Breast sonographic elastography using an advanced breast tissue-specific imaging preset: initial clinical results

Area of Science:

• Medical Imaging
• Diagnostic Ultrasound
• Breast Imaging

Background:

• Distinguishing benign from malignant breast masses is crucial for appropriate patient management.
• Conventional sonography has limitations in accurately differentiating breast lesions.
• Sonographic elastography offers complementary information to conventional ultrasound.

Purpose of the Study:

• To evaluate interpretation criteria of sonographic elastography (size ratio, stain ratio, elasticity score) using a tissue-specific imaging preset.
• To compare the diagnostic performance of elastography with conventional sonography for breast mass differentiation.
• To assess the utility of elastography in improving breast lesion characterization.

Main Methods:

• Conventional sonography and elastography with a tissue-specific preset were performed on 104 patients with 110 breast lesions.
• Interpretation criteria including size ratio, strain ratio, and elasticity score were analyzed.
• Pathologic results from surgical excision or vacuum-assisted removal served as the reference standard.

Main Results:

• Sonographic elastography demonstrated high diagnostic performance, with the strain ratio showing the best results among elastography criteria (AUC 0.901).
• Conventional sonography achieved an AUC of 0.959, with sensitivity and specificity of 93.0% and 83.6% between BI-RADS 4A and 4B.
• Using a strain ratio cutoff of 4.215 yielded 86.0% sensitivity and 85.1% specificity.

Conclusions:

• The strain ratio is the most effective interpretation criterion for sonographic elastography with a tissue-specific imaging preset in breast mass differentiation.
• While elastography shows promise, conventional sonography performance, particularly using BI-RADS categories, was slightly superior, though not statistically significant (P = .052).
• Further research may explore optimizing elastography parameters and integration with conventional techniques for enhanced diagnostic accuracy.