Sonoelastographic Strain Index for Differentiation of Benign and Malignant Nonpalpable Breast Masses

Abstract

Objective. The purpose of this study was to evaluate the diagnostic potential of the sonoelastographic strain index for differentiation of nonpalpable breast masses. Methods. Ninety-nine nonpalpable breast masses (79 benign and 20 malignant) in 94 women (mean age, 45 years; range, 21-68 years) who had been scheduled for a sonographically guided core biopsy were examined with B-mode sonography and sonoelastography. Radiologists who had performed the biopsies analyzed the B-mode sonograms and provided American College of Radiology Breast Imaging Reporting and Data System categories. The strain index (fat to lesion strain ratio) was calculated by dividing the strain value of the subcutaneous fat by that of the mass. The histologic result from the sonographically guided core biopsy was used as a reference standard. The diagnostic performance of the strain index and that of B-mode sonography were compared by receiver operating characteristic (ROC) curve analysis. Results. The mean strain index values ± SD were 6.57 ± 6.62 (range, 1.29-28.69) in malignant masses and 2.63 ± 4.57 (range, 0.54-38.76) in benign masses (P = .019). The area under the ROC curve values were 0.835 (95% confidence interval [CI], 0.747-0.902) for B-mode sonography and 0.879 (95% CI, 0.798-0.936) for the strain index (P = .490). The sensitivity, specificity, positive predictive value, and negative predictive value were 95% (19 of 20), 75% (59 of 79), 48% (19 of 39), and 98% (59 of 60), respectively, when a best cutoff point of 2.24 was used. Conclusions. The strain index based on the fat to lesion strain ratio has diagnostic performance comparable with that of B-mode sonography for differentiation of benign and malignant breast masses.

Sonoelastography Findings of Breast Juvenile Papillomatosis: A Case Report

“…suggested that an SR cut-off value of 2.24 enables the best distinction between benign and malignant masses (10). In this case report all these data of the patient were revealed and findings were consistent with benign ones.…”

“…Colour maps showing the distribution of deformities or elasticity (elasticity score) as a qualitative parameter are evaluated. Another qualitative variable is the ratio of the diameters of lesion in B mode to those on elastography (elastic diameter) (10). Semiquantitative data are deformation or elasticity ratios for two ROI (strain ratio, SR) obtained from lesion and the neighbor fat tissue.…”

Effects of compression force on elasticity index and elasticity ratio in ultrasound elastography

“…The technique has been used to assess the hardness of various normal and abnormal tissues, [1][2][3][4][5][6] and to differentiate malignant from benign lesions in the breast, prostate, thyroid, lymph nodes and salivary glands. [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] Ultrasound elastography uses either strain or shear wave velocity. 25,26 In strain elastography, tissue strain induced by compression with the probe is used as an indicator of hardness.…”

Strain Elastography & Tissue Characterisation as a Tool to Differentiate Tumor from Healthy Tissue

“…SE exhibits a comparative value of strain in contrast to the surrounding area [20]. This approach is achieved in realtime with either manually or automatically compressing the desired tissue [21,22]. Sensation practice is widely used since decades to perceive stiffness change in a tissue.…”