title: Combination of Virtual Touch Tissue Imaging and Virtual Touch Tissue Quantification for Differential Diagnosis of Breast Lesions.
abstract: OBJECTIVE
  Breast cancer is the second leading cause of death from cancer in women, and early detection is the key to successful treatment. Unfortunately, even with technological advances, the specificity of imaging modalities is still low. Therefore, we evaluated the value of a newly developed noninvasive technique, acoustic radiation force impulse imaging, for differentiating benign versus malignant breast lesions.
  
  
  METHODS
  We prospectively examined 141 breast lesions in 122 patients. All lesions were classified according to the American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) for mammography, BI-RADS for sonography, and Virtual Touch tissue imaging (VTI; Siemens Medical Solutions, Mountain View, CA) pattern. Internal and marginal shear wave velocity (SWV) values for the lesions were noted. The sensitivity, specificity, accuracy, and positive and negative predictive values for VTI and Virtual Touch tissue quantification (VTQ; Siemens Medical Solutions) were calculated.
  
  
  RESULTS
  The marginal SWV values were statistically higher in malignant lesions (mean ± SD, 5.41 ± 1.37 m/s) than benign lesions (2.91 ± 0.88 m/s; P < .001). When the SWV cutoff level was set at 4.07 m/s, and the higher of the internal and marginal values was adopted, the combination of VTI and VTQ showed 95.1% sensitivity, 99.0% specificity, and 97.8% accuracy.
  
  
  CONCLUSIONS
  Breast Imaging Reporting and Data System category 4 lesions are the main focus of research for early detection of breast cancer. Unfortunately, BI-RADS category 4 assessment covers a wide range of likelihood of malignancy (2%-95%). This wide range reflects the necessity for a more specific imaging modality. The combination of VTI and VTQ could increase the diagnostic performance of conventional sonography.
authors.affiliation: Departments of Radiology (M.T., G.G., C.H., M.G.Ç., S.H., B.A., G.T.), Radiation Oncology (F.T.), and General Surgery (Ö.U.), Dicle University, Medical School, Diyarbakır, Turkey. memikteke@gmail.com.
authors.forename: Memik
authors.initials: M
authors.lastname: Teke
authors.affiliation: Departments of Radiology (M.T., G.G., C.H., M.G.Ç., S.H., B.A., G.T.), Radiation Oncology (F.T.), and General Surgery (Ö.U.), Dicle University, Medical School, Diyarbakır, Turkey.
authors.forename: Cemil
authors.initials: C
authors.lastname: Göya
authors.affiliation: Departments of Radiology (M.T., G.G., C.H., M.G.Ç., S.H., B.A., G.T.), Radiation Oncology (F.T.), and General Surgery (Ö.U.), Dicle University, Medical School, Diyarbakır, Turkey.
authors.forename: Fatma
authors.initials: F
authors.lastname: Teke
authors.affiliation: Departments of Radiology (M.T., G.G., C.H., M.G.Ç., S.H., B.A., G.T.), Radiation Oncology (F.T.), and General Surgery (Ö.U.), Dicle University, Medical School, Diyarbakır, Turkey.
authors.forename: Ömer
authors.initials: Ö
authors.lastname: Uslukaya
authors.affiliation: Departments of Radiology (M.T., G.G., C.H., M.G.Ç., S.H., B.A., G.T.), Radiation Oncology (F.T.), and General Surgery (Ö.U.), Dicle University, Medical School, Diyarbakır, Turkey.
authors.forename: Cihad
authors.initials: C
authors.lastname: Hamidi
authors.affiliation: Departments of Radiology (M.T., G.G., C.H., M.G.Ç., S.H., B.A., G.T.), Radiation Oncology (F.T.), and General Surgery (Ö.U.), Dicle University, Medical School, Diyarbakır, Turkey.
authors.forename: Mehmet Guli
authors.initials: MG
authors.lastname: Çetinçakmak
authors.affiliation: Departments of Radiology (M.T., G.G., C.H., M.G.Ç., S.H., B.A., G.T.), Radiation Oncology (F.T.), and General Surgery (Ö.U.), Dicle University, Medical School, Diyarbakır, Turkey.
authors.forename: Salih
authors.initials: S
authors.lastname: Hattapoğlu
authors.affiliation: Departments of Radiology (M.T., G.G., C.H., M.G.Ç., S.H., B.A., G.T.), Radiation Oncology (F.T.), and General Surgery (Ö.U.), Dicle University, Medical School, Diyarbakır, Turkey.
authors.forename: Bircan
authors.initials: B
authors.lastname: Alan
authors.affiliation: Departments of Radiology (M.T., G.G., C.H., M.G.Ç., S.H., B.A., G.T.), Radiation Oncology (F.T.), and General Surgery (Ö.U.), Dicle University, Medical School, Diyarbakır, Turkey.
authors.forename: Güven
authors.initials: G
authors.lastname: Tekbaş
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D054459:Elasticity Imaging Techniques; D005260:Female; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014110:Touch; D016217:Ultrasonography, Mammary / Q000295:instrumentation*; D014584:User-Computer Interface
keywords: Virtual Touch tissue imaging; Virtual Touch tissue quantification; acoustic radiation force impulse imaging; breast cancer; breast ultrasound; shear wave velocity