Diagnostic Value of Elastography Using Acoustic Radiation Force Impulse Imaging and Strain Ratio for Breast Tumors|RISS 상세보기

다국어 초록 (Multilingual Abstract)

Purpose: The aim of this study was to determine whether thecombination of B-mode ultrasonography (BUS), acoustic radiationforce impulse (ARFI) elastography, and strain ratio (SR) providesbetter diagnostic performance of breast lesion differentiationthan BUS alone. Methods: ARFI elastography and SR evaluationswere performed on patients with 157 breast lesions diagnosedby BUS from June to September 2013. BUS images wereclassified according to the Breast Imaging-Reporting and DataSystem. ARFI elastography was performed using Virtual Touch™tissue imaging (VTI) and Virtual Touch™ tissue quantification(VTQ). In VTI mode, we evaluated the color-mapped patterns ofthe breast lesion and surrounding tissue. The lesions were classifiedinto five categories by elasticity score. In VTQ mode, eachlesion was assessed using shear wave velocity (SWV) measurements.
SR was calculated from the lesion and comparable lateralfatty tissue. We compared the diagnostic performance of BUSalone and the combination of BUS, ARFI elastography, and SRevaluations. Results: Among the 157 lesions, 40 were malignantand 117 were benign. The mean elasticity score (3.7±1.0 vs. 1.6±0.8, p<0.01), SWV (4.23±1.09 m/sec vs. 2.22±0.88 m/sec, p<0.01), and SR (5.69±1.63 vs. 2.69±1.40, p<0.01) were significantlyhigher for malignant lesions than benign lesions. The resultsfor BUS combined with ARFI elastography and SR valueswere 97.5% sensitivity, 92.3% specificity, 93.6% accuracy, a79.6% positive predictive value (PPV), and a 99.1% negative predictivevalue. The combination of the 3 radiologic examinationsyielded superior specificity, accuracy, and PPV compared to BUSalone (p<0.01 for each). Conclusion: ARFI elastography and SRevaluations showed significantly different mean values for benignand malignant lesions. Moreover, these two modalities complementedBUS and improved the diagnostic performance of breastlesion detection. Therefore, ARFI elastography and SR evaluationscan be used as complementary modalities to make moreaccurate breast lesion diagnoses.

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