Accuracy of Tumor Sizing in Breast Cancer: A Comparison of Strain Elastography, 3-D Ultrasound and Conventional B-Mode Ultrasound with and without Compound Imaging.
The objective of this study was to compare the accuracy of strain elastography (SE), 3-D ultrasound (US), B-mode US with compound imaging (CI) and B-mode US without compound imaging for lesion sizing in breast cancer. The prospective study included 93 patients with invasive breast cancer. The largest tumor diameters measured by B-mode US, B-mode US with CI, SE and 3-D US were compared in Bland-Altman plots versus pathology as reference. A general linear model repeated measures (GLM Rep) was applied to investigate factors influencing tumor sizing. All methods underestimated pathologic size, with SE (-0.08 ± 7.7 mm) and 3-D US (-1.4 ± 6.5 mm) having the smallest mean differences from pathology. Bland-Altman plots revealed that B-mode US, B-mode US with CI and 3-D US systematically underestimated large tumor sizes, and only SE was technically comparable to pathology. The study indicates that sonographic underestimation of tumor size occurs mainly in tumors >20 mm; in this subgroup, SE is superior to other ultrasound methods.
Interdisciplinary Breast Center, Department of Gynecology and Obstetrics, University of Rostock, Rostock, Germany. Electronic address: angrit.stachs@uni-rostock.de.
Angrit
A
Stachs
Interdisciplinary Breast Center, Department of Gynecology and Obstetrics, University of Rostock, Rostock, Germany.
Alexander
A
Pandjaitan
Interdisciplinary Breast Center, Department of Gynecology and Obstetrics, University of Rostock, Rostock, Germany.
Annett
A
Martin
Interdisciplinary Breast Center, Department of Gynecology and Obstetrics, University of Rostock, Rostock, Germany.
Johannes
J
Stubert
Interdisciplinary Breast Center, Department of Gynecology and Obstetrics, University of Rostock, Rostock, Germany.
Steffi
S
Hartmann
Interdisciplinary Breast Center, Department of Gynecology and Obstetrics, University of Rostock, Rostock, Germany.
Bernd
B
Gerber
Institute for Biostatistics, University of Rostock, Rostock, Germany.
Änne
Ä
Glass
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001940:Breast / Q000000981:diagnostic imaging / Q000473:pathology; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D003937:Diagnosis, Differential; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D047368:Tumor Burden; D016217:Ultrasonography, Mammary / Q000379:methods*
3-D ultrasound; Breast cancer; Size estimation; Strain elastography; Ultrasound