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Nonpalpable breast masses: evaluation by US elastography.

Cho N, Moon WK, Park JS, Cha JH, Jang M, Seong MH - Korean J Radiol (2008 Mar-Apr)

Bottom Line: Conventional US and real-time elastographic images were obtained for 100 women who had been scheduled for a US-guided core biopsy of 100 nonpalpable breast masses (83 benign, 17 malignant).For BI-RADS category 4a lesions, 44% (22 of 50) had an elasticity score of 1 and all were found to be benign.The authors conclude that BI-RADS category 4a lesions with an elasticity score of 1 probably do not require biopsy.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology and Clinical Research Institute, Seoul National University Hospital and the Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea.

ABSTRACT

Objective: To compare the diagnostic performances of conventional ultrasound (US) and US elastography for the differentiation of nonpalpable breast masses, and to evaluate whether elastography is helpful at reducing the number of benign biopsies, using histological analysis as a reference standard.

Materials and methods: Conventional US and real-time elastographic images were obtained for 100 women who had been scheduled for a US-guided core biopsy of 100 nonpalpable breast masses (83 benign, 17 malignant). Two experienced radiologists unaware of the biopsy and clinical findings analyzed conventional US and elastographic images by consensus, and classified lesions based on degree of suspicion regarding the probability of malignancy. Results were evaluated by receiver operating characteristic curve analysis. In addition, the authors investigated whether a subset of lesions was categorized as suspicious by conventional US, but as benign by elastography.

Results: Areas under the ROC curves (Az values) were 0.901 for conventional US and 0.916 for elastography (p = 0.808). For BI-RADS category 4a lesions, 44% (22 of 50) had an elasticity score of 1 and all were found to be benign.

Conclusion: Elastography was found to have a diagnostic performance comparable to that of conventional US for the differentiation of nonpalpable breast masses. The authors conclude that BI-RADS category 4a lesions with an elasticity score of 1 probably do not require biopsy.

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Related in: MedlinePlus

Transverse conventional US and elastographic images of fibrocystic changes in 65-year-old woman.A. Conventional US showed 0.5 cm irregular hypoechoic mass.B. By elastography, mass (white region of interest) appeared green. Final assessment was of BI-RADS category C4a by conventional US and score of 1 (E1) by elastography.
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Figure 3: Transverse conventional US and elastographic images of fibrocystic changes in 65-year-old woman.A. Conventional US showed 0.5 cm irregular hypoechoic mass.B. By elastography, mass (white region of interest) appeared green. Final assessment was of BI-RADS category C4a by conventional US and score of 1 (E1) by elastography.

Mentions: In terms of elasticity scores, the mean ± standard deviation for malignant masses was 3.9 ± 1.1 and for benign masses 1.8 ± s0.8 (p < 0.001) (Figs. 2, 3). For conventional US images, when a cutoff point between category 3 and 4a was used, conventional US had 100% (27 of 27) sensitivity, 33% (27 of 83) specificity, a 23% (17 of 73) PPV, and a 100% NPV (27 of 27). When a cutoff point between category 4a and 4b was used, conventional US had 82% (14 of 17) sensitivity, 89% (74 of 83) specificity, a 61% (14 of 23) PPV, and a 96% (74 of 77) NPV (Table 1). When a cutoff point between E1 and E2 was used, elastography had 100% (17 of 17) sensitivity, 41% (34 of 83) specificity, a 26% (17 of 66) PPV, and a 100% (34 of 34) NPV. When a cutoff point between E2 and E3 was used, elastography had 82% (14 of 17) sensitivity, 84% (70 of 83) specificity, a 52% (14 of 27) PPV, and a 96% (70 of 73) NPV (Table 2). The Az value was 0.901 for conventional US and 0.916 for elastography (95% confidence interval, -0.105 to 0.135), which was not significantly different (p = 0.808) (Fig. 4).


Nonpalpable breast masses: evaluation by US elastography.

Cho N, Moon WK, Park JS, Cha JH, Jang M, Seong MH - Korean J Radiol (2008 Mar-Apr)

Transverse conventional US and elastographic images of fibrocystic changes in 65-year-old woman.A. Conventional US showed 0.5 cm irregular hypoechoic mass.B. By elastography, mass (white region of interest) appeared green. Final assessment was of BI-RADS category C4a by conventional US and score of 1 (E1) by elastography.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2627231&req=5

Figure 3: Transverse conventional US and elastographic images of fibrocystic changes in 65-year-old woman.A. Conventional US showed 0.5 cm irregular hypoechoic mass.B. By elastography, mass (white region of interest) appeared green. Final assessment was of BI-RADS category C4a by conventional US and score of 1 (E1) by elastography.
Mentions: In terms of elasticity scores, the mean ± standard deviation for malignant masses was 3.9 ± 1.1 and for benign masses 1.8 ± s0.8 (p < 0.001) (Figs. 2, 3). For conventional US images, when a cutoff point between category 3 and 4a was used, conventional US had 100% (27 of 27) sensitivity, 33% (27 of 83) specificity, a 23% (17 of 73) PPV, and a 100% NPV (27 of 27). When a cutoff point between category 4a and 4b was used, conventional US had 82% (14 of 17) sensitivity, 89% (74 of 83) specificity, a 61% (14 of 23) PPV, and a 96% (74 of 77) NPV (Table 1). When a cutoff point between E1 and E2 was used, elastography had 100% (17 of 17) sensitivity, 41% (34 of 83) specificity, a 26% (17 of 66) PPV, and a 100% (34 of 34) NPV. When a cutoff point between E2 and E3 was used, elastography had 82% (14 of 17) sensitivity, 84% (70 of 83) specificity, a 52% (14 of 27) PPV, and a 96% (70 of 73) NPV (Table 2). The Az value was 0.901 for conventional US and 0.916 for elastography (95% confidence interval, -0.105 to 0.135), which was not significantly different (p = 0.808) (Fig. 4).

Bottom Line: Conventional US and real-time elastographic images were obtained for 100 women who had been scheduled for a US-guided core biopsy of 100 nonpalpable breast masses (83 benign, 17 malignant).For BI-RADS category 4a lesions, 44% (22 of 50) had an elasticity score of 1 and all were found to be benign.The authors conclude that BI-RADS category 4a lesions with an elasticity score of 1 probably do not require biopsy.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology and Clinical Research Institute, Seoul National University Hospital and the Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea.

ABSTRACT

Objective: To compare the diagnostic performances of conventional ultrasound (US) and US elastography for the differentiation of nonpalpable breast masses, and to evaluate whether elastography is helpful at reducing the number of benign biopsies, using histological analysis as a reference standard.

Materials and methods: Conventional US and real-time elastographic images were obtained for 100 women who had been scheduled for a US-guided core biopsy of 100 nonpalpable breast masses (83 benign, 17 malignant). Two experienced radiologists unaware of the biopsy and clinical findings analyzed conventional US and elastographic images by consensus, and classified lesions based on degree of suspicion regarding the probability of malignancy. Results were evaluated by receiver operating characteristic curve analysis. In addition, the authors investigated whether a subset of lesions was categorized as suspicious by conventional US, but as benign by elastography.

Results: Areas under the ROC curves (Az values) were 0.901 for conventional US and 0.916 for elastography (p = 0.808). For BI-RADS category 4a lesions, 44% (22 of 50) had an elasticity score of 1 and all were found to be benign.

Conclusion: Elastography was found to have a diagnostic performance comparable to that of conventional US for the differentiation of nonpalpable breast masses. The authors conclude that BI-RADS category 4a lesions with an elasticity score of 1 probably do not require biopsy.

Show MeSH
Related in: MedlinePlus