Abstract PS4-04-07: Improved Diagnostic Accuracy for Breast Implant Rupture Through Strain Elastography - Results of a User-Based Evaluation Using Standardized Image Sets

Abstract Background: Ultrasound is a widely used tool for evaluating breast implant integrity, but its diagnostic accuracy remains limited by operator dependency. This study investigated whether the addition of strain elastography can improve diagnostic sensitivity and specificity in detecting implant rupture. Methods: Based on a standardized animal model, 15 silicone breast implants (intact and ruptured) were scanned using both B-mode ultrasound and strain elastography. From these scans, 30 paired images were selected for an online evaluation. In total, 99 participants reviewed the image sets and were asked to determine the presence or absence of implant rupture — first using B-mode images alone, and then with the corresponding elastography images. Results: With B-mode alone, participants achieved a diagnostic sensitivity of 81.4% and specificity of 71.0%. When strain elastography was added, sensitivity rose to 90.9%, and specificity increased to 87.6%. Conclusion: The integration of strain elastography significantly enhances diagnostic performance in assessing breast implant rupture. In particular, it reduces false-positive rates while increasing detection of true ruptures. Using standardized image data from an animal model enables reproducible evaluation and may serve as a basis for future training and quality assurance in breast imaging. Citation Format: H. Fritsch, L. Borchert, L. Paul, K. Hide-Moser, C. Vogel-Minea, C. Eichler. Improved Diagnostic Accuracy for Breast Implant Rupture Through Strain Elastography - Results of a User-Based Evaluation Using Standardized Image Sets [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2025; 2025 Dec 9-12; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2026;32(4 Suppl):Abstract nr PS4-04-07.