scholarly journals Added Value of a New Strain Elastography Technique in Conventional Ultrasound for the Diagnosis of Breast Masses: A Prospective Multicenter Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Qi Wei ◽  
Yu-Jing Yan ◽  
Ge-Ge Wu ◽  
Xi-Rong Ye ◽  
Fan Jiang ◽  
...  
Keyword(s):  
Multicenter Study ◽  
Predictive Value ◽  
Breast Imaging ◽  
Strain Ratio ◽  
Added Value ◽  
Prospective Multicenter Study ◽  
Breast Masses ◽  
Strain Elastography ◽  
Conventional Ultrasound ◽  
Sensitivity Specificity

ObjectiveThis study aimed to explore the value of elasticity score (ES) and strain ratio (SR) combined with conventional ultrasound in distinguishing benign and malignant breast masses and reducing biopsy of BI-RADS (Breast Imaging Reporting and Data System) 4a lesions.MethodsThis prospective, multicenter study included 910 patients from nine different hospitals. The acquisition and analysis of conventional ultrasound and strain elastography (SE) were obtained by radiologists with more than 5 years of experience in breast ultrasound imaging. The diagnostic sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under curve (AUC) of conventional ultrasound alone and combined tests with ES and/or SR were calculated and compared.ResultsThe optimal cutoff value of SR for differentiating benign from malignant masses was 2.27, with a sensitivity of 60.2% and a specificity of 84.8%. When combined with ES and SR, the AUC of the new BI-RADS classification increased from 0.733 to 0.824 (p < 0.001); the specificity increased from 48.1% to 68.5% (p < 0.001) without a decrease in the sensitivity (98.5% vs. 96.4%, p = 0.065); and the PPV increased from 52.2% to 63.7% (p < 0.001) without a loss in the NPV (98.2% vs. 97.1%, p = 0.327). All three combinations of conventional ultrasound, ES, and SR could reduce the biopsy rate of category 4a lesions without reducing the malignant rate of biopsy (from 100% to 68.3%, 34.9%, and 50.4%, respectively, all p < 0.001).ConclusionsSE can be used as a useful and non-invasive additional method to improve the diagnostic performance of conventional ultrasound by increasing AUC and specificity and reducing the unnecessary biopsy of BI-RADS 4a lesions.

scholarly journals Breast fibroadenoma: diagnostic performance of gray-scale sonography and sonoelastography: a prospective observational study

2017 ◽  
Vol 6 (1) ◽  
pp. 268
Author(s):  
Suresh Phatak ◽  
Nipun Gupta
Keyword(s):  
Predictive Value ◽  
Diagnostic Performance ◽  
Strain Ratio ◽  
Breast Masses ◽  
Interpretation Criteria ◽  
Conventional Ultrasound ◽  
A New Technique ◽  
Sensitivity Specificity ◽  
Primary Modality

Background: Elastography is a new technique that can be especially helpful when used as an adjunct to conventional B-mode ultrasound in evaluating breast lesions. The aim of this study was to evaluate the diagnostic performance of interpretation criteria for conventional sonography and sonoelastography in characterising fibroadenoma breast with pathological correlation.Methods: 50 breast fibroadenomas were prospectively evaluated by ultrasound as well as by strain elastography followed by FNAC//Histopathology correlation. The criteria used in breast elastography were Elastography Score and Strain Ratio. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value were calculated for each modality.Results: The elastography score was found to have the best performance among the 2 criteria used with a sensitivity, specificity and accuracy of 95.83%, 50% and 94% respectively.Conclusions: While conventional ultrasound remains the primary modality for the characterization of breast masses, elastography has the potential to improve the sensitivity, specificity and accuracy of conventional ultrasound and, thus avoiding unnecessary biopsy.

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

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.

scholarly journals Real-world validation of the 2017 McDonald criteria for pediatric MS

2018 ◽  
Vol 6 (2) ◽  
pp. e528 ◽  
Author(s):  
Yu Yi M. Wong ◽  
C. Louk de Mol ◽  
Roos M. van der Vuurst de Vries ◽  
E. Daniëlle van Pelt ◽  
Immy A. Ketelslegers ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Multicenter Study ◽  
Predictive Value ◽  
Acute Disseminated Encephalomyelitis ◽  
Prospective Multicenter Study ◽  
Mcdonald Criteria ◽  
Sensitivity Specificity

