Ultrasonographic Elasticity Contrast Index of Palpable Breast Lumps

Abstract

Introduction: Elastrography used in addition to grey scale sonography increases its specificity. Elasticity contrast index (ECI) is based on strain elastrography and being a quantitative parameter, maybe more easy to obtain and reproducible while researches has been done in ECI in thyroid lesions, this is the first study, to the best of our knowledge to evaluate in breast lesions. This study was done to evaluate the diagnostic accuracy of Elasticity Contrast Index (ECI) in differentiating benign from malignant lesions of breast and to determine its cutoff value.
 Methods: This is a descriptive cross-sectional study done at tertiary health care centre, which involved retrospective evaluation of data collected from September 2016 to March 2017. Conventional sonography was done followed by elastography on commercially available ultrasound machine. ECI was calculated in thyroid protocol available in the unit. Histopathological diagnosis was obtained for all the lesions and taken as gold standard.
 Results: A total of 89 breast lumps were evaluated, of which was 61 (69.3%) were benign and 27 (30.7%) malignant on histopathology. Independent t test revealed the average ECI value of benign lesions was 2.48 and malignant 5.1. Receiver operating curve showed ECI value of 3.25 as the cutoff, above which the lesions were malignant.
 Conclusions: ECI is a quantitative elastography technique which can be easily used as an adjunct during breast sonography and can increase its specificity for diagnosing a lesion as malignant. This could reduce the number of false positive biopsies.

Role of Sonoelastography in Differentiating Benign and Malignant Breast Lesions: A Prospective Study Comparing Elasticity Contrast Index and Tsukuba Score

“…8 The latter is used for obtaining ECI value for thyroid masses, and its use in breast masses has not been evaluated, with only one study regarding this application. 7 Higher ECI values suggest stiffer masses, thus increasing the likelihood of malignancy. 21 The ECI cut-off value was obtained to be 2.8 in our study with a sensitivity of 59.3%, specificity of 89.2%, and accuracy of 81.8%.…”

“…A minimum of two measurements were obtained for each lesion and the lowest value was recorded. 7,8 Based on ultrasound features masses were categorized into ACR BI-RADS (American College of Radiology Breast Imaging Reporting and Data System) categories (Table 1). 8 BI-RADS 2 and 3 lesions were categorized as benign, 4a and 4b indeterminate, and 4c, and 5 malignant.…”

“…Tsukuba score, also based on strain elastography, has been verified by multiple studies to be more qualitative and subjective. 6,7 In this study, we determined the cut-off of ECI value to differentiate benign and malignant breast lesions, determined the accuracy of the B-mode sonography with Tsukuba score and ECI, and compared them using histopathology diagnosis as the gold standard. To our knowledge, no previous study compares Tsukuba and ECI.…”