title: Differential diagnosis of idiopathic granulomatous mastitis and breast cancer using acoustic radiation force impulse imaging.
abstract: OBJECTIVE
  Differentiation of idiopathic granulomatous mastitis (IGM) from carcinoma with routine imaging methods, such as ultrasonography (US) and mammography, is difficult. Therefore, we evaluated the value of a newly developed noninvasive technique called acoustic radiation force impulse imaging in differentiating IGM versus malignant lesions in the breast.
  
  
  METHODS
  Four hundred and eighty-six patients, who were referred to us with a presumptive diagnosis of a mass, underwent Virtual Touch tissue imaging (VTI; Siemens) and Virtual Touch tissue quantification (VTQ; Siemens) after conventional gray-scale US. US-guided percutaneous needle biopsy was then performed on 276 lesions with clinically and radiologically suspicious features. Malignant lesions (n = 122) and IGM (n = 48) were included in the final study group.
  
  
  RESULTS
  There was a statistically significant difference in shear wave velocity marginal and internal values between the IGM and malignant lesions. The median marginal velocity for IGM and malignant lesions was 3.19 m/s (minimum-maximum 2.49-5.82) and 5.05 m/s (minimum-maximum 2.09-8.46), respectively (p < 0.001). The median internal velocity for IGM and malignant lesions was 2.76 m/s (minimum-maximum 1.14-4.12) and 4.79 m/s (minimum-maximum 2.12-8.02), respectively (p < 0.001).
  
  
  CONCLUSIONS
  The combination of VTI and VTQ as a complement to conventional US provides viscoelastic properties of tissues, and thus has the potential to increase the specificity of US.
authors: Department of Radiology, Medical School, Dicle University, Yenişehir, 21280, Diyarbakır, Turkey. memikteke@gmail.com.
authors: Memik
authors: M
authors: Teke
authors: Department of Radiation Oncology, Medical School, Dicle University, Diyarbakir, Turkey.
authors: Fatma
authors: F
authors: Teke
authors: Department of Radiology, Medical School, Dicle University, Yenişehir, 21280, Diyarbakır, Turkey.
authors: Bircan
authors: B
authors: Alan
authors: Department of General Surgery, Medical School, Dicle University, Diyarbakir, Turkey.
authors: Ahmet
authors: A
authors: Türkoğlu
authors: Department of Radiology, Medical School, Dicle University, Yenişehir, 21280, Diyarbakır, Turkey.
authors: Cihad
authors: C
authors: Hamidi
authors: Department of Radiology, Medical School, Dicle University, Yenişehir, 21280, Diyarbakır, Turkey.
authors: Cemil
authors: C
authors: Göya
authors: Department of Radiology, Medical School, Dicle University, Yenişehir, 21280, Diyarbakır, Turkey.
authors: Salih
authors: S
authors: Hattapoğlu
authors: Department of General Surgery, Medical School, Dicle University, Diyarbakir, Turkey.
authors: Metehan
authors: M
authors: Gumus
mesh_terms: 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; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration; D005260:Female; D058890:Granulomatous Mastitis / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D016217:Ultrasonography, Mammary / Q000379:methods*
keywords: Acoustic radiation force impulse imaging; Breast cancer; Idiopathic granulomatous mastitis; Shear wave velocity; Virtual Touch tissue imaging