Breast sonographic elastography using an advanced breast tissue-specific imaging preset: initial clinical results.
OBJECTIVE
The purpose of this study was to evaluate the interpretation criteria, such as the size ratio, stain ratio, and elasticity score, and to assess the diagnostic performance of sonographic elastography by using an advanced breast tissue-specific imaging preset compared with that of conventional sonography for the differentiation of benign and malignant breast masses.


METHODS
Conventional sonography and sonographic elastography with the tissue-specific imaging preset were performed in 104 patients (age range, 17-76 years; mean age, 47.7 years) with 110 breast lesions (67 benign and 43 malignant; mean size, 1.69 cm). The data from the interpretation criteria of sonographic elastography were obtained. The pathologic results from surgical excision or vacuum-assisted removal were used as a reference standard.


RESULTS
The values for the area under the receiver operating characteristic curve were 0.959 (95% confidence interval [CI], 0.902-0.987) for conventional sonography and 0.901 (95% CI, 0.829-0.949), 0.796 (95% CI, 0.708-0.866), and 0.787 (95% CI, 0.699-0.859) for the strain ratio, size ratio, and elasticity score, respectively. When a strain ratio cutoff point of 4.215 was used, the sensitivity and specificity were 86.0% and 85.1%. With a best cutoff point for conventional sonography between Breast Imaging Reporting and Data System categories 4A and 4B, the sensitivity and specificity were 93.0% and 83.6%.


CONCLUSIONS
The strain ratio showed the best diagnostic performance among the interpretation criteria for sonographic elastography with the tissue-specific imaging preset. The diagnostic performance was slightly higher for Breast Imaging Reporting and Data System categories than for the strain ratio. However, there was no statistical significance (P = .052).
Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul 135-710, Korea.
Hyun Jin
HJ
Jung
Soo Yeon
SY
Hahn
Hye-Young
HY
Choi
Sung Hee
SH
Park
Heung Kyu
HK
Park
D000293:Adolescent; D000328:Adult; D000368:Aged; D019540:Area Under Curve; D001706:Biopsy; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008875:Middle Aged; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016217:Ultrasonography, Mammary / Q000379:methods*