title: Value of Virtual Touch Tissue Imaging Quantification for Evaluation of Ultrasound Breast Imaging-Reporting and Data System Category 4 Lesions.
abstract: The purpose of the study was to evaluate the value of 2-D shear wave elastography (SWE) of virtual touch tissue imaging quantification (VTIQ) for ultrasound (US) Breast Imaging-Reporting and Data System (BI-RADS) category 4 lesions. One hundred sixteen lesions were subject to conventional US, conventional strain elastography (SE) of elasticity imaging (EI), acoustic radiation force impulse (ARFI)-induced SE of virtual touch tissue imaging (VTI) and VTIQ before biopsies. Of the 116 lesions, 69 (59.5%) were benign and 47 (40.5%) were malignant. Significant differences were found between benign and malignant lesions in EI score, VTI score and shear wave speed (SWS) on VTIQ (both p < 0.05). The cut-off values were EI score ≥4, VTI score ≥4 and SWS ≥3.49 m/s, respectively. The diagnostic performance of VTIQ in terms of area under receiver operating characteristic curve (AUROC) were the highest (i.e., AUROC = 0.907), in comparison with EI, VTI alone or a combination of both. The associated sensitivity, specificity and accuracy were 87.2%, 82.6% and 84.5%, respectively. The combination of VTI and VTIQ, however, was similar with US BI-RADS (p = 0.475) in sensitivity in that only two (4.3%) of 47 malignant lesions were misdiagnosed as benign that were BI-RADS category 4b on US. VTIQ is valuable to differentiate benign from malignant BI-RADS category 4 lesions, and the combination of VTI and VTIQ might be useful for patient selection before biopsy.
authors.affiliation: Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, China.
authors.forename: Xiao-Long
authors.initials: XL
authors.lastname: Li
authors.affiliation: Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, China; Department of Ultrasound, Guangdong Medical College Affiliated Hospital, Zhanjiang, China. Electronic address: xuhuixiong@126.com.
authors.forename: Hui-Xiong
authors.initials: HX
authors.lastname: Xu
authors.affiliation: Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, China.
authors.forename: Xiao-Wan
authors.initials: XW
authors.lastname: Bo
authors.affiliation: Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, China.
authors.forename: Bo-Ji
authors.initials: BJ
authors.lastname: Liu
authors.affiliation: Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, China; Department of Ultrasound, Second People's Hospital of Shenzhen, Shenzhen, China.
authors.forename: Xian
authors.initials: X
authors.lastname: Huang
authors.affiliation: Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, China.
authors.forename: Dan-Dan
authors.initials: DD
authors.lastname: Li
authors.affiliation: Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, China.
authors.forename: Le-Hang
authors.initials: LH
authors.lastname: Guo
authors.affiliation: Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, China.
authors.forename: Jun-Mei
authors.initials: JM
authors.lastname: Xu
authors.affiliation: Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, China.
authors.forename: Li-Ping
authors.initials: LP
authors.lastname: Sun
authors.affiliation: Department of Thyroid and Breast Surgery, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Fang
authors.affiliation: Department of Ultrasound, Guangdong Medical College Affiliated Hospital, Zhanjiang, China.
authors.forename: Xiao-Hong
authors.initials: XH
authors.lastname: Xu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D001940:Breast / Q000000981:diagnostic imaging; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011247:Pregnancy; D011873:Radiology Information Systems; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016217:Ultrasonography, Mammary / Q000379:methods*; D055815:Young Adult
keywords: 2-D shear wave elastography; Acoustic radiation force impulse; Breast Imaging-Reporting and Data System category 4 lesions; Breast lesion; Conventional ultrasound; Virtual touch tissue imaging quantification