Contribution of Sonoelastographic Scoring to B-Mode Sonography in the Evaluation of Breast Masses

Abstract

Objectives: The study aims were to evaluate the contribution of sonoelastography to Breast Imaging Reporting, and Data System (BI-RADS) scoring of breast images. Materials and Methods: Two observers evaluated the BI-RADS category, Tsukuba score, and the strain index of 83 lesions of 73 consecutive patients. A new scoring system was established to evaluate the lesions by using the BI-RADS score, Tsukuba score, and strain index ratio. Results: There was a statistically significant difference between the strain index value of benign (3.08 ± 2.71) and malignant group (4.62 ± 2.70) ( P < .05). The sensitivity and specificity were 59.1% and 65.1% for the 3.12 cut-off value for the strain index. In the receiver operating characteristic (ROC) analysis, the area under the curve (AUC) of the only BI-RADS score was 0.834, both BT (BI-RADS + revised Tsukuba score) score and the total score (BI-RADS + revised Tsukuba score + strain index score) was 0.843. The interclass correlation coefficient for the two observers’ measurements of the strain index was weak, with .266 ( P < .05). Conclusion: The potential contribution of sonoelastography on lesion characterization is still controversial. In this study, the agreement among the observers was inadequate, and the contribution of sonoelastography on BI-RADS classification was limited. In addition, in the daily practice of sonoelastograpic evaluation, the Tsukuba score, was easier to apply and should be used rather than strain index measurements.