title: Combined Use of Ultrasound Elastography and B-Mode Sonography for Differentiation of Benign and Malignant Circumscribed Breast Masses.
abstract: OBJECTIVE
  To evaluate the diagnostic performance of combined B-mode sonography and ultrasound elastography for differentiation between benign and malignant breast masses with circumscribed margins.
  
  
  METHODS
  We analyzed 109 pathologically proven circumscribed breast masses. Two radiologists retrospectively reviewed B-mode sonograms and elastograms in consensus. Based on the American College of Radiology Breast Imaging Reporting and Data System, we determined categories of the masses on B-mode sonography. Elastographic scores were assessed by a 3-point scale (negative, 0; equivocal, 1; and positive, 2). When the elastographic score for a lesion was 0 or 2, we downgraded or upgraded the B-mode category, respectively; thus, the reclassified Breast Imaging Reporting and Data System category was defined as the "reclassification category." Mean category values for benign and malignant lesions were compared by a Student t test. The diagnostic performance of B-mode, elastographic, and reclassification assessments was compared by receiver operating characteristic curve analysis.
  
  
  RESULTS
  The mean B-mode category (2.5 versus 1.7), elastographic score (1.7 versus 0.8), and reclassification category (3.2 versus 1.6) were significantly higher in malignant than benign lesions (P < .001). The area under the curve for reclassification assessment was significantly higher than that for B-mode sonography (0.916 versus 0.795; P < .05). With a cutoff value between 1 and 2, the specificity was increased from 26.5% to 42.9% after reclassification.
  
  
  CONCLUSIONS
  For differentiation between benign and malignant circumscribed breast masses, combined use of B-mode sonography and elastography could provide a better diagnostic performance than B-mode sonography alone.
authors.affiliation: Department of Radiology, Hanyang University College of Medicine, Hanyang University Guri Hospital, Gyeonggi-do, Korea (S.-Y.K.); and Department of Radiology, Hanyang University College of Medicine, Hanyang University Hospital, Seoul, Korea (J.S.P., H.R.K.).
authors.forename: Soo-Yeon
authors.initials: SY
authors.lastname: Kim
authors.affiliation: Department of Radiology, Hanyang University College of Medicine, Hanyang University Guri Hospital, Gyeonggi-do, Korea (S.-Y.K.); and Department of Radiology, Hanyang University College of Medicine, Hanyang University Hospital, Seoul, Korea (J.S.P., H.R.K.). jsp@hanyang.ac.kr.
authors.forename: Jeong Seon
authors.initials: JS
authors.lastname: Park
authors.affiliation: Department of Radiology, Hanyang University College of Medicine, Hanyang University Guri Hospital, Gyeonggi-do, Korea (S.-Y.K.); and Department of Radiology, Hanyang University College of Medicine, Hanyang University Hospital, Seoul, Korea (J.S.P., H.R.K.).
authors.forename: Hye Ryoung
authors.initials: HR
authors.lastname: Koo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000465:Algorithms; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016217:Ultrasonography, Mammary / Q000379:methods*; D055815:Young Adult
keywords: breast; breast ultrasound; elasticity imaging techniques; sonography