Application of virtual touch tissue imaging quantification technology in differentiating benign or malignant breast lesions and evaluating the heterogeneity of breast lesions

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Objective To investigate virtual touch tissue imaging quantification shear wave elastography in the differential diagnosis between benign and malignant breast lesions and the value of heterogeneity. Methods A total of 149 patients with 155 breast lesions by ultrasonography were selected from October 2016 to March 2017 in Drum Tower Hospital Affiliated to Nanjing University Medical School. All patients were confirmed by surgical pathology. The breast lesions were first examined by conventional ultrasound and the conventional ultrasonography features were recorded. The lesions were classified by breast imaging reporting and data system (BI-RADS). Then the shear wave velocity (SWV) values were measured under the virtual touch tissue imaging quantification (VTIQ) speed mode. The SWV maximum, average were obtained and coefficient of variation was calculated. According to pathological results, the receiver operating characteristic (ROC) curves of SWV maximum, average and coefficient of variation in differentiating benign or malignant breast lesions were drawn. Results The surgical pathology confirmed that there were 48 malignant lesions and 107 benign lesions in 155 breast lesions. The SWV maximum, average and coefficient of variation in malignant lesions were all higher than those of benign lesions [(6.85±2.26) cm/s vs (3.95±1.54) cm/s, (4.74±1.36) cm/s vs (3.10±0.94) cm, (0.30±0.15) vs (0.17±0.10)], and the difference was all statistically significant (t=8.085, 7.583, 5.366, all P<0.001). According to ROC curve, the areas under the curves of SWV maximum, average and coefficient of variation in differentiating benign or malignant breast lesions were 0.842, 0.826 and 0.759 and the cutoff values were 5.51 cm/s, 4.28 cm/s and 0.25 respectively. The diagnostic sensitivity, specificity and accuracy of SWV maximum, average and coefficient of variation were 72.92%, 85.98% and 81.93%, 64.58%, 87.85% and 80.65%, 64.58%, 84.11% and 78.06%, respectively. And the combined diagnostic sensitivity of coefficient of variation with SWV maximum and SWV average were 81.25%. Conclusion VTIQ technology plays an important role in the differential diagnosis between benign and malignant breast lesions and the value of heterogeneity. Key words: Elasticity imaging techniques; Breast diseases; Heterogeneity