title: Evaluation of virtual touch tissue imaging quantification, a new shear wave velocity imaging method, for breast lesion assessment by ultrasound.
abstract: OBJECTIVE
  To evaluate virtual touch tissue imaging quantification (VTIQ) as a new elastography method concerning its intra- and interexaminer reliability and its ability to differentiate benign from malignant breast lesions in comparison to and in combination with ultrasound (US) B-mode breast imaging reporting and data system (BI-RADS) assessment.
  
  
  METHODS
  US and VTIQ were performed by two examiners in 103 women with 104 lesions. Intra- and interexaminer reliability of VTIQ was assessed. The area under the receiver operating curve (AUC), sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of BIRADS, VTIQ, and combined data were compared.
  
  
  RESULTS
  Fifty-four of 104 lesions were malignant. Intraexaminer reliability was consistent, and interexaminer agreement showed a strong positive correlation (r = 0.93). The mean VTIQ values in malignant lesions were significantly higher than those in benign (7.73 m/s ± 1.02 versus 4.46 m/s ± 1.87; P < 0.0001). The combination of US-BIRADS with the optimal cut-off for clinical decision making of 5.18 m/s yielded a sensitivity of 98%, specificity of 82%, PPV of 86%, and NPV of 98%. The combination of BIRADS and VTIQ led to improved test validity.
  
  
  CONCLUSIONS
  VTIQ is highly reliable and reproducible. There is a significant difference regarding the mean maximum velocity of benign and malignant lesions. Adding VTIQ to BIRADS assessment improves the specificity.
authors.affiliation: Breast Unit, University of Heidelberg, Im Neuenheimer Feld 440, 69120 Heidelberg, Germany.
authors.forename: Michael
authors.identifier: 0000-0002-2605-0060
authors.initials: M
authors.lastname: Golatta
authors.affiliation: Breast Unit, University of Heidelberg, Im Neuenheimer Feld 440, 69120 Heidelberg, Germany.
authors.forename: Mirjam
authors.identifier: 0000-0002-2632-4631
authors.initials: M
authors.lastname: Schweitzer-Martin
authors.affiliation: Breast Unit, University of Heidelberg, Im Neuenheimer Feld 440, 69120 Heidelberg, Germany.
authors.forename: Aba
authors.initials: A
authors.lastname: Harcos
authors.affiliation: Breast Unit, University of Heidelberg, Im Neuenheimer Feld 440, 69120 Heidelberg, Germany.
authors.forename: Sarah
authors.initials: S
authors.lastname: Schott
authors.affiliation: Breast Unit, University of Heidelberg, Im Neuenheimer Feld 440, 69120 Heidelberg, Germany.
authors.forename: Christina
authors.initials: C
authors.lastname: Gomez
authors.affiliation: Breast Unit, University of Heidelberg, Im Neuenheimer Feld 440, 69120 Heidelberg, Germany.
authors.forename: Anne
authors.initials: A
authors.lastname: Stieber
authors.affiliation: Institute of Medical Biometry and Informatics, University of Heidelberg, 69120 Heidelberg, Germany.
authors.forename: Geraldine
authors.initials: G
authors.lastname: Rauch
authors.affiliation: Breast Unit, University of Heidelberg, Im Neuenheimer Feld 440, 69120 Heidelberg, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Domschke
authors.affiliation: Breast Unit, University of Heidelberg, Im Neuenheimer Feld 440, 69120 Heidelberg, Germany.
authors.forename: Joachim
authors.initials: J
authors.lastname: Rom
authors.affiliation: Breast Unit, University of Heidelberg, Im Neuenheimer Feld 440, 69120 Heidelberg, Germany.
authors.forename: Florian
authors.initials: F
authors.lastname: Schütz
authors.affiliation: Breast Unit, University of Heidelberg, Im Neuenheimer Feld 440, 69120 Heidelberg, Germany.
authors.forename: Christof
authors.initials: C
authors.lastname: Sohn
authors.affiliation: Breast Unit, University of Heidelberg, Im Neuenheimer Feld 440, 69120 Heidelberg, Germany.
authors.forename: Jörg
authors.initials: J
authors.lastname: Heil
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D001943:Breast Neoplasms / Q000737:chemistry / Q000000981:diagnostic imaging* / Q000453:epidemiology; D015331:Cohort Studies; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008875:Middle Aged; D012372:ROC Curve; D055815:Young Adult