A comparative study of three ultrasonic elastographic methods for the differentiation and diagnosis of benign and malignant breast masses

Abstract

A comparative study of three ultrasonic elastographic methods for the differentiation and diagnosis of benign and malignant breast masses F. Tang 1* , Y.-F. Kang 2* , G.-L. Lu 2 , Z.-J. Wang 2 , Z.-S. Zhang 3 , S.-Z. Xu 4 , T.-T. Du 2 , J. Tong 2 , J. Li 2 1Department of General Surgery, 2Department of Function, The First Affiliated Hospital of Medical College of Shihezi University, Shihezi, Xinjiang 3Department of Physiology and Pathophysiology, 4Department of Statistics, Medical College of Shihezi University, Shihezi, Xinjiang (China) Summary Background: To evaluate the application of three elastography methods including real-time tissue elasticity imaging (RTE), strain rate ratio elasticity imaging (SR), and acoustic radiation force elastic imaging (ARFI) in two ultrasound instruments for the diagnosis of benign and malignant breast lesions. Materials and Methods: The authors examined 97 breast nodules of 97 patients who were ready to undergo adenomammectomy. For each patient, RTE was applied to determin nodule properties by level 5 score method, SR was applied to measure the strain rate ratio of targeted nodules, and the surrounding mammary glands at the same level, ARFI was applied to measure internal and marginal shear wave velocity (SWV) values of targeted nodules. Results: The sensitivity and specificity of RTE, SR, the internal SWV values, and marginal SWV values were more than 80% in diagnosing breast nodules. Area under the curve of RTE, SR, the internal SWV values, and the marginal SWV values in diagnosis of benign and malignant breast nodules were 0.923, 0.934, 0.934 and 0.916, respectively. No significant differences were found among the four values for the diagnosis efficiency. Conclusions: RTE, SR, and ARFI are all highly valuable in diagnosing benign and malignant breast nodules. Key words: Ultrasonic elastography; Breast masses; Real-time tissue elasticity imaging; Strain rate ratio elasticity imaging; Acoustic radiation force elastic imaging; Differential diagnosis.