Differentiating benign from malignant solid breast masses

TY - JOUR

T1 - Differentiating benign from malignant solid breast masses

T2 - value of shear wave elastography according to lesion stiffness combined with greyscale ultrasound according to BI-RADS classification

A1 - Evans,A.

A1 - Whelehan,P.

A1 - Thomson,K.

A1 - Brauer,K.

A1 - Jordan,L.

A1 - Purdie,C.

A1 - McLean,D.

A1 - Baker,L.

A1 - Vinnicombe,S.

A1 - Thompson,A.

AU - Evans,A.

AU - Whelehan,P.

AU - Thomson,K.

AU - Brauer,K.

AU - Jordan,L.

AU - Purdie,C.

AU - McLean,D.

AU - Baker,L.

AU - Vinnicombe,S.

AU - Thompson,A.

PY - 2012

Y1 - 2012

N2 - Background:The aim of this study was to assess the performance of shear wave elastography combined with BI-RADS classification of greyscale ultrasound images for benign/malignant differentiation in a large group of patients. Methods:One hundred and seventy-five consecutive patients with solid breast masses on routine ultrasonography undergoing percutaneous biopsy had the greyscale findings classified according to the American College of Radiology BI-RADS. The mean elasticity values from four shear wave images were obtained. Results:For mean elasticity vs greyscale BI-RADS, the performance results against histology were sensitivity: 95% vs 95%, specificity: 77% vs 69%, Positive Predictive Value (PPV): 88% vs 84%, Negative Predictive Value (NPV): 90% vs 91%, and accuracy: 89% vs 86% (all P>0.05). The results for the combination (positive result from either modality counted as malignant) were sensitivity 100%, specificity 61%, PPV 82%, NPV 100%, and accuracy 86%. The combination of BI-RADS greyscale and shear wave elastography yielded superior sensitivity to BI-RADS alone (P=0.03) or shear wave alone (P=0.03). The NPV was superior in combination compared with either alone (BI-RADS P=0.01 and shear wave P=0.02). Conclusion:Together, BI-RADS assessment of greyscale ultrasound images and shear wave ultrasound elastography are extremely sensitive for detection of malignancy.British Journal of Cancer advance online publication, 12 June 2012; doi:10.1038/bjc.2012.253 www.bjcancer.com.

AB - Background:The aim of this study was to assess the performance of shear wave elastography combined with BI-RADS classification of greyscale ultrasound images for benign/malignant differentiation in a large group of patients. Methods:One hundred and seventy-five consecutive patients with solid breast masses on routine ultrasonography undergoing percutaneous biopsy had the greyscale findings classified according to the American College of Radiology BI-RADS. The mean elasticity values from four shear wave images were obtained. Results:For mean elasticity vs greyscale BI-RADS, the performance results against histology were sensitivity: 95% vs 95%, specificity: 77% vs 69%, Positive Predictive Value (PPV): 88% vs 84%, Negative Predictive Value (NPV): 90% vs 91%, and accuracy: 89% vs 86% (all P>0.05). The results for the combination (positive result from either modality counted as malignant) were sensitivity 100%, specificity 61%, PPV 82%, NPV 100%, and accuracy 86%. The combination of BI-RADS greyscale and shear wave elastography yielded superior sensitivity to BI-RADS alone (P=0.03) or shear wave alone (P=0.03). The NPV was superior in combination compared with either alone (BI-RADS P=0.01 and shear wave P=0.02). Conclusion:Together, BI-RADS assessment of greyscale ultrasound images and shear wave ultrasound elastography are extremely sensitive for detection of malignancy.British Journal of Cancer advance online publication, 12 June 2012; doi:10.1038/bjc.2012.253 www.bjcancer.com.

U2 - 10.1038/bjc.2012.253

DO - 10.1038/bjc.2012.253

M1 - Article

JO - British Journal of Cancer

JF - British Journal of Cancer

SN - 0007-0920

IS - 2

VL - 107

SP - 224

EP - 229

ER -