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Comparison of Strain Elastography Findings of Breast Lesions with Histopathological Results-Breast Elastrography

Ayla Turkar （ Umraniye Training and Research Hospital, Radiology Department, Istanbul, Turkey. ）

Tamer Baysal （ Kartal Dr. Lütfi Kırdar Training and Research Hospital, Radiology Department, Istanbul, Turkey ）

https://doi.org/10.37155/3060-8708-01

Abstract

Objectives

Elastography is an adjunctive method used in the evaluation of breast lesions combined with ultrasonography. The goal of this study is to analyse the efficiency of strain elastography and its concordance with pathological results on patients who have sonographically demarcated breast lesions.

Materials and methods

39 female patients with breast lesion were included in this study. Strain elastography technique was applied and lesions were categorized into 5 groups by Tsukuba scoring system, and each lesion was scored. Strain ratio value was measured for each lesion. The collected data was compared with the histopathological results which were taken as gold standard.

Results

The mean age of the patients was calculated as 46±12. 26 of 39 lesions were determined as benign, 13 lesions as malignant. The mean SR of the benign lesions was calculated as 2,02±1,73 and the mean SR of the malignant lesions is calculated as 5,7±4,2 (p<0,002). The threshold value of strain ratio is calculated as 2,36 according to ROC curve. While 20 of the benign lesions’ SR values were below the threshold value, 6 were above. On the other hand, 11 of the malignant lesions’ SR values were above threshold value whereas 2 were under. All benign lesions had an elasticity score representing benignancy. 11 of the malignant lesions had an elasticity score representing malignancy; however, elasticity scores of 2 lesions indicated benignancy.

Conclusion

Strain elastography technique of benign and malignant breast lesions may reduce the necessity of biopsy and lower the costs.

Keywords

Elastography; Breast lesions; Strain ratio; Elasticity score

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References

References
1. Balleyguier C, Canale S, Ben Hassen W, et al., Breast elasticity: principles, technique, results: an update and overview of commercially available software, European Journal of Radiology, 2013:82(3);427-434.
2. Itoh A, Ueno E, Tohno E, et al., Breast disease: clinical application of US elastography for diagnosis, Radiology, 2006:239(2);341-350.
3. Greenlee R.T, Murray T, Bolden S, et al., Cancer statistics, 2000, CA- A Cancer Journal for Clinicians, 200:50(1);7-33.
4. Berg W.A, Gutierrez L, NessAiver M.S, et al., Diagnostic accuracy of mammography, clinical examination, US, and MR imaging in preoperative assessment of breast cancer. Radiology, 2004:233(3);830-849
5. Hlawatsch A, Teifke A, Schmidt M, et al., Preoperative Assessment of Breast Cancer; Sonography Versus MR Imaging, American Journal of Roentgenology, 2002:179(6);1493-1501.
6. Garra B.S, Elastography: history, principles, and technique comparison, Abdominal Imaging, 2015:40(4);680-697.
7. Chen E.J, Adler R.S, Carson P.L, et al., Ultrasound tissue displacement imaging with application to breast cancer, Ultrasound in Medicine Biology, 1995:21(9);1153-1162.
8. Barr R.G, Sonographic Breast Elastography: a primer, Journal of Ultrasound in Medicine, 2012:31(5);773-783.
9. Chang J.M, Won J.K, Lee K.B, et al., Comparison of shear-wave and strain ultrasound elastography in the differentiation of benign and malignant breast lesions. American Journal of Roentgenology, 2013:201(2);347-356.
10. Mutala T.M, Ndaiga P, Aywak A, Comparison of qualitative and semiquantitative strain elastography in breast lesions for diagnostic accuracy, Cancer Imaging, 2016:16:12
11. Carlsen J.F, Ewertsen C, Lönn L, et al., Strain Elastography Ultrasound: An Overview with Emphasis on Breast Cancer Diagnosis. Diagnostics, 2013:3;117-125
12. Elkharbotly A, Farouk H.M, Ultrasound elastography improves differentiation between benign and malignant breast lumps using B-mode ultrasound and color Doppler, The Egyptian Journal of Radiology and Nuclear Medicine, 2015:46(4);1231-1239.
13. Zhao Q.L, Ruan L.T, Zhang H, et al., Diagnosis of solid breast lesions by elastography 5-point score and strain ratio method. European Journal of Radiology, 2012:81(11);3245-3249.
14. Zhi H, Xiao X.Y, Yang H.Y, et al., Ultrasonic elastography in breast cancer diagnosis: strain ratio vs 5-point scale. Academic Radiology, 2010:17(10);1227-1233.
15. Mousa A.E, Aboelatta M, Zalata K, Combined sonoelastographic scoring and strain ratio in evaluation of breast masses, The Egyptian Journal of Radiology and Nuclear Medicine, 2012:43(4);647-656.
16. Gheonea I.A, Stoica Z, Bondari S. Differential diagnosis of breast lesions using ultrasound elastography. Indian Journal of Radiology and Imaging, 2011:21(4);301–305.
17. Stavros A.T, Breast Ultrasound, Malignant Solid Breast Nodules: Specific types, Philadelphia: Lippincott Williams&Wilkins, 2004:14;597-688.
18. Durur-Karakaya A, Durur-Subaşı I, Akçay M.N, et al., Sonoelastography findings for idiopathic granulomatous mastitis, Japanese Journal of Radiology, 2015:33(1);33-38.
19. Tan P.H, Lai L.M, Carrington E.V, Opaluwa A.S, Ravikumar K.H, Chetty N, Fat Necrosis of the Breast--a review. Breast. 2006:15(3): 313-318.
20. Sickles E.A, Periodic Mammographic Follow-up of Probably Benign Lesions: Results in 3184 Consecutive Cases, Radiology. 1991:179;463-468.
21. Wiratkapun C, Bunyapa Boonsri W, Wibul Polprasert B, et al., Biopsy rate and positive predictive value of breast cancer in BI-RADS category 4 breast lesions. Journal of the Medical Association of Thailand, 2010:93(7);830-837.
22. Moukhtar F.Z, ElMaati A.A.A, Real-time tissue elastography combined with BIRADS-US classification system for improving breast lesion evaluation, The Egyptian Journal of Radiology and Nuclear Medicine, 2014:45(3);1021-1028.
23. Duma M.M, Chiorean A.R, Chiorean M, et al., Breast Diagnosis: Concordance Analysis Between the BI-RADS Classification and Tsukuba Sonoelastography Score, Clujul Medical, 2014:87(4);250-257.

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