title: Application of real-time ultrasound elastography for differential diagnosis of breast tumors.
abstract: OBJECTIVE
  The purpose of this study was to explore the clinical value of real-time ultrasound elastography in differentiating malignant from benign breast tumors and to determine an optimal cutoff for the traced area ratio by receiver operator characteristic (ROC) analysis for differential diagnosis between malignant and benign breast masses.
  
  
  METHODS
  From October 2010 to June 2011, 102 patients with 192 breast tumors were enrolled. Conventional sonograms and real-time elastograms were obtained from the patients. The sensitivity, specificity, and accuracy rates for sonography and elastography were calculated, and an ROC analysis was performed.
  
  
  RESULTS
  Tumors with an elasticity grade of 4 or higher were defined as malignant. The sensitivity, specificity, and accuracy of elastography were 92.65%, 73.39%, and 81.25%, respectively. These values were similar to those for conventional sonography. However, when the techniques were combined, the sensitivity, specificity, and accuracy increased to 88.23%, 95.97%, and 93.23%. A value of 1.65 was determined to be the traced area ratio cutoff by the ROC analysis and was used in this study for differential diagnosis. The sensitivity, specificity, and accuracy of this value were 76.47%, 96.77%, and 89.58%, respectively.
  
  
  CONCLUSIONS
  Both conventional sonography and ultrasound elastography could be used to differentiate malignant and benign breast tumors. If these techniques were combined, the diagnostic values would improve. In addition, a traced area ratio of 1.65 could be used as a cutoff to differentiate benign and malignant breast tumors.
authors.affiliation: Department of Ultrasound, Shanghai Huashan Hospital, Fudan University, 12 Urumqi Zhong Rd, Jing'an District, 200040 Shanghai, China. y_wang1111@hotmailcom.
authors.forename: Xia
authors.initials: X
authors.lastname: Gong
authors.forename: Yi
authors.initials: Y
authors.lastname: Wang
authors.forename: Ping
authors.initials: P
authors.lastname: Xu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D003199:Computer Systems; D003937:Diagnosis, Differential; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D012372:ROC Curve; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016217:Ultrasonography, Mammary / Q000379:methods*; D055815:Young Adult
keywords: breast tumor; conventional sonography; real-time elastography; traced area ratio