Real-time sonoelastography performed in addition to B-mode ultrasound and mammography: improved differentiation of breast lesions?
OBJECTIVE
The goal of the present study was to compare the sensitivity and specificity of elastography with that of B-mode ultrasound (US) and mammography.


METHODS
A total of 300 patients with histologically confirmed breast lesions (168 benign, 132 malignant) were included. Evaluation was by means of the three-dimensional finite-element method. The data are color-coded and superimposed on the B-mode US scan. The images were evaluated by two independent readers. The results were compared with mammography, histology, and the data obtained by previous US investigations. Sensitivities and specificities were calculated.


RESULTS
Sensitivity and specificity in the differentiation of benign and malignant lesions were 87% and 85%, respectively, for mammography and 94% and 83% for B-mode US. The two examiners were in very good agreement in their evaluation of the elastograms (kappa: 0.86). Elastography had a sensitivity of 82% and a specificity of 87%. Elastography was superior to B-mode US in diagnosing Breast Imaging Reporting and Data System (BI-RADS) 3 lesions (92% vs. 82% specificity) and in lipomatous involution (80% vs. 69% specificity).


CONCLUSIONS
Elastography in breast lesions showed a higher specificity and a lower sensitivity in comparison with B-mode sonography. Elastography may be beneficial in BI-RADS 3 lesions and in lipomatous involution.
Thomas
Anke
A
Department of Obstetrics and Gynecology, Chariteplatz, Charité - Universitätsmedizin, Berlin 10117, Germany. anke.thomas@charite.de
Kümmel
Sherko
S
Fritzsche
Florian
F
Warm
Mathias
M
Ebert
Bernd
B
Hamm
Bernd
B
Fischer
Thomas
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D004548:Elasticity; D005260:Female; D020342:Finite Element Analysis; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008327:Mammography; D008875:Middle Aged; D012680:Sensitivity and Specificity; D014463:Ultrasonography