Abstract
The accurate diagnosis of subcentimeter lesions is controversial, and therefore a standardized diagnosis algorithm is needed. The objective of the present work was to study the value of the elastography patterns obtained through the use of the shear wave elastography (SWE) technique with respect to histopathology for the evaluation of nodular breast lesions ≤1 cm. A retrospective study was conducted which included 65 sub-centimeter lesions from 57 patients with an average age of 45.6 ± 11.9. For all the cases, a B-mode ultrasound study, shear wave elastography, and a posterior anatomopathological study were conducted. The lesions had a diameter greater than 7.5 ± 1.7 mm (range: 4–9 mm). Through elastography, the distribution of the patterns was: cyst artifact (n = 13), pattern 1 (n = 4), pattern 2 (n = 31), pattern 3 (n = 13), and pattern 4 (n = 4). Of the 65 lesions, 15 were cysts, 46 were solid benign lesions, and 3 were malignant lesions. The sensitivity of the elastography was 75%, with a specificity of 98.46% and a correct diagnosis in 96.92% of the cases (n = 63). The results from this study show the usefulness of SWE for the evaluation of sub-centimeter breast lesions. In addition, this diagnostic strategy helps with the differential diagnosis between benign and malignant lesions and contributes to the early detection of malignant breast lesions.
Highlights
Elastography is a type of imaging method based on the stiffness of a tissue, which is analogous to a clinical palpation for a malignant neoplasm, as it provides a quantification of stiffness [1], with ultrasound elastography (USE) first being described in the 1990s [2]
The greater advantage of elastography is the improvement in the characterization of BI-RADS 3 and 4a lesions, so that we are able to “upgrade” or “downgrade” the lesions as a function of the elastography maps provided by the image [8], in a similar manner as that provided by diffusion in magnetic resonance in the study of the prostate
A retrospective study was conducted from August 2018 to March 2019, with 60 patients who had lesions ≤1 cm, which were detected with an ultrasound (US) in women who were referred from the Breast Care Unit at our hospital
Summary
Elastography is a type of imaging method based on the stiffness of a tissue, which is analogous to a clinical palpation for a malignant neoplasm, as it provides a quantification of stiffness [1], with ultrasound elastography (USE) first being described in the 1990s [2].Elastography maps show additional information in B-mode, as with characterization via Doppler, increasing the diagnostic precision [3,4,5,6].The two types of elastography utilized with breasts are compression elastography (strain imaging) and shear wave elastography (SWE). The greater advantage of elastography is the improvement in the characterization of BI-RADS 3 and 4a lesions, so that we are able to “upgrade” or “downgrade” the lesions as a function of the elastography maps provided by the image [8], in a similar manner as that provided by diffusion in magnetic resonance in the study of the prostate. It could be considered an image biomarker
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