title: Ultrasound Elastography Combined With BI-RADS-US Classification System: Is It Helpful for the Diagnostic Performance of Conventional Ultrasonography?
abstract: OBJECTIVE
  To evaluate the additive diagnostic performance of ultrasound elastography (UE) to ultrasound (US) with the 2003 or 2013 Breast Imaging Reporting and Data System (BI-RADS)-US classification systems for the differentiation of benign and malignant breast lesions.
  
  
  METHODS
  From June 2010 to December 2012, 738 women with 770 breast lesions were recruited into this retrospective study. Breast lesions were evaluated separately by US, UE, and both. US assessment was based on the 2003 or 2013 BI-RADS-US, and UE assessment was based on a previously reported 5-point scale. Diagnostic performance of US, UE, and both was compared.
  
  
  RESULTS
  Before category 4 lesions were subdivided, the area under the receiver operating characteristic curve (AUC) for US, UE, and both were, respectively, 0.735, 0.877, 0.878 (P < .01). When subcategories of 4 lesions were considered, the AUC for US, UE, and both were, respectively, 0.865, 0.877, and 0.883 (P > .05). Adding UE to analysis of 4A lesions can decrease the percentages of malignancy to 2.56%.
  
  
  CONCLUSIONS
  When the 2003 BI-RADS was considered, UE could give US some help in differentiating breast lesions. However, when the 2013 BI-RADS was considered, UE gave little help to US, although it reduced unnecessary biopsies of benign category 4A lesions.
authors.affiliation: Department of Ultrasound, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, China.
authors.forename: Shao-Yun
authors.initials: SY
authors.lastname: Hao
authors.affiliation: Department of Ultrasound, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, China.
authors.forename: Qiong-Chao
authors.initials: QC
authors.lastname: Jiang
authors.affiliation: Department of Ultrasound, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, China.
authors.forename: Wen-Jing
authors.initials: WJ
authors.lastname: Zhong
authors.affiliation: Department of Ultrasound, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, China.
authors.forename: Xin-Bao
authors.initials: XB
authors.lastname: Zhao
authors.affiliation: Department of Ultrasound, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, China.
authors.forename: Ji-Yi
authors.initials: JY
authors.lastname: Yao
authors.affiliation: Department of Ultrasound, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, China.
authors.forename: Lu-Jing
authors.initials: LJ
authors.lastname: Li
authors.affiliation: Department of Ultrasound, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, China.
authors.forename: Bao-Ming
authors.initials: BM
authors.lastname: Luo
authors.affiliation: Department of Ultrasound, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, China. Electronic address: oubing77@163.com.
authors.forename: Bing
authors.initials: B
authors.lastname: Ou
authors.affiliation: Department of Ultrasound, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, China. Electronic address: zhihui18123@163.com.
authors.forename: Hui
authors.initials: H
authors.lastname: Zhi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016217:Ultrasonography, Mammary / Q000379:methods*; D055815:Young Adult
keywords: BI-RADS; Breast lesions; Diagnostic performance; Elastography; Ultrasonography