Differential diagnosis of breast lesions using ultrasound elastography

The recent introduction of elastography has increased the specificity of USG and enabled early diagnosis of breast cancer. Quantitative elastography, especially with strain ratio (SR) index, improves diagnostic accuracy and decreased number of biopsies.

The purpose of this study was to assess the role of USG elastography in the differential diagnosis of breast lesions.

This prospective study was conducted in the University of Medicine and Pharmacy Research Centre of Craiova.

Fifty-eight patients diagnosed with breast lesions between January 2009 and January 2010 were included in this prospective study. All the patients were examined in the supine position, and the B-mode USG image was displayed alongside the elastography strain image. For obtaining the elastography images we used a EUS Hitachi EUB 8500 ultrasound system with a 6.5-MHz linear probe. The elastography strain images were scored according to the Tsukuba elasticity score.

We performed receiver operator characteristic (ROC) analysis for assessment of the role of USG elastography in the diagnosis of breast lesions.

We obtained a sensitivity of 86.7% and a specificity of 92.9% for elasticity score and a sensitivity of 93.3% and a specificity of 92.9% for SR (when a cutoff point of 3.67 was used). There was very good correlation between SR and elasticity score (Spearman coefficient of 0.911).

Elastography is a fast, simple method that can complement conventional USG examination. This method has the lowest cost/efficiency ratio and it is also the most noninvasive and accessible imaging method, with an accuracy comparable to MRI.