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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 J+Ultrason
2013 ; 13
(52
): 31-49
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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
#MMPMID26673828
Dobruch-Sobczak K
J Ultrason
2013[Mar]; 13
(52
): 31-49
PMID26673828
show ga
Sonoelastography is a dynamically developing method of ultrasound examination
used to differentiate the character of focal lesions in the breasts. The aim of
the Part II of the study is to determine the usefulness of sonoelastography in
the differentiation diagnosis of focal breast lesions including the evaluation of
the diagnostic value of Tsukuba score and FLR ratio in characterizing solid
lesions in the breasts. Furthermore, the paper provides a comparison of classic
B-mode imaging and sonoelastography. MATERIAL AND METHODS: From January to July
2010 in the Ultrasound Department of the Cancer Centre, The Institute of Maria
Sk?odowska-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. RESULTS: 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). CONCLUSIONS: 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.