Nonpalpable breast masses: evaluation by US elastography.
OBJECTIVE
To compare the diagnostic performances of conventional ultrasound (US) and US elastography for the differentiation of nonpalpable breast masses, and to evaluate whether elastography is helpful at reducing the number of benign biopsies, using histological analysis as a reference standard.


METHODS
Conventional US and real-time elastographic images were obtained for 100 women who had been scheduled for a US-guided core biopsy of 100 nonpalpable breast masses (83 benign, 17 malignant). Two experienced radiologists unaware of the biopsy and clinical findings analyzed conventional US and elastographic images by consensus, and classified lesions based on degree of suspicion regarding the probability of malignancy. Results were evaluated by receiver operating characteristic curve analysis. In addition, the authors investigated whether a subset of lesions was categorized as suspicious by conventional US, but as benign by elastography.


RESULTS
Areas under the ROC curves (Az values) were 0.901 for conventional US and 0.916 for elastography (p = 0.808). For BI-RADS category 4a lesions, 44% (22 of 50) had an elasticity score of 1 and all were found to be benign.


CONCLUSIONS
Elastography was found to have a diagnostic performance comparable to that of conventional US for the differentiation of nonpalpable breast masses. The authors conclude that BI-RADS category 4a lesions with an elasticity score of 1 probably do not require biopsy.
Cho
Nariya
N
Department of Radiology and Clinical Research Institute, Seoul National University Hospital and the Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea.
Moon
Woo Kyung
WK
Park
Jeong Seon
JS
Cha
Joo Hee
JH
Jang
Mijung
M
Seong
Min Hyun
MH
D000328:Adult; D000368:Aged; D044963:Biopsy, Fine-Needle; D001940:Breast / Q000473:pathology / Q000648:ultrastructure*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D054459:Elasticity Imaging Techniques; D005260:Female; D006801:Humans; D008875:Middle Aged; D012372:ROC Curve; D012680:Sensitivity and Specificity; D018084:Ultrasonography, Interventional