Elastography ultrasound and questionable breast lesions: does it count?

Area of Science:

• Medical imaging
• Radiology
• Oncology

Background:

• Conventional ultrasound is effective but can be limited in characterizing "questionable" breast lesions (BI-RADS categories 3 and 4).
• Elastography ultrasound offers additional information on tissue stiffness, potentially improving diagnostic accuracy for these ambiguous findings.

Purpose of the Study:

• To evaluate the added value of elastography ultrasound in the precise diagnosis of questionable breast lesions.
• To compare the diagnostic performance of conventional ultrasound, elastography scoring, and quantitative strain ratios.

Main Methods:

• Ninety-seven patients with questionable breast lesions underwent conventional ultrasound followed by elastography ultrasound.
• Pathological confirmation via biopsy served as the gold standard for diagnosis (58 benign, 39 malignant).
• Elastography assessment included a 5-point scoring method and quantitative strain ratio calculations.

Main Results:

• Conventional ultrasound showed sensitivity, specificity, and accuracy of 89.7%, 86.2%, and 87.6%, respectively.
• Elastography 5-point scoring yielded 92.3% sensitivity, 74.1% specificity, and 81.4% accuracy.
• Quantitative strain ratios achieved 87.1% sensitivity, 89.6% specificity, and 88.6% accuracy.

Conclusions:

• Ultrasound elastography, both qualitative and quantitative, enhances the diagnostic performance of conventional B-mode ultrasound.
• Elastography significantly improves specificity and accuracy in diagnosing questionable breast lesions (BI-RADS 3 and 4).