title: Elastography ultrasound for breast lesions: fat-to-lesion strain ratio vs gland-to-lesion strain ratio.
abstract: OBJECTIVE
  To compare the diagnostic performance of the fat-to-lesion strain ratio (FLR) and gland-to-lesion strain ratio (GLR) in the diagnosis of breast lesions.
  
  
  METHODS
  This was an institutional ethics committee approved prospective study. One hundred and ninety-three breast lesions in 193 women (mean age, 46.03 ± 13.60 years, range 18-82 years) were examined with conventional and elastographic US. Both the FLR and GLR of the lesions were calculated. The elasticity scores of the lesions were also evaluated using the five-point elasticity scoring system. For diagnostic performance, the sensitivity, specificity and receiver operating characteristic (ROC) analysis were obtained.
  
  
  RESULTS
  Seventy lesions were malignant and 123 were benign. Both the FLR and GLR of the lesions were significantly higher in malignant cases than in benign ones (P < 0.001 for both). The Az values for the FLR (0.847) and the elasticity score (0.829) were significantly higher than that for the GLR (0.752) (P = 0.009, P = 0.029, respectively). However, there was no significant difference in the Az value between the FLR and the elasticity score (P = 0.443).
  
  
  CONCLUSIONS
  The FLR yielded better diagnostic performance than GLR in breast lesions; the fatty tissue was better than glandular tissue as the reference normal tissue for calculating strain ratio in breast elastography.
  
  
  CONCLUSIONS
  FLR was higher than GLR in both malignant and benign breast lesions. Both FLR and GLR were higher in malignant than in benign breast lesions. FLR yielded better diagnostic performance than GLR in breast lesions.
authors.affiliation: Department of Ultrasound, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200025, China.
authors.forename: JianQiao
authors.initials: J
authors.lastname: Zhou
authors.forename: Chun
authors.initials: C
authors.lastname: Zhou
authors.forename: WeiWei
authors.initials: W
authors.lastname: Zhan
authors.forename: XiaoHong
authors.initials: X
authors.lastname: Jia
authors.forename: YiJie
authors.initials: Y
authors.lastname: Dong
authors.forename: ZhiFang
authors.initials: Z
authors.lastname: Yang
mesh_terms: D000273:Adipose Tissue / Q000473:pathology / Q000648:ultrastructure; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D001941:Breast Diseases / Q000000981:diagnostic imaging* / Q000473:pathology; D003937:Diagnosis, Differential; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D012372:ROC Curve; D016217:Ultrasonography, Mammary; D055815:Young Adult