Real-Time Sonoelastography Performed in Addition to B-Mode Ultrasound and Mammography: Improved Differentiation of Breast Lesions?

Thomas, Anke; Kümmel, Sherko; Fritzsche, Florian; Warm, Mathias; Ebert, Bernd; Hamm, Bernd; Fischer, Thomas

doi:10.1016/j.acra.2006.08.012

Cited by 116 publications

(102 citation statements)

References 31 publications

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“…Recent studies have showed that elastography markedly increased the specificity of ultrasound and the early diagnosis of breast cancer under one centimeter, and it decreased the number of unnecessary biopsies especially in BIRADS 3 and 4 lesions (16,17). It is stated that elastography can be clinically used as an imaging method in patient follow-up or as a method for determining whether to perform an invasive procedure or not.…”

Section: Discussionmentioning

confidence: 99%

The Role of Ultrasographic Elastography in the Differential Diagnosis of Breast Masses and Its Contribution to Classical Ultrasonographic Evaluation

Yaðtu¹,

Turan²,

Turan³

2014

J Breasth Health

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Objective: The aim of this study was to understand the role of ultrasonographic elastography method in the differentiation of breast masses and to assess its contribution to classic ultrasonographic evaluation. Materials and Methods:In this retrospective study, 76 breast masses in 76 patients were firstly evaluated by conventional ultrasonography (U.S.) and scored according to breast imaging report and data systems (BIRADS) and then evaluated with the Elastographic method during the same session between January and December 2013 in our hospital's Radiology Department. Findings were compared with pathological results. In statistical evaluation of the data, independent sample t tests were used for variables between groups. Results:The mean strain ratio of benign masses was 2.48±1.605 and strain score was 2.307±1.327. The mean strain ratio of malignant masses was 5.546±1.434 and strain score was 4.458±0.721. The most frequent benign masses were fibroadenoma and fibrocystic lesions. The most common malignant lesion was invasive ductal carcinoma. When the cut-off value for strain ratio was accepted as 4.009 in receiver operating curve (ROC) analysis for the differential diagnosis of malignant breast masses, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated as 83.8%, 76.9%, 62.3%, and 90.7%, respectively. When the limit value of strain patterns was accepted as scores 4 and 5, the sensitivity, specificity, PPV, and NPV were calculated as 42.7%, 94.2%, 77.2%, and 78%, respectively. When conventional ultrasonography (U.S.) findings were considered together with the elastographic strain ratios the sensitivity, specificity, PPV and NPV were 87.5%, 71.1%, 58.3% and 92.5%, respectively. Conclusion:Elastography is not a method that can replace conventional breast ultrasound for detecting breast cancer, however it may be an adjunct to conventional ultrasound by increasing its diagnostic power.

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Section: Discussionmentioning

confidence: 99%

The Role of Ultrasographic Elastography in the Differential Diagnosis of Breast Masses and Its Contribution to Classical Ultrasonographic Evaluation

Yaðtu¹,

Turan²,

Turan³

2014

J Breasth Health

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“…38,39 Some investigators have reported good interobserver agreement in elastograms used for evaluation of breast lesions. 33,50 However, these studies performed assessments using static images rather than real-time conventional sonography and elastography. In our study, we used real-time elastography to determine the level of interobserver concordance.…”

Section: Discussionmentioning

confidence: 99%

“…In both cases, observer 1 classified the thyroid elastograms as pattern 4, less than observer 2. The quality factor was higher for observer 2 (55) than for observer 1 (50).…”

Section: Agreement Analysismentioning

confidence: 98%

Interobserver Agreement for Thyroid Elastography

Calvete

Rodrı́guez

Berná-Mestre

et al. 2013

Journal of Ultrasound in Medicine

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Objectives The purpose of our study was to investigate interobserver agreement for thyroid ultrasound elastography and to analyze the reproducibility of real‐time freehand elastography in thyroid nodules. Methods A prospective nonrandomized double‐blind study was conducted between September 2008 and June 2010. Real‐time elastography of 89 thyroid nodules was performed by two radiologists, with the first radiologist evaluating each thyroid nodule 5 minutes before the second. The elastograms were obtained with the patients holding their breath and considered valid when the quality factor was 50 or higher. The region of interest was positioned to include the nodule and 0.5 cm of surrounding normal thyroid parenchyma but to exclude the carotids and esophageal‐tracheal structures. The elastograms were classified on a scale of 5 different patterns. Results Observers 1 and 2 coincided in 79 elastographic patterns and disagreed on 10 nodules (11.2%). The results between the radiologists had a statistically significant agreement (P < .005), with a κ value of 0.838. Conclusions The introduction of a quality factor in elastographic software and the selection of elastograms with a quality factor of 50 or higher confer almost perfect interobserver agreement for thyroid nodule elastography and make elastography a reproducible technique that could be used in daily clinical practice.

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“…Knowing that malignant tissues are generally harder than normal surrounding tissue, elastography might provide interesting clinical information to help distinguish benign from malignant tissue based on their specific tissue consistency. Clinical research has shown promising results in differentiating between benign and malignant tissue in the thyroid gland [5] , breast [6][7][8] , prostate [9,10] and to assess liver fibrosis [11][12][13][14] . Recently, elastography has also been introduced during EUS examination [15][16][17][18][19] .…”

Section: Introductionmentioning

confidence: 99%

Endoscopic ultrasound elastography for evaluation of lymph nodes and pancreatic masses: A multicenter study

Giovannini¹,

Botelberge²,

Bories³

et al. 2009

WJG

247

183

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AIM:To evaluate the ability of endoscopic ultrasound (EUS) elastography to distinguish benign from malignant pancreatic masses and lymph nodes. METHODS:A multicenter study was conducted and included 222 patients who underwent EUS examination with assessment of a pancreatic mass (n = 121) or lymph node (n = 101). The classification as benign or malignant, based on the real time elastography pattern, was compared with the classification based on the B-mode EUS images and with the final diagnosis obtained by EUS-guided fine needle aspiration (EUS-FNA) and/or by surgical pathology. An interobserver study was performed. RESULTS:The sensitivity and specificity of EUS elastography to differentiate benign from malignant pancreatic lesions are 92.3% and 80.0%, respectively, compared to 92.3% and 68.9%, respectively, for the conventional B-mode images. The sensitivity and specificity of EUS elastography to differentiate benign from malignant lymph nodes was 91.8% and 82.5%, respectively, compared to 78.6% and 50.0%, respectively, for the B-mode images. The kappa coefficient was 0.785 for the pancreatic masses and 0.657 for the lymph nodes.CONCLUSION: EUS elastography is superior compared to conventional B-mode imaging and appears to be able to distinguish benign from malignant pancreatic masses and lymph nodes with a high sensitivity, specificity and accuracy. It might be reserved as a second line examination to help characterise pancreatic masses after negative EUS-FNA and might increase the yield of EUS-FNA for lymph nodes.

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Real-Time Sonoelastography Performed in Addition to B-Mode Ultrasound and Mammography: Improved Differentiation of Breast Lesions?

Cited by 116 publications

References 31 publications

The Role of Ultrasographic Elastography in the Differential Diagnosis of Breast Masses and Its Contribution to Classical Ultrasonographic Evaluation

The Role of Ultrasographic Elastography in the Differential Diagnosis of Breast Masses and Its Contribution to Classical Ultrasonographic Evaluation

Interobserver Agreement for Thyroid Elastography

Endoscopic ultrasound elastography for evaluation of lymph nodes and pancreatic masses: A multicenter study

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