title: New diagnostic criteria in real-time elastography for the assessment of breast lesions.
abstract: OBJECTIVE
  Elastography is a new ultrasonographic method that has been examined as a diagnostic tool for breast lesions. This study was intended to create and define new elastographic criteria allowing assessment of whether breast lesions are malignant or benign.
  
  
  METHODS
  217 patients with a total of 245 breast lesions of unknown malignancy underwent ultrasound examination. The new eSie Touch Elasticity Imaging technology (Siemens, Erlangen, Germany) was used with a 10-MHz linear transducer (Acuson Antares). Lesions were examined using B-mode and real-time elastography (RTE). Each lesion was histologically assessed by core biopsy. Five RTE characteristics were examined: elasticity proportion (EP), different location on RTE in comparison with B-mode (MV), different contrast patterns (SOS), dorsal lesion limitation visibility and different size on RTE in comparison with B-mode.
  
  
  RESULTS
  54 malignant lesions (54 %) appeared inelastic, in contrast to the benign control group (34.5 %; P = 0.001). A completely elastic pattern was visible in 10 malignant (10 %) and 39 benign lesions (26.9 %). MV was identified in 23 cases, with 22 of the lesions being malignant and one benign. The SOS was negative in 89 malignant lesions (89 %) and positive in 100 benign lesions. The dorsal lesion limitation was visible on RTE without B-mode in 88 malignant lesions (88 %) and 27 benign lesions (18.6 %). The size was assessed as larger in 45 malignant lesions (45 %) and seven benign lesions (4.8 %).
  
  
  CONCLUSIONS
  SOS and a larger tumor size on RTE are specific characteristics of malignant breast lesions. EP, MV and distal mass border are further helpful signs to assess the malignancy of tumors.
authors.affiliation: Universität Erlangen, Diagnostische Radiologie, Erlangen.
authors.forename: B R
authors.initials: BR
authors.lastname: Adamietz
authors.forename: M
authors.initials: M
authors.lastname: Meier-Meitinger
authors.forename: P
authors.initials: P
authors.lastname: Fasching
authors.forename: M
authors.initials: M
authors.lastname: Beckmann
authors.forename: A
authors.initials: A
authors.lastname: Hartmann
authors.forename: M
authors.initials: M
authors.lastname: Uder
authors.forename: L
authors.initials: L
authors.lastname: Häberle
authors.forename: R
authors.initials: R
authors.lastname: Schulz-Wendtland
authors.forename: S A
authors.initials: SA
authors.lastname: Schwab
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging; D004548:Elasticity; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D018226:Fibroadenoma / Q000000981:diagnostic imaging; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008875:Middle Aged; D015999:Multivariate Analysis; D018300:Papilloma, Intraductal / Q000000981:diagnostic imaging; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D016217:Ultrasonography, Mammary / Q000379:methods*; D055815:Young Adult