Real-Time Ultrasound Elastography: Its Potential Role in Assessment of Breast Lesions

Zhu, Qingli; Jiang, Yuxin; Liu, Ji‐Bin; Li, He; Sun, Qiang; Dai, Qi; Chen, Xiao

doi:10.1016/j.ultrasmedbio.2008.01.004

Cited by 100 publications

(60 citation statements)

References 14 publications

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“…In this 5 score classification system color spectrum changes are taken in a dynamic form, and it is suggested to have a higher specificity in differential diagnosis. This scoring system has been used in several studies and the effectiveness of elastography as an adjunct to B mode ultrasonography was investigated (6)(7)(8)(9)(10)(11)(12)(13)(14)(15). Modified versions of Ueno's classification by Scaperrotta et al (16) and Regini et al (17) also confirmed higher specificity for US elastography.…”

Section: Discussionmentioning

confidence: 98%

Value of Strain Elastography Ultrasound in Differentiation of Breast Masses and Histopathologic Correlation

Atabey¹,

Arıbal

Ergelen

et al. 2014

J Breasth Health

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Objective: US elastography is an emerging technique that can be used during breast US examination. The increasing awareness of breast cancer led to an increase in mammography and breast US examinations. The specificity of these techniques is not high enough to prevent unnecessary biopsies. There is still a need for a more specific technique that can overcome this problem. This study aimed to evaluate the value of strain elastography in breast lesions. Materials and Methods:In this study, 110 lesions of 96 patients were evaluated with strain elastography. Five score system was used for lesion scoring. The histopathologic results of lesions were obtained and were accepted as gold standard. The sensitivity, specificity, PPV and NPV of the technique were calculated. Histopathologic and strain elastography results were correlated. Results:The sensitivity of US strain elastography was calculated as 83%, the specificity as 89%, the positive predictive value as 79% and the negative predictive value as 91%.There were no score 1 lesions. All score 2 lesions were benign. Score 5 had the highest true positivity rate. Conclusion:We believe that ultrasound elastography is an effective imaging technique that can be used as an adjunct for differential diagnosis, prior to the decision to biopsy a lesion in certain cases.Key words: Elastography, breast elastography, breast lesions, sonoelastography IntroductionBreast screening and diagnostic breast imaging provides early diagnosis of breast cancer. Although breast imaging modalities have high sensitivity rates, there is still need for a higher specificity in imaging to rule out malignancy in incidentally found breast lesions. Especially ultrasonography (US) examination can detect more malign masses with lower specificity, which leads to a high number of unnecessary biopsies (1, 2). US elastography, which shows the stiffness of the lesion, is being widely used in recent years. It determines the change of the size of the lesion in neutral position and under pressure. Generally, breast cancers are hard due to fibrous desmo-plastic reaction and are expected to remain stable during pressure application. There are 2 different types of techniques widely used for determination of the rigidity of the lesion with US; strain elastography and shear wave elastography techniques. In strain elastography, the observer or the patient produces the pressure either with the probe or by breathing whereas in the shear wave technique that pressure is formed by the US probe by a special sound wave, which is called shear wave (3). In this study, we aimed to evaluate the value of strain elastography technique in breast lesions by correlation of elastographic features with histopathological results. Materials and Methods PatientsIn this study, 110 lesions of 96 patients, who were admitted for biopsy of a breast lesion, were evaluated prospectively between December 2009 and September 2010. The mean age of patients was 50 (range 19-87) years. An ethical committee approval was obtained from Medical Re...

