Diagnosis Of Solid Breast Masses Research Articles

Radiological Significance of Shear-Wave Elastography Technique for Evaluation of Solid Breast Masses with Histopathological Correlation

Background: Although various imaging modalities are available for evaluating suspicious breast lesions, ultrasound-based Shear-Wave Elastography (SWE) is an advanced, non-invasive technique complementary to grayscale sonography. This technique evaluates the elasticity of a specific tissue by applying sonic pressure to that tissue. Objective: The aim is to assess the role of SWE in evaluating solid breast masses in correlation to histopathological study results. Subjects and Methods: This prospective study was done in a tertiary care teaching hospital from September 2019 to August 2020. A study population of 50 women aged 18 years or above with an ultrasonographic (USG) diagnosis of solid breast masses was included. Results: A significantly higher value of SWE elasticity ratio (E-mean) was observed in malignant tumors than in benign tumors (p <0.0001). The area-under-curve (AUC) for the BI-RADS 4 lesions was 0.522 (95% CI, 0.343-0.701) with an E-ratio cut-off score of 85.25, the sensitivity and specificity were 50% for diagnosing malignant tumors, whereas AUC for the HPE study was 1.000 (95% CI, 1.000-1.000) with an E-ratio cut-off score of 134.25; both the sensitivity and specificity were 100% for diagnosing malignant tumors. Conclusions: Carcinoma breast is one of the most prevalent cancers globally. The most common benign tumor of the breast is a fibroadenoma, whereas Invasive Ductal Carcinoma is the most common malignant breast mass. A well-defined SWE elasticity ratio range might help predict the aggressiveness of breast tumors. SWE's correlation with BI-RADS in suspicious lesions adds to histopathology's advantage in distinguishing malignant tumors from benign ones.

The diagnostic value of sonoelastographic strain ratio in discriminating malignant from benign solid breast masses

ObjectiveTo detect the diagnostic efficiency of sono elastographic strain ratio in discriminating malignant from benign solid breast masses and compare it with the sono elastographic elasticity score method. Patients and methodsThis study included 120 histopathologically diagnosed solid breast masses from 120 females (mean age 38.2 years). Elastography score and strain ratio (SR) were performed for each mass. Receiver operating characteristic (ROC) curve was plotted for both methods. ResultsThe benign lesions had significant lower SR (mean 2.12 ± 1.72) than that of malignant lesions (mean 6.91 ± 3.96). The AUC from ROC curve was 0.98 for elasticity score and 0.99 for SR. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of the elasticity score in the diagnosis of solid breast masses were 100%, 88%, 83.3%, 100% and 92.5% respectively, and of the strain ratio were 93.3%, 97.3%, 95.5%, 96.1% and 95.8% respectively (when cutoff value 3.77 was used). There is no statistically significant difference found between both methods. ConclusionSR has high diagnostic performance in differentiating malignant from benign solid breast masses, however there is no statistically significant difference between SR and elasticity score.

2082081 Evaluation of Virtual Touch IQ Shear Wave Velocity for Solid Breast Masses

2082081 Evaluation of Virtual Touch IQ Shear Wave Velocity for Solid Breast Masses

Acoustic Radiation Force Impulse Technology in the Differential Diagnosis of Solid Breast Masses with Different Sizes: Which Features Are Most Efficient?

Purpose. To evaluate diagnostic performance of acoustic radiation force impulse (ARFI) technology for solid breast masses with different sizes and determine which features are most efficient. Materials and Methods. 271 solid breast masses in 242 women were examined with ARFI, and their shear wave velocities (SWVs), Virtual Touch tissue imaging (VTI) patterns, and area ratios (ARs) were measured and compared with their histopathological outcomes. Receiver operating characteristic curves (ROC) were calculated to assess diagnostic performance of ARFI for small masses (6–14 mm) and big masses (15–30 mm). Results. SWV of mass was shown to be positively associated with mass size (P < 0.001). For small masses, area under ROC (Az) of AR was larger than that of SWV (P < 0.001) and VTI pattern (P < 0.001); no significant difference was found between Az of SWV and that of VTI pattern (P = 0.906). For big masses, Az of VTI pattern was less than that of SWV (P = 0.008) and AR (P = 0.002); no significant difference was identified between Az of SWV and that of AR (P = 0.584). Conclusions. For big masses, SWV and AR are both efficient measures; nevertheless, for small masses, AR seems to be the best feature.

Comparison of the diagnostic value of the gray scale and color Doppler ultrasonography in the diagnosis of solid breast masses

Comparison of the diagnostic value of the gray scale and color Doppler ultrasonography in the diagnosis of solid breast masses

Shear Wave Velocity Measurements for Differential Diagnosis of Solid Breast Masses: A Comparison between Virtual Touch Quantification and Virtual Touch IQ

This study compared the diagnostic performance of two shear wave speed measurement techniques in 81 patients with 83 solid breast lesions. Virtual Touch Quantification, which provides single-point shear wave speed measurement capability (SP-SWS), was compared with Virtual Touch IQ, a new 2-D shear wave imaging technique with multi-point shear wave speed measurement capability (2D-SWS). With SP-SWS, shear wave velocity was measured within the lesion ("internal" value) and the marginal areas ("marginal" value). With 2D-SWS, the highest velocity was measured. The marginal values obtained with the SP-SWS and 2D-SWS methods were significantly higher for malignant lesions and benign lesions, respectively (p < 0.0001). Sensitivity, specificity and accuracy were 86% (36/42), 90% (37/41) and 88% (73/83), respectively, for SP-SWS, and 88% (37/42), 93% (38/41) and 90% (75/83), respectively, for 2D-SWS. It is concluded that 2D-SWS is a useful diagnostic tool for differentiating malignant from benign solid breast masses.

