title: Impact of breast mass size on accuracy of ultrasound elastography vs. conventional B-mode ultrasound: a meta-analysis of individual participants.
abstract: OBJECTIVE
  To conduct an individual patient data meta-analysis comparing the diagnostic performance of ultrasound elastography (USE) versus B-mode ultrasound (USB) across size ranges of breast masses.
  
  
  METHODS
  An extensive literature search of PubMed and other medical/general purpose databases from inception through August 2011 was conducted. Corresponding authors of published studies that reported a direct comparison of the diagnostic performance of USE using the elasticity score versus USB for characterisation of focal breast masses were contacted for their original patient-level data set. Summary diagnostic performance measures were compared for each test within and across three mass size groups (<10 mm, 10-19 mm, and >19 mm).
  
  
  RESULTS
  The patient-level data sets were received from five studies, providing information on 1,412 breast masses. For breast masses <10 mm (n = 543; 121 malignant), the sensitivity/specificity of USE and USB were 76 %/93 % and 95 %/68 %, respectively. For masses 10-19 mm of size (n = 528; 247 malignant), sensitivity/specificity of USE and USB were 82 %/90 % and 95 %/67 %, respectively. For masses >19 mm of size (n = 325; 162 malignant), sensitivity/specificity of USE and USB were 74 %/94 % and 97 %/55 %, respectively.
  
  
  CONCLUSIONS
  Regardless of the mass size, USE has higher specificity and lower sensitivity compared to USB in characterising breast masses. The performance of each of these two tests does not vary significantly by mass size.
authors.affiliation: Department of Radiology, University of Michigan Medical Center, 1500 E. Medical Center Dr, B1 132H Taubman Center, Ann Arbor, MI 48109-5302, USA. gelarehsadigh@yahoo.com
authors.forename: Gelareh
authors.initials: G
authors.lastname: Sadigh
authors.forename: Ruth C
authors.initials: RC
authors.lastname: Carlos
authors.forename: Colleen H
authors.initials: CH
authors.lastname: Neal
authors.forename: Sebastian
authors.initials: S
authors.lastname: Wojcinski
authors.forename: Ben A
authors.initials: BA
authors.lastname: Dwamena
mesh_terms: D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000473:pathology*; D054459:Elasticity Imaging Techniques / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D009929:Organ Size; D015995:Prevalence; D015203:Reproducibility of Results; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D016217:Ultrasonography, Mammary / Q000706:statistics & numerical data*