Characterisation of indeterminate focal breast lesions on grey-scale ultrasound: role of ultrasound elastography.

Massimo Midiri, Tommaso Vincenzo Bartolotta, Safina, Genova, Ienzi, Pitarresi, Raffaele Ienzi, Cirino, Tommaso Vincenzo Bartolotta, Massimo Midiri

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Abstract

PURPOSE: This study was undertaken to evaluate the role of ultrasound (US)elastography in characterising focal breast lesions classified as indeterminateon B-mode US.MATERIALS AND METHODS: Eighty-four focal breast lesions, 64 benign and 20malignant (mean diameter, 15.1 mm), detected but not characterised on B-mode USin 72 women, Breast Imaging Reporting and Data System (BI-RADS) US category 3(n=56) or category 4 (n=28), were studied with US elastography and classified in consensus by two radiologists according to a five-point colour scale.Sensitivity, specificity and positive and negative predictive values (PPV andNPV) of US elastography compared with conventional US were calculated in relationto microhistology (n=67) and cytology (n=17), which were used as the referencestandard.RESULTS: A total of 65/84 (77.4%) lesions were correctly classified as benign or malignant using US elastography, whereas the remaining 19/84 (22.6%) wereincorrectly assessed. There were no statistically significant differences betweenUS elastography and B-mode US with regard to sensitivity (70% vs. 68.4%),specificity (79.6% vs. 78.5%), PPV (51.8% vs. 48.1%) and NPV 89% vs. 89.5%(p>0.5). By contrast, a statistically significant difference was noted in theevaluation of BI-RADS 3 lesions, in which US elastography had 50% sensitivity,86% specificity, 30% PPV and 93.5% NPV compared with BI-RADS 4 lesions (78.6%,57.1%, 64.7% and 72.7%) (p<0.5).CONCLUSIONS: The high NPV of US elastography may help reduce the use of biopsy inBI-RADS 3 lesions, but its low PPV in BI-RADS 4 lesions does not allow avoidance of biopsy on the basis of the US elastographic score alone in this group oflesions.
Lingua originaleEnglish
pagine (da-a)1027-1038
Numero di pagine12
RivistaLA RADIOLOGIA MEDICA
Volume116
Stato di pubblicazionePublished - 2011

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All Science Journal Classification (ASJC) codes

  • Medicine(all)
  • Radiology Nuclear Medicine and imaging

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Midiri, M., Bartolotta, T. V., Safina, Genova, Ienzi, Pitarresi, Ienzi, R., Cirino, Bartolotta, T. V., & Midiri, M. (2011). Characterisation of indeterminate focal breast lesions on grey-scale ultrasound: role of ultrasound elastography. LA RADIOLOGIA MEDICA, 116, 1027-1038.