Breast elastography: A literature review

Abstract

KEYWORDS Sonoelastography; Breast elastography; Breast lesions.Abstract Breast elastography is a new sonographic imaging technique which provides information on breast lesions in addition to conventional ultrasonography (US) and mammography. Elastography provides a noninvasive evaluation of the stiffness of a lesion. Today, two technical solutions are available for clinical use: strain elastography and shear wave elastography. Initial evaluations of these techniques in clinical trials suggest that they may substantially improve the possibility of differentiating benign from malignant breast lesions thereby limiting recourse to biopsy and considerably reducing the number of benign breast biopsy diagnoses. This article reviews the basics of this technique, how to perform the examination, image interpretation and the results of major clinical studies. Although elastography is easy to perform, training and technical knowledge are required in order to obtain images permitting a correct interpretation. This paper will highlight the technique and point out common pitfalls.Sommario L'elastosonografia mammaria è una nuova tecnica di imaging a ultrasuoni che fornisce informazioni aggiuntive sulle lesioni della mammella rispetto all'ecografia e alla mammografia. Consente una valutazione non invasiva della rigidità tessutale di una lesione. Sono attualmente disponibili due soluzioni tecniche per uso clinico: l'elastografia con strain e l'elastografia shear wave. I primi studi clinici di valutazione di queste tecniche suggeriscono che esse possano migliorare la caratterizzazione delle lesioni mammarie differenziando quelle benigne dalle maligne e riducendo in modo sostanziale il numero di biopsie per lesioni benigne. Questo articolo rivisita le basi tecniche, i criteri interpretativi delle immagini, i principali studi clinici e le possibili cause di errore. Per quanto l'elastosonografia sia di facile esecuzione, richiede tuttavia un training e delle conoscenze tecniche adeguate per ottenere immagini correttamente interpretabili. ª

Breast hamartoma: ultrasound, elastosonographic, and mammographic features. Mini pictorial essay

“…4, 5, 6). The use of elastosonographic software can be helpful for defining the margins of the mass [9]. The success of elastographic assessment of hamartomas depends to some extent on their size: for optimal and reliable data collection, the mass must fit within the evaluation box.…”

Acoustic radiation force impulse (ARFI) elastography of testicular disorders in dogs: preliminary results

“…It aids the detection of small lesions or those inaccessible by palpation and provides details of the testicular tissue that cannot be obtained by radiography (Brandão et al 2006;Davidson and Baker 2009;Goddi et al 2012;Souza and Silva 2014). However, in most cases, ultrasonography is unable to differentiate the various canine testicular disorders and thus it must be used in conjunction with the animal's reproductive history, complimentary laboratory tests and invasive diagnostic techniques such as fine needle aspiration cytology, testicular biopsy and histopathology (Gradil et al 2007).…”

“…Qualitative ARFI creates a static greyscale map (elastogram) that represents the relative stiffness of the tissue in the scanned area and which can be compared to a corresponding conventional ultrasound scan. In general, lighter areas represent more pliable tissue than darker areas (D'Anastasi et al 2011;Goddi et al 2012). Quantitative ARFI creates propagating pressure waves that are capable of deforming the tissue quantitatively (pressure wave velocity of propagation or shear velocity).…”

Strain Elastography of Breast and Prostata Cancer: Similarities and Differences

“…This is certainly a reason for the occasionally low positive predictive value of only up to 39 %, as we reported in a study of men with PSA serum values < 4 ng/ML [24]. For most mammary lesions, benign tumors are harder than normal glandular tissues, but softer than malignant lesions [25]. False-positive changes can be observed in hyaline fibroadenomas and fatty tissue necrosis, since these can involve tissue hardening [5, 26,27].…”

“…Verification of reduced elasticity of these lesions can result in a biopsy instead of only monitoring [25,26] ( • " Fig. 10).…”