The differentiation of the character of solid lesions in the breast in the compression sonoelastography. Part II: Diagnostic value of BIRADS-US classification, Tsukuba score and FLR ratio
Open Access
- 25 February 2012
- journal article
- Published by Medical Communications Sp. z.o.o. in Journal of Ultrasonography
- Vol. 13 (52), 31-49
- https://doi.org/10.15557/JoU.2013.0003
Abstract
From January to July 2010 in the Ultrasound Department of the Cancer Centre, The Institute of Maria Skłodowska-Curie, 375 breast ultrasound examinations were conducted. The examined group included patients who in B-mode examinations presented indications for pathological verification. They were 80 women aged between 17 and 83 (mean age was 50) with 99 solid focal lesions in the breasts. All patients underwent: the interview, physical examination, B-mode ultrasound examination and elastography of the mammary glands and axillary fossae. The visualized lesions were evaluated according to BIRADS-US classification and Tsukuba score as well as FLR ratio was calculated. In all cases, the histopathological and/or cytological verification of the tested lesions was obtained. In the group of 80 patients, the examination revealed 39 malignant neoplastic lesions and 60 benign ones. The mean age of women with malignant neoplasms was 55.07 (SD = 10.54), and with benign lesions – 46.9 (SD = 15.47). In order to identify threshold values that distinguish benign lesions from malignant ones, a comparative analysis of statistical models based on BIRADS-US classification and Tsukuba score was conducted and the cut-off value for FLR was assumed. The sensitivity and specificity values for BIRADS-US 4/5 were 76.92% and 96.67% and for Tsukuba 3/4 – 64.1% and 98.33% respectively. The assumed FLR threshold value to differentiate between benign and malignant lesions in the breasts equaled 3.13. The combined application of both classifications (with the threshold value of BIRADS-US 4/Tsukuba 3) improved the total value of sensitivity and specificity of character differentiation of focal lesions (87.2% and 95% respectively). In the case of problematic focal lesions, i.e. BIRADS-US 3, the study revealed that obtaining Tsukuba score of 1 and 2 for lesions classified as BIRADS-US 3 confirms their benign character. This allows to avoid the cytological verification.Keywords
This publication has 16 references indexed in Scilit:
- The differentiation of the character of solid lesions in the breast in the compression sonoelastography. Part I: The diagnostic value of the ultrasound B-mode imaging in the differentiation diagnostics of solid, focal lesions in the breast in relation to the pathomorphological verificationJournal of Ultrasonography, 2012
- Elastography ultrasound and questionable breast lesions: Does it count?European Journal of Radiology, 2012
- Standards of the Polish Ultrasound Society – update. Sonomammography examinationJournal of Ultrasonography, 2012
- Ultrasonographic differentiation of malignant from benign breast lesions: a meta-analytic comparison of elasticity and BIRADS scoringBreast Cancer Research and Treatment, 2011
- Breast ultrasound elastography—Results of 193 breast lesions in a prospective study with histopathologic correlationEuropean Journal of Radiology, 2011
- Significant Differentiation of Focal Breast Lesions: Calculation of Strain Ratio in Breast SonoelastographyAcademic Radiology, 2010
- Multicenter Study of Ultrasound Real-Time Tissue Elastography in 779 Cases for the Assessment of Breast Lesions: Improved Diagnostic Performance by Combining the BI-RADS®-US Classification System with SonoelastographyUltraschall in der Medizin - European Journal of Ultrasound, 2010
- Nonpalpable Breast Masses: Evaluation by US ElastographyKorean Journal of Radiology, 2008
- Breast Disease: Clinical Application of US Elastography for DiagnosisRadiology, 2006
- Elastic Moduli of Breast and Prostate Tissues under CompressionUltrasonic Imaging, 1998