Sonoelastography for 1786 Non-Palpable Breast Masses

Sonoelastography for 1786 non-palpable breast masses: diagnostic value in the decision to biopsy.

Yi A, Cho N, Chang JM, Koo HR, La Yun B, Moon WK.
Eur Radiol. 2011 Nov 25. [Epub ahead of print]

Abstract

OBJECTIVES: To evaluate the diagnostic value of sonoelastography by correlation with histopathology compared with conventional ultrasound on the decision to biopsy.
METHODS: Prospectively determined BI-RADS categories of conventional ultrasound and elasticity scores from strain sonoelastography of 1786 non-palpable breast masses (1,523 benign and 263 malignant) in 1,538 women were correlated with histopathology. The sensitivity and specificity of two imaging techniques were compared regarding the decision to biopsy. We also investigated whether there was a subset of benign masses that were recommended for biopsy by B-mode ultrasound but that had a less than 2% malignancy rate with the addition of sonoelastography.
RESULTS: The mean elasticity score of malignant lesions was higher than that of benign lesions (2.94 ± 1.10 vs. 1.78 ± 0.81) (P < 0.001). In the decision to biopsy, B-mode ultrasound had higher sensitivity than sonoelastography (98.5% vs. 93.2%) (P < 0.001), whereas sonoelastography had higher specificity than B-mode ultrasound (42.6% vs. 16.3%) (P < 0.001). BI-RADS category 4a lesions with an elasticity score of 1 had a malignancy rate of 0.8%.

CONCLUSIONS: Sonoelastography has higher specificity than B-mode ultrasound in the differentiation between benign and malignant masses and has the potential to reduce biopsies with benign results.

KEY POINTS:
• Sonoelastography has higher specificity than B-mode ultrasound in distinguishing benign from malignant masses. • Sonoelastography could potentially help reduce the number of biopsies with benign results.
• Lesion stiffness on sonoelastography correlated with the malignant potential of the lesion.

Real-time Sonoelastography of Major Salivary Gland Tumors

Real-time Sonoelastography of Major Salivary Gland Tumors

Dana Dumitriu, Sorin Dudea, Carolina Botar-Jid, Mihaela Băciuț, Grigore Băciuț, Dumitriu D, Dudea S, Botar-Jid C, Băciuț M,  Băciuț G

AJR 2011; 197:W924–W930 © American Roentgen Ray Society 

OBJECTIVE. The purpose of this study was to determine the performance of real-time sonoelastography in the differential diagnosis of salivary gland tumors.

SUBJECTS AND METHODS. Between 2007 and 2010, 74 salivary gland tumors were examined by ultrasound and sonoelastography in 66 patients. Lesions were graded according to a 4-point elastography score. Surgical excision and histopathologic examination were performed in all cases. The difference in elastographic score between benign and malignant masses and that between pleomorphic adenomas and Warthin tumors were evaluated. 

RESULTS. Of the 74 salivary tumors, 63 were located in the parotid, and 11 were in the submandibular gland. There were 18 malignant and 56 benign tumors. The mean (± SD) elastographic score was 2.58 ± 0.87 for pleomorphic adenomas, 2.15 ± 0.80 for Warthin tumors, 2.00 ± 0.57 for other benign tumors, and 2.94 ± 0.87 for malignant tumors. For benign tumors overall, the mean elastographic score was 2.41 ± 0.87. The difference in elastographic score between benign and malignant tumors overall was statistically significant (p > 0.05), but the difference between malignant tumors and pleomorphic adenomas and that between Warthin tumors and pleomorphic adenomas were not statistically significant. Using cutoff values between scores 2 and 3 and scores 3 and 4, there was no statistically significant difference between benign and malignant tumors. 

 

CONCLUSION. Although this study revealed a difference in elastographic score between benign and malignant tumors, detailed analysis did not provide consistent results. Consequently, real-time sonoelastography appears to be a limited technique in the differential diagnosis between benign and malignant salivary masses.

-----------------------------------------

ARFI of WARTHIN TUMOR from MEDIC MEDICAL CENTER, HCMC, VIETNAM

Man 62 yo suffered from swollen parotid region both 2 sides and submandibular nodes for 1 month. Ultrasound detected ovoid lesion in parotid gland  with small lacuna and hypervascular.

ARFI technique shows lesion in dark mixed color in comparison to parotid parenchyma (VTI) and stiffen  with a range of elastic velocity from 2.4 to 6.3m/s.

n

FNAC was done and pathohistological result prove a Warthin tumor of parotid.