title: Breast Diagnosis: Concordance Analysis Between the BI-RADS Classification and Tsukuba Sonoelastography Score.
abstract: OBJECTIVE
  To establish the correlations between the ultrasound (US) BI-RADS classification and Tsukuba elastography score when assessing breast lesions. To determine which type of breast lesion (BI-RADS category) would benefit most from an elastographic assessment.
  
  
  METHODS
  The investigated sample of imaging comprised a number of 129 images belonging to 92 subjects examined with a Hitachi 8500 US device. Each lesion was assessed according to the BI-RADS and Tsukuba elastography score. Histopathology was obtained by means of percutaneous biopsy or post-surgery. Fibroadenoma-like lesions unchanged over a period of 3 years were considered benign.
  
  
  RESULTS
  The 1, 2 and BGR Tsukuba scores mostly correlated with BI-RADS II and III lesions such as cysts, hamartomas, lipomas, hematomas, non-palpable fibroadenomas. Palpable fibroadenomas initially included in BI-RADS IVa/b category, usually received benign elasticity scores (1 or 2), the exception being represented by a minority of cases of old, fibrotic or calcified lesions (elastic score 3 or 4). Non-specific BI-RADS IVa/b lesions, such as mastopathic nodules demonstrated rather soft, elastic properties on elastogram (score 1 or 2). The 4 and 5 Ueno-Itoh scores were predominantly correlated with BI-RADS IVc and V categories represented by high risk lesions (radial scar, papillomas, atypical epithelial ductal hyperplasia) and in situ or invasive carcinomas.
  
  
  CONCLUSIONS
  Generally the BI-RADS classification correlates well with the Tsukuba elasticity score, the main exception being represented by fibrotic, calcified lesions which falsely appear more suspicious post-elastography. BI-RADS III and IV lesions would benefit most from an elastographic assessment, a low Tsukuba score allowing a less invasive approach, while a high score imposes histopathological evaluation.
authors.affiliation: Department of Radiology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania ; Radiology Clinic - Cluj Napoca ER County Hospital, Romania.
authors.forename: Maria Magdalena
authors.initials: MM
authors.lastname: Duma
authors.affiliation: Department of Radiology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania ; Radiology Clinic - Cluj Napoca ER County Hospital, Romania.
authors.forename: Angelica Rita
authors.initials: AR
authors.lastname: Chiorean
authors.affiliation: 5th year medical student, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania.
authors.forename: Marco
authors.initials: M
authors.lastname: Chiorean
authors.affiliation: Department of Medical Informatics and Biostatistics, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania.
authors.forename: Sorana Daniela
authors.initials: SD
authors.lastname: Bolboaca
authors.affiliation: Radiology Clinic - Cluj Napoca ER County Hospital, Romania.
authors.forename: Madalina
authors.initials: M
authors.lastname: Florea
authors.affiliation: Department of Radiology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania ; Radiology Clinic - Cluj Napoca ER County Hospital, Romania.
authors.forename: Diana Sorina
authors.initials: DS
authors.lastname: Feier
authors.affiliation: Department of Radiology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania ; Radiology Clinic - Cluj Napoca ER County Hospital, Romania.
authors.forename: Georgeta Mihaela
authors.initials: GM
authors.lastname: Rusu
authors.affiliation: Department of Radiology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania ; Radiology Clinic - Cluj Napoca ER County Hospital, Romania.
authors.forename: Silviu Andrei
authors.initials: SA
authors.lastname: Sfrangeu
keywords: BI-RADS; Tsukuba; breast; elastography; ultrasound