Role of sonoelastography and MR spectroscopy in diagnosis of solid breast lesions with histopathological correlation

Abstract

ObjectiveTo demonstrate the role of ultrasound elastography and magnetic resonance spectroscopy in diagnosis of solid breast lesions with histopathological correlation. Patients and methodsThis study included 40 female patients, and their ages ranged from 17 to 73years with mean age of 43.18years. Patients were referred on the basis of suspected breast lesion and/or nipple discharge. All patients underwent elastography in addition to conventional ultrasonography and MR spectroscopy and the radiological results were correlated with histopathological examination for achieving confirmed final diagnosis. ResultsAll benign lesions were 17 on the basis of elastography, while the malignant lesions were 18. Fifteen malignant lesions (93.7%, 15/21) had an elastography score 5, while Thirteen benign lesions (86.7%, 13/19) had an elastography score 3. On the basis of DCE-MRI, benign lesions were 16, while the malignant lesions were 19. Sixteen malignant lesions (94.1%) were diagnosed as BI-RADS 5, while fourteen benign lesions (93.3%) were diagnosed as BI-RADS 3. On the basis of MR spectroscopy, benign lesions were 17, while the malignant lesions were 19. Nineteen malignant lesions (90.5) had positive choline peak while seventeen benign lesions (89.5%) had negative choline peak. The study showed conventional ultrasound sensitivity, specificity, PPV, NPV and accuracy as 85%, 80%, 80.9%, 84.2% and 82.5% respectively, and sono-elastography sensitivity, specificity, PPV, NPV and accuracy as 90%, 85%, 85.7%, 89.4% and 87.5% respectively. Dynamic contrast enhanced MRI sensitivity, specificity, PPV, NPV and accuracy were 85.7%, 84.2%, 85.7%, 84.2% and 85% respectively, while MR spectroscopy sensitivity, specificity, PPV, NPV and accuracy were 90.4%, 89.4%, 90.4%, 89.5% and 80.5% respectively. ConclusionThe study showed that sono-elastography and MR spectroscopy are valuable noninvasive diagnostic imaging techniques in diagnosis of early breast malignancy than any other diagnostic tools, consequently help to avoid nondesirable invasive surgical biopsy of the breast lesions.