using ROC curve and Youden index, the difference in diagnostic performance between ES, SR and SWER was not significant in differentiation between benign and malignant breast lesions and also was non-significant difference when comparing them with conventional US alone. Conclusion ES, SR, and SWER have a high diagnostic performance in differentiating malignant from benign breast lesions with no statistically significant difference between them.

Virtual touch tissue imaging and quantification (VTIQ) in the evaluation of breast lesions: The associated factors leading to misdiagnosis

European Journal of Radiology ◽

10.1016/j.ejrad.2018.11.021 ◽

2019 ◽

Vol 110 ◽

pp. 97-104 ◽

Author(s):

Jia-Wei Sun ◽

Xiao-Lei Wang ◽

Qing Zhao ◽

Hang Zhou ◽

Lin Tao ◽

...

Keyword(s):

Associated Factors ◽

Tissue Imaging ◽

Breast Lesions ◽

US-Elastography for Breast Lesion Characterization: Prospective Comparison of US BIRADS, Strain Elastography and Shear wave Elastography

Ultraschall in der Medizin - European Journal of Ultrasound ◽

10.1055/a-1134-4937 ◽

2020 ◽

Author(s):

Vito Cantisani ◽

Emanuele David ◽

Richard G. Barr ◽

Maija Radzina ◽

Valeria de Soccio ◽

...

Keyword(s):

Shear Wave ◽

Diagnostic Performance ◽

Color Doppler ◽

Shear Wave Elastography ◽

Strain Ratio ◽

Breast Lesions ◽

Strain Elastography ◽

Prospective Comparison ◽

Malignant Breast ◽

Sensitivity Specificity

Abstract Purpose To evaluate the diagnostic performance of strain elastography (SE) and 2 D shear wave elastography (SWE) and SE/SWE combination in comparison with conventional multiparametric ultrasound (US) with respect to improving BI-RADS classification results and differentiating benign and malignant breast lesions using a qualitative and quantitative assessment. Materials and Methods In this prospective study, 130 histologically proven breast masses were evaluated with baseline US, color Doppler ultrasound (CDUS), SE and SWE (Toshiba Aplio 500 with a 7–15 MHz wide-band linear transducer). Each lesion was classified according to the BIRADS lexicon by evaluating the size, the B-mode and color Doppler features, the SE qualitative (point color scale) and SE semi-quantitative (strain ratio) methods, and quantitative SWE. Histological results were compared with BIRADS, strain ratio (SR) and shear wave elastography (SWE) all performed by one investigator blinded to the clinical examination and mammographic results at the time of the US examination. The area under the ROC curve (AUC) was calculated to evaluate the diagnostic performance of B-mode US, SE, SWE, and their combination. Results Histological examination revealed 47 benign and 83 malignant breast lesions. The accuracy of SR was statistically significantly higher than SWE (sensitivity, specificity and AUC were 89.2 %, 76.6 % and 0.83 for SR and 72.3 %, 66.0 % and 0.69 for SWE, respectively, p = 0.003) but not higher than B-mode US (B-mode US sensitivity, specificity and AUC were 85.5 %, 78.8 %, 0.821, respectively, p = 1.000). Conclusion Our experience suggests that conventional US in combination with both SE and SWE is a valid tool that can be useful in the clinical setting, can improve BIRADS category assessment and may help in the differentiation of benign from malignant breast lesions, with SE having higher accuracy than SWE.