Acoustic Radiation Force Impulse Imaging in Benign and Malignant Breast Lesions

Elastography is a promising way to assess tissue differences regarding stiffness or elasticity, which has been historically assessed manually by palpation. Combined with conventional imaging modalities, shear wave elastography can potentially evaluate the stiffness of a breast lesion and consequently help detect malignant breast tumor from benign ones. The aim of this study was to evaluate the diagnostic role of shear wave elastography in breast lesions in the Indian population.

Fifty patients presenting with breast lesions were included in the study. All the patients were subjected to B-mode ultrasound and elastography using shear wave with Virtual Touch Imaging (VTI^TM) (Siemens Medical Solutions USA, Inc., PA, USA) and Virtual Touch Quantification (VTQ^TM) (Siemens Medical Solutions USA, Inc., PA, USA) and the obtained data was analyzed using an appropriate statistical test (independent samples t-test).

In our study group of 50 patients, 34 were benign and 16 were malignant. VTI^TM showed a sensitivity of 97% and a specificity of 93% with a positive predictive value (PPV) of 97% for benign lesions. VTI^TM showed a sensitivity of 87.5 % and a specificity of 100% with a PPV of 100% for malignant lesions. VTQ^TM showed a sensitivity of 71.4% and a specificity of 100% with a PPV of 100% for benign lesions. VTQ^TM showed a sensitivity of 100% and a specificity of 100% with a PPV of 76.6% for malignant lesions.

VTI^TM was more reliable as a diagnostic tool compared to VTQ^TM in benign lesions and both are equally reliable in identifying malignant lesions. Acoustic radiation force impulse (ARFI) plays a significant role as an adjuvant diagnostic tool to B-mode imaging for assessing breast lesions.