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Section: Discussionmentioning

confidence: 98%

Value of Strain Elastography Ultrasound in Differentiation of Breast Masses and Histopathologic Correlation

Atabey¹,

Arıbal

Ergelen

et al. 2014

J Breasth Health

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“…The velocity information produces a color image of the stiffness and measures SWE features such as the minimum elasticity (Emin), mean elasticity (Emean), and maximum elasticity (Emax) and ratio of lesion-to-fat (SWE ratio) elasticity in a region of interest (1,2,(9)(10)(11)(12)(13). Using quantitative elasticity data, SWE thus provides more objective information than static elastography and enhanced lesion differentiation than conventional grayscale US (14)(15)(16)(17). Based on these characteristics, quantitative US elastography using SWE is expected to have higher reproducibility.…”

Section: Intra-and Interobserver Reproducibility Of Shear Wave Elastomentioning

confidence: 99%

Intra- and Interobserver Reproducibility of Shear Wave Elastography for Evaluation of the Breast Lesions

Hong

Kim

2017

J Korean Soc Radiol

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Purpose: To evaluate reproducibility of shear wave elastography (SWE) for breast lesions within and between observers and compare the reproducibility of SWE features. Materials and Methods: For intraobserver reproducibility, 225 masses with 208 patients were included; and two consecutive SWE images were acquired by each observer. For interobserver reproducibility, SWE images of the same mass were obtained by another observer before surgery in 40 patients. Intraclass correlation coefficients (ICC) were used to determine intra-and interobserver reproducibility. Results: Intraobserver reliability for mean elasticity (Emean) and maximum elasticity (Emax) were excellent (ICC = 0.803, 0.799). ICC for SWE ratio and minimum elasticity (Emin) were fair to good (ICC = 0.703, 0.539). Emean showed excellent ICC regardless of histopathologic type and tumor size. Emax, SWE ratio and Emin represented excellent or fair to good reproducibility based on histopathologic type and tumor size. In interobserver study, ICC for Emean, Emax and SWE ratio were excellent. Emean, Emax and SWE ratio represented excellent ICC irrespective of histopathologic type. ICC for Emean was excellent regardless of tumor size. SWE ratio and Emax showed fair to good interobserver reproducibility based on tumor size. Emin represented poor interobserver reliability. Conclusion: Emean in SWE was highly reproducible within and between observers. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Index terms

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“…In most cases, compression to the area of interest is manually applied, with some scanners relying on internal patient movement such as respiratory or cardiac motion. [10][11][12][13] The commercially-available intravascular ultrasound (IVUS) system (EndoSonics, USA) investigates the morphology of the coronary wall and plaque by observing the induced strain in the vascular tissue via different levels of the intraluminal pressure.…”

Section: Static Elastographymentioning

confidence: 99%

Review of ultrasound elastography quality control and training test phantoms

Cournane

Fagan

Browne³

2011

Ultrasound

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While the rapid development of ultrasound elastography techniques in recent decades has sparked its prompt implementation in the clinical setting adding new diagnostic information to conventional imaging techniques, questions still remain as to its full potential and efficacy in the hospital environment. A limited number of technical studies have objectively assessed the full capabilities of the different elastography approaches, perhaps due, in part, to the scarcity of suitable tissue-mimicking materials (TMMs) and appropriately designed phantoms available. Few commercially available elastography phantoms possess the necessary test target characteristics or mechanical properties observed clinically, or indeed reflect the lesion-to-background elasticity ratio encountered during clinical scanning. Thus, while some phantoms may prove useful, they may not fully challenge the capabilities of the different elastography techniques, proving limited when it comes to quality control (QC) and/or training purposes. Although a variety of elastography TMMs, such as agar and gelatine dispersions, co-polymer in oil and poly(vinyl) alcohol cryogel, have been developed for specific research purposes, such work is yet to produce appropriately designed phantoms to adequately challenge the variety of current commercially available elastography applications. Accordingly, there is a clear need for the further development of elastography TMMs and phantoms to keep pace with the rapid developments in elastography technology, to ensure that the performance of these new diagnostic approaches are validated, and for clinical training purposes.

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Real-Time Ultrasound Elastography: Its Potential Role in Assessment of Breast Lesions

Cited by 100 publications

References 14 publications

Value of Strain Elastography Ultrasound in Differentiation of Breast Masses and Histopathologic Correlation

Value of Strain Elastography Ultrasound in Differentiation of Breast Masses and Histopathologic Correlation

Intra- and Interobserver Reproducibility of Shear Wave Elastography for Evaluation of the Breast Lesions

Review of ultrasound elastography quality control and training test phantoms

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