Characterization of Breast Lesions Using a Novel Combined Approach of Ultrasonography and Elastography Prior to Invasive Procedures: Are New Age Modalities Set to Replace the Diagnostic Giant?

Abstract

ObjectiveThe goal of this study was to evaluate the diagnostic yield of B-mode ultrasound and ultrasound elastography used alone and in combination for differentiating breast lesions into benign and malignant. Materials and methodsEighty-five patients were investigated with B-mode ultrasonography and elastography and provided a Breast Imaging Reporting, and Data System (BI-RADS) score based on ultrasonography, strain ratio, and elastography score (ES) based on elastography. Each lesion was then evaluated by a combination method, combining BI-RADS with strain ratio and BI-RADS with elastography score. Each modality was assessed for the successful detection and characterization of the lesion and whether combining ultrasonography B-mode imaging with strain elastography improves diagnosis and is reliable enough to replace invasive procedures such as biopsy that have been the mainstay of diagnosis. ResultsOf 85 lesions, 23 lesions (27%) were found to be malignant, and 62 lesions (72.9%) were benign. When used alone, BI-RADS had 100.0% sensitivity, 13% specificity, 50% and 100% positive and negative predictive values (respectively), and 72.9% accuracy. BI-RADS results were then combined with strain ratio (SR) and ES. BI-RADS with SR had 91.3% sensitivity, 95.2% specificity, 87.5% and 96.7% positive and negative predictive values (respectively), and 94.1% accuracy. Similarly, BI-RADS with ES had 91.3% sensitivity, 93.5% specificity, 84.0% and 96.7% positive and negative predictive values, and 92.9% accuracy. characterize which lesions are better suited for biopsy, leading to a decline in unnecessary invasive procedures.

A Pilot Study for Evaluation of Role of B-Mode Ultrasound and Strain Elastography in Differentiating Benign and Malignant Breast Masses

“…Li et al [33] reported approximately 25% of phyllodes masses reporting an ES score more than 3. Similar false-positive results with phyllodes were reported by Khanduri et al [34] Li et al [33] has documented 5% of fibroadenoma to have an ES more than 3 as compared to 5.8% reported in our study.…”