title: [Proposal for the systematization of the elastographic study of mammary lesions through ultrasound scan].
abstract: OBJECTIVE
  Proposal of systematization for the elastographic study in the ultrasound routine.
  
  
  METHODS
  Evaluation was made of 308 patients forwarded to the breast intervention service in the CTC-Genesis from May 1, 2007 to March 1, 2008 to perform percutaneous breast biopsy. Prior to the percutaneous biopsy, an ultrasound study and an elastography were performed. Lesions were primarily analyzed and classified according to the Bi-Rads lexicon criteria by the conventional ultrasound scan (B mode). The elastography was then performed and analyzed in accordance with the systematization proposed by the authors, using images obtained during compression and after decompression of the area of interest. Lesions were classified following the system developed by the authors using a four-point scale, where scores (1) and (2) were considered benign, score (3) probably benign and score (4) suspicion of malignancy. Results obtained by the two methods were compared with the histological results using the areas within the ROC (receiver operator curves) curves.
  
  
  RESULTS
  The area within the curve for elastography was of 0.952 with a confidence interval between 0.910 and 0.966, error of 0.023, and of 0.867 with a confidence interval between 0.823 and 0.903, error of 0.0333 for the ultrasound. When the areas were compared, a difference between the curves of 0.026 was observed, which was statistically significant.
  
  
  CONCLUSIONS
  This work shows the systematization of the elastographic study using information obtained during compression and after decompression of the ultrasound scan sample, thus showing that elastography might enhance the assessment of risk of malignancy for lesions characterized by the ultrasound.
authors.affiliation: Faculdade de Ciências Médicas, Santa Casa São Paulo. edufleury@hotmail.com
authors.forename: Eduardo de Faria Castro
authors.initials: Ede F
authors.lastname: Fleury
authors.forename: Jose Carlos Vendramini
authors.initials: JC
authors.lastname: Fleury
authors.forename: Vilmar Marques de
authors.initials: VM
authors.lastname: Oliveira
authors.forename: Jose Francisco
authors.initials: JF
authors.lastname: Rinaldi
authors.forename: Sebastiao
authors.initials: S
authors.lastname: Piato
authors.forename: Decio
authors.initials: D
authors.lastname: Roveda Junior
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D054459:Elasticity Imaging Techniques / Q000379:methods*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008875:Middle Aged; D012984:Software; D016217:Ultrasonography, Mammary / Q000379:methods*; D055815:Young Adult