Contribution of sonoelastography in the differentiation of benign and malignant breast masses: A comparative analysis on sonographic birads classification

In this study, we aimed to investigate the effectivity of ultrasonographic elastography in the differentiation of benign and malignant lesions detected on B-mode ultrasonography. The retrospective study included 133 consecutive patients who underwent B-mode USG followed by elastography between January 2013 and December 2015. The lesions were scored by using B-mode USG with breast imaging-report and data systems (BIRADS) and then sonoelastographic color-coded maps were obtained by elastography in a single session. Sonoelastographic scoring was achieved with a 5-point scoring system. Elasticity scores and strain ratio (SR) values were compared with histopathological findings. The 133 patients included 132 (99.2%) women and 1 (0.8%) man. Mean age was 40.45±14.8 years. The lesions were mostly localized in the left breast (n=70, 52.3% vs. n=63, 47.7%). Depending on the pathological findings, 94 (71.2%) lesions were classified as benign and 39 (28.8%) as malignant. Mean SR value was 4.419±1.43, with 5.5 in malignant lesions and 4.3 in benign lesions. At the cut-off value of 4.95 for SR, the sensitivity and specificity of USG in elastographic examination were 81.6% and 78.7%, respectively. A significant correlation was found between the SR value and the BIRADS score calculated on USG (rho=0.86; two-tailed; p<0.001). Similarly, a significant correlation was found between the SR value and the elasticity score (rho=0.88; two-tailed; p<0.001). In conclusion, the use of sonoelastographic examination following the USG examination with B-mode ultrasonography can be a complementary diagnostic method that increases the specificity of USG. Moreover, it can also reduce unnecessary biopsies in lesions with suspicious malignancy.

Kaynakça

1. Garra BS. Imaging and estimation of tissue elasticity by ultrasound. Ultrasound Q 2007; 23: 255-268.

2. Bamber J, Cosgrove D, Dietrich CF, et al. F. EFSUMB guidelines and recommendations on the clinical use of ultrasound elastography. Part 1: Basic principles and technology. Ultraschall Med 2013; 34: 169-184.

3. Erdoğan S. Meme Kitlelerinin Değerlendirilmesinde Nükleer Tip Yaklaşimi. Cerrahpaşa Tıp Dergisi 2003; 34.

4. Yamamoto A, Fukushima H, Okamura R, et al. K. Dynamic helical CT mammography of breast cancer. Radiat Med 2006; 24: 35-40.

5. Zhao QL, Ruan LT, Zhang H, Yin YM, Duan SX. Diagnosis of solid breast lesions by elastography 5- point score and strain ratio method. Eur J Radiol 2012; 81: 3245-3249.6. Radiology ACo. Breast imaging reporting and data system. BI-RADS 2003.

7. Itoh A, Ueno E, Tohno E, et al. Breast disease: clinical application of US elastography for diagnosis. Radiology 2006; 239: 341-350.

8. Balleyguier C, Canale S, Ben Hassen W, et al. Breast elasticity: principles, technique, results: an update and overview of commercially available software. Eur J Radiol 2013; 82: 427-434.

9. Greenlee RT, Murray T, Bolden S, Wingo PA. Cancer statistics, 2000. CA Cancer J Clin 2000; 50: 7-33.

10. Haydaroğlu A, Dubova S, Özsaran Z, et al. Breast cancer in Ege University "evaluation of 3897 cases". Eur J Breast Health 2005; 1: 6-11.

11. Stachs A, Hartmann S, Stubert J, et al. Differentiating between malignant and benign breast masses: factors limiting sonoelastographic strain ratio. Ultraschall Med 2013; 34: 131-136.

12. Ophir J, Cespedes I, Ponnekanti H, Yazdi Y, Li X. Elastography: a quantitative method for imaging the elasticity of biological tissues. Ultrason Imaging 1991; 13: 111-134.

13. Garra BS, Cespedes EI, Ophir J, et all. Elastography of breast lesions: initial clinical results. Radiology 1997; 202:79-86.

14. Zhi H, Xiao XY, Yang HY, Ou B, Wen YL, Luo BM. Ultrasonic elastography in breast cancer diagnosis: strain ratio vs 5-point scale. Acad Radiol 2010; 17: 1227-1233.

15. Sadigh G, Carlos RC, Neal CH, Dwamena BA. Ultrasonographic differentiation of malignant from benign breast lesions: a meta-analytic comparison of elasticity and BIRADS scoring. Breast Cancer Res Treat 2012; 133: 23-35.

16. Yerli H, Yilmaz T, Ural B, Gulay H. The diagnostic importance of evaluation of solid breast masses by sonoelastography. Ulus Cerrahi Derg 2013; 29: 67- 71.

17. Gazioğlu D, Büyükaşık O, Hasdemir AO, Kargıcı H. BIRADS 3 ve 4 Meme Lezyonlarına Yaklaşım: Hangi Olgulara Biyopsi Yapılmalı? Turgut Özal Tıp Merkezi Dergisi 2009; 16.

18. Cho EY, Ko ES, Han BK, et al. Shear-wave elastography in invasive ductal carcinoma: correlation between quantitative maximum elasticity value and detailed pathological findings. Acta Radiol 2016; 57: 521-528.

19. Ganau S, Andreu FJ, Escribano F, et al.Shear-wave elastography and immunohistochemical profiles in invasive breast cancer: evaluation of maximum and mean elasticity values. Eur J Radiol 2015; 84: 617- 622.

20. Gheonea IA, Stoica Z, Bondari S. Differential diagnosis of breast lesions using ultrasound elastography. Indian J Radiol Imaging 2011; 21: 301-305.

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