Table of Contents
ISRN Radiology
Volume 2014, Article ID 396368, 8 pages
Clinical Study

Diagnostic Performance and Additional Value of Elastosonography in Focal Breast Lesions: Statistical Correlation between Size-Dependant Strain Index Measurements, Multimodality-BI-RADS Score, and Histopathology in a Clinical Routine Setting

1Department for Diagnostic, Interventional and Pediatric Radiology, University Hospital Inselspital Bern, Freiburgstraße 10, 3010 Bern, Switzerland
2Institute of Forensic Medicine, University of Zürich, Virtopsy, 8057 Zurich, Switzerland

Received 12 December 2013; Accepted 21 January 2014; Published 9 March 2014

Academic Editors: J.-H. Chen and A. Samani

Copyright © 2014 Lukas Ebner et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objective. To evaluate the diagnostic benefit of real-time elastography (RTE) in clinical routine. Strain indices (SI) for benign and malignant tumors were assessed. Methods. 100 patients with 110 focal breast lesions were retrieved. Patients had mammography (MG), ultrasound (US), and, if necessary, MRI. RTE was conducted after ultrasound. Lesions were assessed with BI-RADS for mammography and ultrasound. Diagnosis was established with histology or follow-up. Results. SI for BI-RADS 2 was . Higher SI was observed for BI-RADS 3 lesions. SI of BI-RADS 4 and 5 lesions were significantly higher and . 31 malignant tumors exhibited an average SI of ; SI of benign lesions was ( value ). ROC analysis threshold was >3.8 for malignant disease. Sensitivity of sonography was 90.3% (specificity 78.5%). RTE showed a sensitivity of 87.1% (specificity 79.7%). Accuracy of all modalities combined was 96.8%. In BI-RADS 3 lesions RTE was able to detect all malignant lesions (sensitivity 100%, specificity 92.9%, and accuracy 93.9%). Conclusions. RTE increased sensitivity and specificity for breast cancer detection when used in combination with ultrasound.