ObjectiveTo compare the diagnostic accuracy of the McDonald 2017 vs the McDonald 2010 criteria to predict a second attack of MS (clinically definite MS [CDMS]) at the first attack of acquired demyelinating syndromes (ADS).MethodsOne hundred sixty-four children (aged <18 years) with an incident attack of ADS were included in a prospective multicenter study between June 2006 and December 2016. Brain (and spinal if available) MRI was performed ≤3 months after symptom onset. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were compared at baseline between the 2010 and 2017 criteria.ResultsAmong the 164 patients, 110 patients (67%) presented without encephalopathy (ADS–, female 63%; median age 14.8 years, IQR 11.3–16.1years) and 54 (33%) with encephalopathy (acute disseminated encephalomyelitis [ADEM], female 52%; median age 4.0 years, IQR 2.6–6.1 years). Of the 110 ADS– patients, 52 (47%) were diagnosed with CDMS within a median follow-up of 4.5 years (IQR 2.6–6.7 years). The sensitivity was higher for the 2017 criteria than for the 2010 criteria (83%; 95% CI 67–92, vs 49%; 95% CI 33–65; p < 0.001), but the specificity was lower (73%; 95% CI 59–84 vs 87%; 95% CI 74–94, p = 0.02). At baseline, 48 patients fulfilled the 2017 criteria compared with 27 patients when using the 2010 criteria. The results for children aged <12 years without encephalopathy were similar. In patients with ADEM, 8% fulfilled the 2010 criteria and 10% the 2017 criteria at baseline but no patient fulfilled the criteria for CDMS.ConclusionsThe McDonald 2017 criteria are more sensitive than the McDonald 2010 criteria for predicting CDMS at baseline. These criteria can also be applied in children aged <12 years without encephalopathy but not in children with ADEM.Classification of evidenceThis study provides Class II evidence that in children with ADS, the 2017 McDonald criteria are more sensitive but less specific than the 2010 McDonald criteria for predicting CDMS.

scholarly journals Value of Strain Elastography Ultrasound in Differentiation of Benign and Malignant Breast Masses with Histopathological Correlation

2020 ◽  
pp. 17-25
Author(s):  
Mahbuba Azim Moonmoon ◽  
M. N. Rubaia Islam Bony ◽  
Md. Ubaidul Islam ◽  
Parbati Devnath ◽  
Nahid Safrin
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Treatment Plan ◽  
Strain Ratio ◽  
Cross Sectional ◽  
Breast Masses ◽  
Validity Test ◽  
Strain Elastography ◽  
Malignant Breast

Introduction: Breast cancer is currently one of the leading causes of cancer deaths in women. Early detection and accurate classification of suspicious masses as benign or malignant is important for arriving at an appropriate treatment plan. Elastography has shown potential in differentiating benign from malignant breast tumors. Objective: To evaluate the usefulness of Strain Elastography ultrasound in differentiation of benign and malignant breast masses taken histopathology as Gold Standard. Methods: This cross-sectional study was carried out in the Department of Radiology and Imaging, BIRDEM, Dhaka, from July 2017 to June 2019. A total of 92 female patients with breast masses were enrolled in this study. Strain Elastography Ultrasound and histopathology were done in all these patients. Statistical analyses of the results were obtained by using window-based computer software devised with Statistical Packages for Social Sciences (SPSS-22). Results: The validity test of B-mode ultrasonography for differentiation of benign and malignant breast mass has sensitivity 95.0%, specificity 71.2%, accuracy 81.5% and positive predictive value 71.7% and negative predictive value 94.9%. Strain Score has sensitivity 85.0%, specificity 92.3%, accuracy 89.1%, positive predictive value 89.5% and negative predictive value 88.9%. Strain ratio has sensitivity 87.5%, specificity 94.2%, accuracy 91.3%, positive predictive value 92.1% and negative predictive value 90.7%. The validity test of Combined (B-mode sonography and Elastography) has sensitivity 97.5%, specificity 96.2%, accuracy 96.7%, positive predictive value 95.1% and negative predictive value 98.0%. The areas under the curve (AUCs) from the receiver operating characteristic (ROC) curves were 0.948 for ACR-BIRADS classification, 0.986 for Strain Score, 0.956 for Strain Ratio and 0.990 for combination. Conclusion: The combination of strain elastography with B-mode ultrasonography has the potential to improve the differentiation of benign and malignant breast masses.

scholarly journals Results of liver and spleen endoscopic ultrasonographic elastography predict portal hypertension secondary to chronic liver disease

