Elastography of breast lesions: initial clinical results

To determine the appearance of various breast lesions on elastograms and to explore the potential of elastography in the diagnosis of breast lesions.

A total of 46 breast lesions were examined with elastography. Patients underwent biopsy or aspiration of all lesions, revealing 15 fibroadenomas, 12 carcinomas, six fibrocystic nodules, and 13 other lesions. The elastogram was generated from radio-frequency data collected with use of a 5-MHz linear-array transducer. The elastogram and corresponding sonogram were evaluated by a single observer for lesion visualization, relative brightness, and margin definition and regularity. The sizes of the lesions at each imaging examination and at biopsy were recorded and compared.

Softer tissues such as fat appear as bright areas on elastograms. Firm tissues, including parenchyma, cancers, and other masses, appear darker. The cancers were statistically significantly darker than fibroadenomas (P < .005) and substantially larger on the elastogram than on the sonogram. Seventy-three percent of fibroadenomas and 56% of solid benign lesions could be distinguished from cancers by using lesion brightness and size difference. Some cancers that appeared as areas of shadowing on sonograms appeared as discrete masses on elastograms.

Elastography has the potential to be useful in the evaluation of areas of shadowing on the sonogram. It also may be helpful in the distinction of benign from malignant masses.