title: Elastography ultrasound and questionable breast lesions: does it count?
abstract: OBJECTIVE
  To check possible additional value of using elastography ultrasound in the specification of questionable breast lesions.
  
  
  METHODS
  Questionable breast lesions on gray scale ultrasound examination had been further evaluated by elastography ultrasound in 97 cases with median age of 42 years. The studied lesions were pathologically proven (58 benign and 39 malignant) using true cut tissue/surgical excision biopsy that was considered the gold standard of reference.
  
  
  RESULTS
  Conventional ultrasound categorization before biopsy included: category 3 (probably benign) in 42.3% (n=41), category 4a (low suspicion of malignancy) in 13.4% (n=13), category 4b (intermediate suspicion of malignancy) in 16.5% (n=16) and category 4c (moderate suspicion of malignancy) in 27.8% (n=27). We had evaluated elastography ultrasound regarding elastography strain scoring and quantitative strain ratio. Sensitivity, specificity and accuracy were 89.7%, 86.2% and 87.6% for conventional ultrasound, 92.3%, 74.1% and 81.4% for elastogram 5-point scoring method and 87.1%, 89.6% and 88.6% for the calculated strain ratios respectively in the assessment of the examined breast lesions.
  
  
  CONCLUSIONS
  Ultrasound elastography, using both qualitative and quantitative methods can improve the performance of conventional B-mode ultrasound and enhance its specificity and accuracy in the diagnosis of questionable (BI-RADS categories 3 and 4) breast lesions.
authors.affiliation: Radiology Department (Women's Imaging Unit), Faculty of Medicine, Cairo University, Egypt. sahar_mnsr@yahoo.com
authors.forename: Sahar M
authors.initials: SM
authors.lastname: Mansour
authors.forename: Omar S
authors.initials: OS
authors.lastname: Omar
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016217:Ultrasonography, Mammary / Q000379:methods*