title: Diagnostic Performance and Additional Value of Elastosonography in Focal Breast Lesions: Statistical Correlation between Size-Dependant Strain Index Measurements, Multimodality-BI-RADS Score, and Histopathology in a Clinical Routine Setting.
abstract: Objective. To evaluate the diagnostic benefit of real-time elastography (RTE) in clinical routine. Strain indices (SI) for benign and malignant tumors were assessed. Methods. 100 patients with 110 focal breast lesions were retrieved. Patients had mammography (MG), ultrasound (US), and, if necessary, MRI. RTE was conducted after ultrasound. Lesions were assessed with BI-RADS for mammography and ultrasound. Diagnosis was established with histology or follow-up. Results. SI for BI-RADS 2 was 1.71 ± 0.86. Higher SI (2.21 ± 1.96) was observed for BI-RADS 3 lesions. SI of BI-RADS 4 and 5 lesions were significantly higher (16.92 ± 20.89) and (19.54 ± 10.41). 31 malignant tumors exhibited an average SI of 16.13 ± 14.67; SI of benign lesions was 5.29 ± 11.87 (P value <0.0001). ROC analysis threshold was >3.8 for malignant disease. Sensitivity of sonography was 90.3% (specificity 78.5%). RTE showed a sensitivity of 87.1% (specificity 79.7%). Accuracy of all modalities combined was 96.8%. In BI-RADS 3 lesions RTE was able to detect all malignant lesions (sensitivity 100%, specificity 92.9%, and accuracy 93.9%). Conclusions. RTE increased sensitivity and specificity for breast cancer detection when used in combination with ultrasound.
authors: Department for Diagnostic, Interventional and Pediatric Radiology, University Hospital Inselspital Bern, Freiburgstraße 10, 3010 Bern, Switzerland.
authors: Lukas
authors: 0000-0001-5117-6047
authors: L
authors: Ebner
authors: Department for Diagnostic, Interventional and Pediatric Radiology, University Hospital Inselspital Bern, Freiburgstraße 10, 3010 Bern, Switzerland.
authors: Harald M
authors: HM
authors: Bonel
authors: Department for Diagnostic, Interventional and Pediatric Radiology, University Hospital Inselspital Bern, Freiburgstraße 10, 3010 Bern, Switzerland.
authors: Adrian
authors: A
authors: Huber
authors: Institute of Forensic Medicine, University of Zürich, Virtopsy, 8057 Zurich, Switzerland.
authors: Steffen
authors: 0000-0002-0928-4084
authors: S
authors: Ross
authors: Department for Diagnostic, Interventional and Pediatric Radiology, University Hospital Inselspital Bern, Freiburgstraße 10, 3010 Bern, Switzerland.
authors: Andreas
authors: A
authors: Christe