Sonoelastography and Dynamic Magnetic Resonance Mammogram in the Evaluation of BIRADS III and above Breast Lesions Categories- A Prospective Cohort Study

Abstract

Introduction: Breast cancer has become a major health hazard in society. Early diagnosis of breast cancers plays a vital role in its management and control. Sonoelastography and Magnetic Resonance (MR) mammography are non invasive imaging methods in the diagnosis of breast lesions. Aim: To determine the accuracy of sonoelastography and dynamic MR mammogram in the evaluation of breast masses of Breast Imaging Reporting and Database System score (BIRADS)- III and above (BIRADS-IV, V and VI ) lesion categories. Materials and Methods: The present prospective cohort study conducted in the Department of Radiodiagnosis at Bowring and Lady Curzon Medical College and Research Institute and Prestige Medical Health Sciences, Bangalore, India from June 2019 to March 2020. A total of 60 female cases clinically and histopathologically diagnosed with breast cancers above 28 years of age were recruited. All the subjects underwent conventional B mode ultrasonogram. Cases with BIRADS-III and above lesion category were assessed through sonoelastography and dynamic contrast enhances MR mammogram. MR mammogram was performed by using 1.5 tesla GE Magnetic Resonance Imaging (MRI). The sequences like axial and sagittal Time (T)1 Weighted (W)1 and T2 WI, Diffusion Weighted Imaging (DWI), axial Short Inversion Time Inversion Recovery (STIR) were performed. The Chi-square test was used to compare the difference between study variables. Results: A total of 60 female cases, clinically and histopathologically diagnosed with breast cancers above 28 years of age were included in the study with maximum in age range of 41-50 years. The dynamic MRI curve category sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy as 91.8%, 95.3%, 96.3%, 92% and 94.8%, respectively. The study showed sonoelastography sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy as 79.8%, 93%, 88.6%, 82.2% and 84%, respectively. Conclusion: The MR mammogram and sonoelastography are effective methods in the diagnosis of breast lesions; however, MR mammography has higher sensitivity, specificity and diagnostic accuracy.