Real-Time Elastography for Differentiation of Breast Lesions

Area of Science:

• Medical Imaging
• Oncology
• Radiology

Background:

• Distinguishing malignant from benign breast lesions is crucial for appropriate patient management.
• Conventional B-mode ultrasonography (US) has limitations in characterizing all breast masses.

Purpose of the Study:

• To evaluate the diagnostic performance of the elastography-based strain index ratio for differentiating malignant and benign breast lesions.
• To determine the optimal cut-off value of the strain ratio for lesion classification.

Main Methods:

• Seventy-nine breast masses (BI-RADS categories 3-5) were prospectively evaluated using real-time sonoelastography (RTE).
• RTE findings were correlated with histopathology or ultrasound follow-up data.
• Receiver Operating Characteristic (ROC) curve analysis was used to determine the optimal strain ratio cut-off value.

Main Results:

• Malignant lesions (n=36) showed a significantly higher mean strain index (6.59±3.44) compared to benign lesions (n=43) (2.79±2.16).
• US demonstrated 100% sensitivity and 90% specificity for malignant lesion detection.
• An optimal strain ratio of 4.25 yielded 86% sensitivity and 76% specificity for diagnosing malignancy.

Conclusions:

• Real-time sonoelastography (RTE) is a valuable tool for differentiating malignant and benign breast masses.
• The strain index ratio, particularly with an optimal cut-off, enhances diagnostic accuracy.
• RTE should be utilized in conjunction with conventional ultrasonography for comprehensive breast lesion assessment.