Shear-wave elastography in the diagnosis of solid breast masses: what leads to false-negative or false-positive results?

To investigate the factors that have an effect on false-positive or false-negative shear-wave elastography (SWE) results in solid breast masses. From June to December 2012, 222 breast lesions of 199 consecutive women (mean age: 45.3 ± 10.1years; range, 21 to 88years) who had been scheduled for biopsy or surgical excision were included. Greyscale ultrasound and SWE were performed in all women before biopsy. Final ultrasound assessments and SWE parameters (pattern classification and maximum elasticity) were recorded and compared with histopathology results. Patient and lesion factors in the 'true' and 'false' groups were compared. Of the 222 masses, 175 (78.8%) were benign, and 47 (21.2%) were malignant. False-positive rates of benign masses were significantly higher than false-negative rates of malignancy in SWE patterns, 36.6% to 6.4% (P < 0.001). Among both benign and malignant masses, factors showing significance among false SWE features were lesion size, breast thickness and lesion depth (all P < 0.05). All 47 malignant breast masses had SWE images of good quality. False SWE features were more significantly seen in benign masses. Lesion size, breast thickness and lesion depth have significance in producing false results, and this needs consideration in SWE image acquisition. • Shear-wave elastography (SWE) is widely used during breast imaging • At SWE, false-positive rates were significantly higher than false-negative rates • Larger size, breast thickness, depth and fair quality influences false-positive SWE features • Smaller size, larger breast thickness and depth influences false-negative SWE features.

Diagnostic performances of shear wave elastography: which parameter to use in differential diagnosis of solid breast masses?

To evaluate which shear wave elastography (SWE) parameter proves most accurate in the differential diagnosis of solid breast masses. One hundred and fifty-six breast lesions in 139 consecutive women (mean age: 43.54 ± 9.94 years, range 21-88 years), who had been scheduled for ultrasound-guided breast biopsy, were included. Conventional ultrasound and SWE were performed in all women before biopsy procedures. Ultrasound BI-RADS final assessment and SWE parameters were recorded. Diagnostic performance of each SWE parameter was calculated and compared with those obtained when applying cut-off values of previously published data. Performance of conventional ultrasound and ultrasound combined with each parameter was also compared. Of the 156 breast masses, 120 (76.9 %) were benign and 36 (23.1 %) malignant. Maximum stiffness (Emax) with a cut-off of 82.3 kPa had the highest area under the receiver operating characteristics curve (Az) value compared with other SWE parameters, 0.860 (sensitivity 88.9 %, specificity 77.5 %, accuracy 80.1 %). Az values of conventional ultrasound combined with each SWE parameter showed lower (but not significantly) values than with conventional ultrasound alone. Maximum stiffness (82.3 kPa) provided the best diagnostic performance. However the overall diagnostic performance of ultrasound plus SWE was not significantly better than that of conventional ultrasound alone. • SWE offers new information over and above conventional breast ultrasound • Various SWE parameters were explored regarding distinction between benign and malignant lesions • An elasticity of 82.3 kPa appears optimal in differentiating solid breast masses • However, ultrasound plus SWE was not significantly better than conventional ultrasound alone.

Correlations between shear wave elastography and mammographic findings in invasive breast cancer

Shear wave elastography is a new ultrasound technique which shows promise in the differential diagnosis of solid breast masses. This study compares the mean tumour stiffness with mammographic findings and mammographic density in women with invasive breast cancer.

Color Doppler ultrasound and spectral analysis of tumor vessels in the differential diagnosis of solid breast masses.

The purpose of this study was to evaluate the usefulness of color Doppler and spectral analysis of specific tumor vessels in the differentiation of benign from malignant breast masses. Forty-eight patients with solid breast masses were evaluated with color Doppler ultrasound prospectively. When tumor vessels were visualized, spectral analysis was performed and peak systolic and end diastolic Doppler frequency shifts were recorded. Histology was obtained in all but two cases. In 28 out of 29 malignant lesions tumor vessels were visualized. Thirteen of 19 benign lesions showed no demonstrable flow. The peak systolic Doppler frequency shifts recorded over the vessels of the malignant breast masses were significantly higher than those of the benign breast masses (P < 0.01). In our preliminary series, spectral Doppler analysis of tumor vessels shows promise in differentiating benign from malignant breast masses.

Direct contact B-scan ultrasound in the diagnosis of solid breast masses

Our experience of breast ultrasound in the differentiation of benign and solid malignant breast masses indicates a specificity of 93% for carcinoma; 7% of cancers were regarded as benign. Eight of 89 proven fibroadenomas were considered possibly malignant. Typical, and overlapping, features are described, and the world literature is discussed. Whereas most previous workers have used a water-path technique, we employ direct contact B-scanning, which is quick, simple, and apparently at least as successful. The small group of solid masses where there is overlap between fibroadenoma and carcinoma needs further study; this might be helped by histological correlation with the ultrasound appearances of malignancy, the causes of which are still debated. The exclusion of a focal solid mass in a patient with a breast lump can reduce the biopsy rate.