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Ultrasonic Elastography Research Based on a Multicenter Study: Adding Strain Ratio after 5-Point Scoring Evaluation

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Ultrasonographic elastography (UE) strain ratio calculation is essential for differentiating breast lesions, especially for large solid masses and those with elasticity scores of 3 or 4, complementing the 5-point scoring method.

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Area of Science:

  • Medical Imaging
  • Oncology
  • Diagnostic Ultrasound

Background:

  • Ultrasonographic elastography (UE) is a valuable tool for breast lesion characterization.
  • Current UE assessment often relies on a 5-point elasticity scoring system.
  • The role of strain ratio calculation in conjunction with scoring requires further clarification.

Purpose of the Study:

  • To evaluate the added diagnostic value of strain ratio calculation to the 5-point elasticity scoring system for differentiating benign from malignant breast lesions using UE.
  • To compare the diagnostic performance of strain ratio method versus the 5-point scoring method.

Main Methods:

  • A multicenter retrospective study involving 1080 female patients with breast lesions.
  • All patients underwent UE, and strain ratios were calculated.
  • Histological findings served as the gold standard for diagnosis.
  • Sensitivity, specificity, accuracy, and ROC curves were analyzed for both methods.

Main Results:

  • Significant differences in strain ratios were observed between benign (mean 2.6±2.0) and malignant lesions (mean 7.9±5.8) (p <0.01).
  • The strain ratio method achieved 79.8% sensitivity, 82.8% specificity, and 81.3% accuracy (cutoff 3.01).
  • The 5-point scoring method yielded 93.1% sensitivity, 73.0% specificity, and 76.8% accuracy.
  • Areas under the ROC curve were comparable (0.863 for strain ratio, 0.865 for 5-point scoring).
  • The strain ratio method demonstrated superior diagnostic performance for lesions with elasticity scores of 3 and 4.

Conclusions:

  • Both UE methods show similar overall diagnostic performance.
  • Separate calculation of strain ratios is crucial, particularly for large solid breast lesions and those with elasticity scores of 3 and 4.
  • Strain ratio analysis enhances the diagnostic accuracy of UE for specific breast lesion categories.