Role of elastography in the assessment of breast lesions: preliminary results

The purposes of this study were to evaluate the diagnostic utility of elastography in differentiating benign from malignant breast lesions and compare it with conventional sonography.

A total of 124 breast lesions (59 malignant and 65 benign) were examined with B-mode sonography and subsequently with elastography. Conventional sonographic findings were classified according to the American College of Radiology Breast Imaging Reporting and Data System for sonography, and elastographic images were assigned an elasticity score of 1 to 5 (1-3, benign; 4 and 5, malignant) according to the Ueno classification. Cytologic diagnoses obtained from fine-needle aspiration and histopathologic results from a core-needle biopsy or surgical biopsy were used as reference standards. Statistical analysis included sensitivity, specificity, and positive and negative predictive values for both elastography and conventional sonography.

B-mode sonography had sensitivity of 96.6% (95% confidence interval, 93.3%-99.9%), specificity of 76.9% (69.2%-84.6%), a positive predictive value of 79.2% (72.1%-86.2%), and a negative predictive value of 96.2% (92.4%-99.9%), compared with sensitivity of 69.5% (60.5%-78.5%), specificity of 83.1% (76.3%-89.8%), a positive predictive value of 78.9% (70.6%-87.1%), and a negative predictive value of 75.0% (67.4%-82.6%) for elastography. Elastography showed less sensitivity but higher specificity than conventional sonography.

Our results show that elastography may be useful as a complementary technique in addition to conventional sonography in the characterization of breast lesions because it increases the diagnostic specificity, thus reducing the false-positive rate.