Real-time elastography for differentiation of breast lesions

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Yılmaz E., Yılmaz A., Aslan A., Inan I., Evren M. C., Tekesin K.

Polish Journal of Radiology, vol.82, pp.664-669, 2017 (Scopus) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 82
  • Publication Date: 2017
  • Doi Number: 10.12659/pjr.902596
  • Journal Name: Polish Journal of Radiology
  • Journal Indexes: Scopus
  • Page Numbers: pp.664-669
  • Keywords: Breast Diseases, Breast Neoplasms, Elasticity Imaging Techniques, Ultrasonography, Mammary
  • Istanbul Medipol University Affiliated: Yes


Backroung: To investigate the diagnostic performance of the elastography-based strain index ratio in the differential diagnosis of malignant and benign breast lesions. Material/Methods: Seventy-nine breast masses that were classified as BI-RADS category 3, 4, and 5 on B-mode ultrasonography (US) were further prospectively evaluated by real-time sonoelastography (RTE). To obtain an optimal cut-off value of the strain ratio for differentiating between malignant and benign breast lesions, RTE findings were compared with histopathology of core needle biopsy samples or with ultrasound follow-up data of the analyzed masses. Results: Seventy-nine breast lesions [BI-RADS category 3 (n=15), BI-RADS category 4 (n=34), and BI-RADS category 5 (n=30)] were classified as malignant (n=36) or benign (n=43). The mean strain index value was 6.59±3.44 (range 0.6–14) for malignant lesions and 2.79±2.16 (range 0.6–8.7) for benign lesions, respectively (p<0.05). As regards the detection of malignant lesions, US was characterized by sensitivity and specificity of 100% (CI 95%; 88–100) and 90% (CI 95%; 76–97), respectively. When an optimal value of the strain ratio (4.25) was obtained by ROC curve analysis, the sensitivity and specificity for diagnosing malignant lesions were 86% (CI 95%; 70–95) and 76% (CI 95%; 60–87), respectively. Conclusions: RTE can play an important role in the differentiation between malignant and benign breast masses, but it should be used in conjunction with ultrasonography.