Can strain elastography combined with ultrasound breast imaging reporting and data system be a more effective method in the differentiation of benign and malignant breast lesions?
OBJECTIVE
To investigate whether a novel method that combines breast imaging reporting and data system (BI-RADS) with strain elastography contributes to diagnostic performance in differentiation of malignant and benign breast lesions.


METHODS
In 81 patients, 81 breast lesions were prospectively investigated. Breast lesions were separately evaluated with ultrasonography and strain elastography. While evaluations with ultrasonography were based on 2003 BI-RADS-US, strain elastography evaluations were based on a 5-point scale and strain ratio. Diagnostic performances of ultrasonography, strain elastography, and the combined method were compared.


RESULTS
Among 81 lesions, 43 (53.1%) were benign and 38 (46.9%) were malignant. When a cutoff point of category 3 was used, sensitivity, specificity, positive and negative predictive values, and accuracy for BI-RADS were 100, 11.6, 50, 100, and 53%, respectively. When BI-RADS and strain ratio were combined, sensitivity, specificity, positive and negative predictive values, and accuracy were 89.5, 93, 91.9, 90.9, and 91.3%, respectively. When BI-RADS and elastography scores were combined, sensitivity, specificity, positive and negative predictive values, and accuracy were 86.8, 97.7, 97.1, 89.4, and 92.5%, respectively.


CONCLUSIONS
The combination of strain elastography and BI-RADS was found to have better diagnostic performances to diagnose breast lesions than BI-RADS alone.
Department of Radiology, Konya Training and Research Hospital, Konya, Turkey. arslanserdar10@gmail.com.|, Hacı Şaban Mah. Meram Yeniyol Caddesi No: 97, Meram, Konya, 42090, Turkey. arslanserdar10@gmail.com.
Serdar
http://orcid.org/0000-0001-7984-4326
S
Arslan
Department of Radiology, Medical School of Baskent University, Ankara, Turkey.
Nihal
N
Uslu
Department of Radiology, Medical School of Baskent University, Ankara, Turkey.
Funda Ulu
FU
Ozturk
Department of Pathology, Medical School of Baskent University, Ankara, Turkey.
Eda Yilmaz
EY
Akcay
Department of General Surgery, Medical School of Baskent University, Ankara, Turkey.
Tugan
T
Tezcaner
Department of Radiology, Medical School of Baskent University, Ankara, Turkey.
Ahmet Muhtesem
AM
Agildere
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D001940:Breast / Q000000981:diagnostic imaging* / Q000473:pathology; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D018567:Breast Neoplasms, Male / Q000000981:diagnostic imaging / Q000473:pathology; D003937:Diagnosis, Differential; D054459:Elasticity Imaging Techniques; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011873:Radiology Information Systems; D016217:Ultrasonography, Mammary; D055815:Young Adult
Benign; Breast imaging reporting and data system; Breast lesions; Malignant; Strain elastography