2020 ◽  
Vol 08 (11) ◽  
pp. E1623-E1632
Author(s):  
Carlos Robles-Medranda ◽  
Roberto Oleas ◽  
Miguel Puga-Tejada ◽  
Manuel Valero ◽  
Raquel Del Valle ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Portal Hypertension ◽  
Liver Disease ◽  
Chronic Liver Disease ◽  
Predictive Value ◽  
Strain Ratio ◽  
Chronic Liver ◽  
Spleen Stiffness ◽  
Eus Elastography ◽  
Sensitivity Specificity

Abstract Background and study aims Assessment of endoscopic ultrasonography (EUS)-elastography of the liver and spleen may identify patients with portal hypertension secondary to chronic liver disease. We aimed to evaluate use of EUS-elastography of the liver and spleen in identification of portal hypertension in patients with chronic liver disease. Patients and methods This was a single-center, diagnostic cohort study. Consecutive patients with liver cirrhosis and portal hypertension underwent EUS-elastography of the liver and spleen. Patients without a history of liver disease were enrolled as controls. The primary outcome was diagnostic yield of liver and spleen stiffness measurement via EUS-elastography in prediction of portal hypertension secondary to chronic liver cirrhosis. Cutoff values were defined through Youden’s index. Overall accuracy was calculated for parameters with an area under the receiver operating characteristic (AUROC) curve ≥ 80 %. Results Among the 61 patients included, 32 had cirrhosis of the liver. Liver and spleen stiffness was measured by the strain ratio and strain histogram, with sensitivity/(1 − specificity) AUROC values ≥ 80 %. For identification of patients with cirrhosis and portal hypertension, the liver strain ratio (SR) had a sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 84.3 %, 82.8 %, 84.4 %, and 82.8 %, respectively; the liver strain histogram (SH) had values of 87.5 %, 69.0 %, 75.7 %, and 83.3 %, respectively. EUS elastography of the spleen via the SR reached a sensitivity, specificity, PPV, and NPV of 87.5 %, 69.0 %, 75.7 %, and 83.3 %, respectively, whereas the values of SH were 56.3 %, 89.7 %, 85.7 %, and 65.0 %, respectively. Conclusion Endoscopic ultrasonographic elastography of the liver and spleen is useful for diagnosis of portal hypertension in patients with cirrhosis.

Emergency Physicians Performing Point-of-Care Lung Sonography to Diagnose Pneumonia: A Prospective Multicenter Study

2021 ◽  
pp. 875647932098324
Author(s):  
Mohammad Amin Zare ◽  
Mahtab Mizani ◽  
Azadeh Sameti ◽  
Alireza Bahmani ◽  
Marzieh Fathi
Keyword(s):  
Multicenter Study ◽  
Predictive Value ◽  
Point Of Care ◽  
Signs And Symptoms ◽  
Clinical Syndrome ◽  
Emergency Physicians ◽  
Prospective Multicenter Study ◽  
Lung Sonography ◽  
Ed Visits ◽  
Limited Accuracy

Objective: There has always been some issues in the accurate diagnosis of pneumonia, a common cause of emergency department (ED) visits and revisits, which is typically made based on the patient’s clinical syndrome. This is made more difficult due to the traditional chest radiography having limited accuracy. This prospective multicenter study was conducted to determine the diagnostic accuracy of a point-of-care lung sonography performed by emergency physicians for the diagnosis of pneumonia in an acute care setting. This was compared with chest computed tomography (CT), the diagnostic gold standard. Methods: ED patients who presented with signs and symptoms of pneumonia were eligible to enroll in the study. After enrollment, point-of-care lung sonography was performed on patients by emergency physicians who had passed a focused teaching course on lung sonographic findings of pneumonia. All enrolled patients were followed up. Patients who underwent a chest CT during their hospital admission course were finally included and analyzed. Results: Emergency physicians who performed a point-of-care lung sonography had a sensitivity of 100%, specificity of 75%, positive predictive value of 88.88%, negative predictive value of 100%, and an overall accuracy of 90% in the diagnosis of pneumonia. Conclusion: These emergency physicians could accurately diagnose pneumonia, with a point-of-care lung sonography, after completing a focused sonography course.

scholarly journals Predictive Value of Endobronchial Ultrasound Strain Elastography in Mediastinal Lymph Node Staging: The E-Predict Multicenter Study Results

