EP22.24: Role of ultrasound elastography in BIRADS 3 and 4a breast lesions

To assess the diagnostic performance of strain elastography added to the conventional B-mode ultrasound in evaluating BIRADS 3 and 4a breast lesions. 50 breast lesions categorised BIRADS 3 and 4a by conventional ultrasound. Ultrasound Elastography was performed following conventional B mode ultrasound of the breast to evaluate its possible impact on accurate diagnosis of breast lesions and consequent guidance for management planning. Regarding quantitative elastography by using strain ratio of 3.8 as a cut off value, the mean SR for malignant lesions (mean 3.95 ± 1.59; range 2.1 – 5.5) was significantly greater than that for benign lesions (mean 1.9 ± 1.06; range 0.5 – 4.8); p value 0.007 was considered to indicate significant differences. The calculated sensitivity, specificity and total accuracy of strain ratio method were 60%, 93.33, and 90% respectively. As for qualitative elastography the distribution of E-scores for different lesions were as follows: 47/50 cases (94%) scored 1, 2 and 3 were considered benign, whereas 3/50 cases (6%) scored 4 were considered malignant. The calculated sensitivity of qualitative Elastography was 60%, specificity was 100%, and the total accuracy was 96%. In our study, combined US/Elastography gave the same sensitivity as US alone (80%). However it gave higher specificity and accuracy than US alone (100% and 98% versus 73.33% and 74%), and the PPV and NPV were 100%, and 97.83% respectively. US Elastography provides useful information about distinguishing benign and malignant breast lesions. Thus, consideration of lesion stiffness could increase positive predictive values and reduce unnecessary biopsies for benign lesions. The elastography is better to be done using qualitative and quantitative techniques. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.