Abstract
Purpose. To evaluate diagnostic performance of acoustic radiation force impulse (ARFI) technology for solid breast masses with different sizes and determine which features are most efficient. Materials and Methods. 271 solid breast masses in 242 women were examined with ARFI, and their shear wave velocities (SWVs), Virtual Touch tissue imaging (VTI) patterns, and area ratios (ARs) were measured and compared with their histopathological outcomes. Receiver operating characteristic curves (ROC) were calculated to assess diagnostic performance of ARFI for small masses (6–14 mm) and big masses (15–30 mm). Results. SWV of mass was shown to be positively associated with mass size (P < 0.001). For small masses, area under ROC (Az) of AR was larger than that of SWV (P < 0.001) and VTI pattern (P < 0.001); no significant difference was found between Az of SWV and that of VTI pattern (P = 0.906). For big masses, Az of VTI pattern was less than that of SWV (P = 0.008) and AR (P = 0.002); no significant difference was identified between Az of SWV and that of AR (P = 0.584). Conclusions. For big masses, SWV and AR are both efficient measures; nevertheless, for small masses, AR seems to be the best feature.
Highlights
Breast cancer is common; its incidence has kept rising in China in the recent years and has for instance, occupied the first place in the list of malignant tumors occurring to women in Shanghai [1]
271 breast masses were categorized into four subgroups: small benign masses (SBM), big benign masses (BBM), small malignant masses (SMM), and big malignant masses (BMMs)
Combined with US, Acoustic radiation force impulse (ARFI) has the potential to improve the accuracy of Breast Imaging Reporting and Data System (BI-RADS) US categorization of breast masses and avoid the need for unnecessary biopsies [4, 8, 13, 14]
Summary
Breast cancer is common; its incidence has kept rising in China in the recent years and has for instance, occupied the first place in the list of malignant tumors occurring to women in Shanghai [1]. ARFI can yield highly reproducible information on the tissue stiffness of solid breast masses within and across observers [3,4,5]. It incorporates two different modes: Virtual Touch tissue quantification (VTQ) and Virtual Touch tissue imaging (VTI) [6]. Several studies have demonstrated that SWV, VTI pattern, and AR are useful in differentiating between benign and malignant solid breast masses [4,5,6,7,8,9]. No studies have compared the diagnostic performance of these features
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