Respiration ◽  
2020 ◽  
Vol 99 (6) ◽  
pp. 484-492 ◽  
Author(s):  
Roel Lambertus Johannes Verhoeven ◽  
Rocco Trisolini ◽  
Fausto Leoncini ◽  
Piero Candoli ◽  
Michela Bezzi ◽  
...  
Keyword(s):  
Lymph Node ◽  
Multicenter Study ◽  
Predictive Value ◽  
Mediastinal Lymph Node ◽  
Endobronchial Ultrasound ◽  
Lymph Node Staging ◽  
Strain Elastography ◽  
Study Results

scholarly journals A New Computer-Aided Diagnosis System with Modified Genetic Feature Selection for BI-RADS Classification of Breast Masses in Mammograms

2020 ◽  
Vol 2020 ◽  
pp. 1-17 ◽  
Author(s):  
Said Boumaraf ◽  
Xiabi Liu ◽  
Chokri Ferkous ◽  
Xiaohong Ma
Keyword(s):  
Feature Selection ◽  
Predictive Value ◽  
Breast Imaging ◽  
Feature Selection Method ◽  
Computer Aided Diagnosis ◽  
Screening Mammography ◽  
Breast Masses ◽  
Computer Aided ◽  
Aided Diagnosis

Mammography remains the most prevalent imaging tool for early breast cancer screening. The language used to describe abnormalities in mammographic reports is based on the Breast Imaging Reporting and Data System (BI-RADS). Assigning a correct BI-RADS category to each examined mammogram is a strenuous and challenging task for even experts. This paper proposes a new and effective computer-aided diagnosis (CAD) system to classify mammographic masses into four assessment categories in BI-RADS. The mass regions are first enhanced by means of histogram equalization and then semiautomatically segmented based on the region growing technique. A total of 130 handcrafted BI-RADS features are then extracted from the shape, margin, and density of each mass, together with the mass size and the patient’s age, as mentioned in BI-RADS mammography. Then, a modified feature selection method based on the genetic algorithm (GA) is proposed to select the most clinically significant BI-RADS features. Finally, a back-propagation neural network (BPN) is employed for classification, and its accuracy is used as the fitness in GA. A set of 500 mammogram images from the digital database for screening mammography (DDSM) is used for evaluation. Our system achieves classification accuracy, positive predictive value, negative predictive value, and Matthews correlation coefficient of 84.5%, 84.4%, 94.8%, and 79.3%, respectively. To our best knowledge, this is the best current result for BI-RADS classification of breast masses in mammography, which makes the proposed system promising to support radiologists for deciding proper patient management based on the automatically assigned BI-RADS categories.

scholarly journals Comparison of Mammography and Ultrasonography in Evaluation of Breast Masses

2019 ◽  
Vol 13 (2) ◽  
pp. 22-24
Author(s):  
Zebun Nahar ◽  
Md Enamul Kabir ◽  
Taharul Alam ◽  
Shamoli Yasmin ◽  
Maisha Naowar
Keyword(s):  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Breast Tumour ◽  
Military Hospital ◽  
Kappa Statistics ◽  
K Value ◽  
Breast Masses ◽  
Malignant Breast ◽  
Diagnostic Modalities ◽  
Sensitivity Specificity

Introduction: Breast cancer is the most common cancer and second leading cause of cancer deaths in women. Early detection, efficient and accurate diagnosis can reduce the mortality rate. Objectives: To compare the screening accuracy of mammography (MMG) and ultrasonography (USG) in suspected cases of breast masses. Material and Methods: This cross-sectional analytical study was carried out in the Department of Radiology and Imaging, Combined Military Hospital, Dhaka from June 2016 to July 2017. A total of 100 clinically suspected case of breast masses aged from 20 to 75 years referred for MMG and USG was selected. Each patient underwent USG and MMG followed by a histopathological examination of the biopsy material taken from the lump lesion. Two cases histopathological report was not found. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy of USG and MMG were compared with histopathology as the gold standard. In order to determine the agreement of diagnoses between USG and MMG, consistency analysis was performed using Kappa-statistics. Results: Sensitivity, specificity, PPV, NPV and diagnostic accuracy of USG was 58.8%, 98.4%, 77.8%, 85.0% and 83.6% and for MMG 92.0%, 84.5%, 67.6%, 96.8% and 84.7% respectively. Kappa-statistics shows that the two diagnostic modalities had a test agreement in 39.8% cases to differentiate malignant breast tumour from the benign one (k-value = 0.398, p > 0.05). Conclusion: Two diagnostic modalities USG and MMG had a fair agreement in the differentiation of malignant breast tumour from the benign. Journal of Armed Forces Medical College Bangladesh Vol.13(2) 2017: 22-24

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