Abstract
BackgroundThis study aimed to confirm whether strain ratio should be added after evaluation of lesions with 5-point elasticity scoring for differentiating benign and malignant breast lesions on ultrasonographic elastography(UE).Materials and MethodsFrom June 2010 to March 2012, 1080 consecutive female patients with breast lesions were recruited into a multicenter retrospective study, which involved 8 centers across China. Each institutional ethic review board approved the study, and all the patients gave written informed consent. All the patients underwent the UE procedure and the strain ratios were calculated and the final diagnosis was made by histological findings. The sensitivity, specificity, accuracy, PPV and NPV were calculated for each of the two evaluation systems and the areas under the ROC curve were compared.ResultsThe strain ratios of benign lesions (mean, 2.6±2.0) and malignant lesions (mean,7.9±5.8) were significantly different (p <0.01). When the cutoff point was 3.01, strain ratio method had 79.8% sensitivity, 82.8% specificity, and 81.3% accuracy, while the 5-point scoring method had 93.1% sensitivity, 73.0% specificity, and 76.8% accuracy. The areas under the ROC curve with the strain ratio method and 5-point scoring method were 0.863 and 0.865, respectively(p>0.05). The strain ratio method shows better a diagnosis performance of the lesions with elasticity score 3 and 4.ConclusionsAlthough the two UE methods have similar diagnostic performance, separate calculation of the strain ratios seems compulsory, especially for the large solid breast lesions and the lesions with elasticity score 3 and 4.
Highlights
As the incidence of breast cancer rises continuously, early breast cancer detection becomes increasingly important[1]
For the concept that harder masses are more likely to be malignant, in the last decade, different ultrasonographic elastography(UE) diagnosis systems have been developed to determine the relationship between different structures and their tissue inherent elasticity for diagnosing malignant tumors ultrasound elastography (UE), which involves the visual display of tissue stiffness, is a newly developed dynamic technique widespread used for detecting pathological tissue alterations in vivo
The 5-point scoring system is used as an evaluation system when we diagnose a breast lesion, which scales a lesion by different color map which reflected by the stiffness of the focal tissue
Summary
As the incidence of breast cancer rises continuously, early breast cancer detection becomes increasingly important[1]. Palpation is a highly applied way for surgeons in the clinical routine, yet as a subjective method, the size and location of the lesion require rich experience of the practitioner When it comes to imaging examination, ultrasonography become an important evaluation of the first time screening as a convenient and noninvasive diagnoses method. In practice, we found that just as the palpation, the score judgment of a lesion might be influenced by multiple subjective factors, that means different doctors will not generate a consistent diagnosis of a same lesion under the same conditions In this circumstance, Waki et al present a new diagnosis system using the strain ratio measurement [10]. This study aimed to confirm whether strain ratio should be added after evaluation of lesions with 5-point elasticity scoring for differentiating benign and malignant breast lesions on ultrasonographic elastography(UE)
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