Contribution of Sonoelastographic Scoring to B-Mode Sonography in the Evaluation of Breast Masses

Abstract

Objectives: The study aims were to evaluate the contribution of sonoelastography to Breast Imaging Reporting, and Data System (BI-RADS) scoring of breast images. Materials and Methods: Two observers evaluated the BI-RADS category, Tsukuba score, and the strain index of 83 lesions of 73 consecutive patients. A new scoring system was established to evaluate the lesions by using the BI-RADS score, Tsukuba score, and strain index ratio. Results: There was a statistically significant difference between the strain index value of benign (3.08 ± 2.71) and malignant group (4.62 ± 2.70) ( P < .05). The sensitivity and specificity were 59.1% and 65.1% for the 3.12 cut-off value for the strain index. In the receiver operating characteristic (ROC) analysis, the area under the curve (AUC) of the only BI-RADS score was 0.834, both BT (BI-RADS + revised Tsukuba score) score and the total score (BI-RADS + revised Tsukuba score + strain index score) was 0.843. The interclass correlation coefficient for the two observers’ measurements of the strain index was weak, with .266 ( P < .05). Conclusion: The potential contribution of sonoelastography on lesion characterization is still controversial. In this study, the agreement among the observers was inadequate, and the contribution of sonoelastography on BI-RADS classification was limited. In addition, in the daily practice of sonoelastograpic evaluation, the Tsukuba score, was easier to apply and should be used rather than strain index measurements.

Comparisons among the Ultrasonography Prediction Model, Real-Time and Shear Wave Elastography in the Evaluation of Major Salivary Gland Tumors

“…There were different scoring systems (2 to 5 points) among the studies. The 5-point Tsukuba elasticity scores are widely used in the evaluation of breast lesions [ 24 , 25 , 26 ]. A score of 1 represents almost soft (almost green within the lesion), a score of 2 represents mostly soft (green more than blue), a score of 3 represents mostly stiff (blue more than green), a score of 4 represents almost stiff (almost blue), and a score of 5 represents stiffness out of the lesion (blue extends out of the lesion).…”