Improving B mode ultrasound evaluation of breast lesions with real-time ultrasound elastography--a clinical approach.
Ultrasound elastography using the extended combined auto-correlation method of tissue elasticity allows for real-time strain image visualisation using a free-hand probe with concurrent conventional B mode imaging. Four hundred and fifteen consecutive women with 550 breast lesions confirmed on B mode ultrasound were assessed with elastography using the elasticity score. There were 119 malignant and 431 benign lesions. The elastography sensitivity was 78.0%, specificity was 98.5% and overall accuracy was 93.8%. The median score for malignancy was 5 and that for benign lesions was 2. There was good correlation with B mode BIRADS category. 98.6% of lesions with an elasticity score of 2 or below (95%CI=96.8-99.4) were benign. BIRADS 3 lesions with an elasticity score of 2 or below may be re-classified as BIRADS 2 lesions. We found that 15.3% of BIRADS 2 and 3 lesions with an elasticity score of 3 were malignant. Real-time ultrasound elastography is user-friendly with a high accuracy rate, thereby improving B mode ultrasound assessment.
Tan
S M
SM
Department of Surgery, Changi General Hospital, Singapore. su_ming_tan@cgh.com.sg
Teh
H S
HS
Mancer
J F Kent
JF
Poh
W T
WT
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging; D018275:Carcinoma, Lobular / Q000000981:diagnostic imaging; D003199:Computer Systems; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010173:Palpation; D012509:Sarcoma / Q000000981:diagnostic imaging; D012680:Sensitivity and Specificity; D016217:Ultrasonography, Mammary / Q000379:methods*