Acoustic Radiation Force Impulse Imaging in Benign and Malignant Breast Lesions

Abstract

BackgroundElastography is a promising way to assess tissue differences regarding stiffness or elasticity, which has been historically assessed manually by palpation. Combined with conventional imaging modalities, shear wave elastography can potentially evaluate the stiffness of a breast lesion and consequently help detect malignant breast tumor from benign ones. The aim of this study was to evaluate the diagnostic role of shear wave elastography in breast lesions in the Indian population.Material and methodsFifty patients presenting with breast lesions were included in the study. All the patients were subjected to B-mode ultrasound and elastography using shear wave with Virtual Touch Imaging (VTITM) (Siemens Medical Solutions USA, Inc., PA, USA) and Virtual Touch Quantification (VTQTM) (Siemens Medical Solutions USA, Inc., PA, USA) and the obtained data was analyzed using an appropriate statistical test (independent samples t-test).ResultsIn our study group of 50 patients, 34 were benign and 16 were malignant. VTITM showed a sensitivity of 97% and a specificity of 93% with a positive predictive value (PPV) of 97% for benign lesions. VTITM showed a sensitivity of 87.5 % and a specificity of 100% with a PPV of 100% for malignant lesions. VTQTM showed a sensitivity of 71.4% and a specificity of 100% with a PPV of 100% for benign lesions. VTQTM showed a sensitivity of 100% and a specificity of 100% with a PPV of 76.6% for malignant lesions.ConclusionsVTITM was more reliable as a diagnostic tool compared to VTQTM in benign lesions and both are equally reliable in identifying malignant lesions. Acoustic radiation force impulse (ARFI) plays a significant role as an adjuvant diagnostic tool to B-mode imaging for assessing breast lesions.

Diagnostic Accuracy of Shear Wave Elastography in Differentiation Between Benign and Malignant Solid Breast Masses Compared with Strain Elastography

“…In the current study, there was statistically significant difference in the three studied elastography techniques between the benign and malignant masses, with the malignant masses had higher SWV, ARFI mean elastography score and free hand mean elastography score than benign masses. Our results are similar to several previous studies [4,20,21,26]. In the current study, the mean SWV in the benign masses was 2.4+1.3m/sec (figure 6) which is significantly lower than the mean SWV in the malignant masses 7.3 + 2.2m/sec, P value < 0.001.…”

Breast cancer, screening and diagnostic tools: All you need to know

“…This technique uses a short-duration, focused, high intensity ultrasound to provide information about the mechanical properties of tissue by generating radiation force (the interaction of an acoustic wave with an object) and using ultrasonic correlation-based methods [121,198]. This new ultrasoundbased elastography is a promising tool which provides quantitative and semiquantitative measurements of the strain of hardness of a tissue lesion [199]. Several studies have shown that malignant tumors are usually stiffer than benign masses and the transmission of shear waves differ in both cases [121,199].…”

“…This new ultrasoundbased elastography is a promising tool which provides quantitative and semiquantitative measurements of the strain of hardness of a tissue lesion [199]. Several studies have shown that malignant tumors are usually stiffer than benign masses and the transmission of shear waves differ in both cases [121,199]. Jayaraman et al, revealed that velocity of shear waves of 34 benign lesions (2.08 m/s) were lower than that of 16 cancer specimens (6.28 m/s) [199].…”

“…Several studies have shown that malignant tumors are usually stiffer than benign masses and the transmission of shear waves differ in both cases [121,199]. Jayaraman et al, revealed that velocity of shear waves of 34 benign lesions (2.08 m/s) were lower than that of 16 cancer specimens (6.28 m/s) [199]. A retrospective study evaluated the diagnostic performance of ARFI with virtual touch tissue imaging and quantification in 83 patients with benign and malignant breast lesions.…”

“…Results showed a sensitivity and a specificity of 82.4% and 80.4% respectively [200]. ARFI may be used as an adjuvant diagnostic tool to conventional imaging to differentiate malignant breast tumors from benign ones without extra radiation or invasive methods [199,201,202].…”