Combination of conventional ultrasonography and virtual touch tissue imaging quantification for differential diagnosis of breast lesions smaller than 10 mm

Article type: Research Article

Authors: Zhang, Shu-Pin^c | Zeng, Zeng^{a; b} | Liu, Hui^{a; b} | Yao, Ming-Hua^{a; b} | Xu, Guang^{a; b} | Wu, Rong^{a; b; *}

Affiliations: [a] Department of Medical Ultrasound, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China | [b] Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, China | [c] Department of Medical Ultrasound, Baoshan Branch Shanghai First People’s Hospital, Shanghai, China

Correspondence: [*] Corresponding author: R. Wu, PhD, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China. Tel.: +86 021 66307539; E-mail: wurong7111@163.com.

Abstract: OBJECTIVE:To determine the value of combining conventional ultrasonography with virtual touch tissue imaging quantification (VTIQ) for differential diagnosis of breast lesions smaller than 10 mm. METHODS:A total of 98 breast lesions smaller than 10 mm were examined by conventional ultrasound and VTIQ using a Siemens ACUSON S3000 ultrasound machine. Pathologic diagnosis was established after surgery or fine needle biopsy. RESULTS:Malignant lesions were characterized by taller-than-wide shape, poorly circumscribed margin, and marked hypoechogenicity. The mean VTIQ shear wave velocity (SWV) value of malignant lesions was 4.88±1.87 m/s (range, 1.75–9.34 m/s), significantly higher than that of benign lesions (2.68±1.02 m/s; range, 1.18–4.67 m/s). The optimal cutoff SWV value was 3.27 m/s, with sensitivity, specificity, diagnostic accuracy, positive predictive value (PPV), and negative predictive value (NPV) of 86.20%, 95.65%, 92.86%, 89.29%, and 94.29%, respectively. The combination of SWV >3.27 m/s plus the US feature of poorly circumscribed margin had the highest sensitivity (93.33%) and specificity (100%) for diagnosis of malignant breast lesions. CONCLUSION:Features such as taller-than-wide shape, poorly circumscribed margin, and marked hypoechogenicity on conventional US, and SWV >3.27 m/s on VTIQ, are indicators of malignancy in breast lesions with diameter <10 mm. The combination of poorly circumscribed margin and SWV >3.27 m/s provides the highest specificity and diagnostic accuracy.

Keywords: Conventional ultrasonography, virtual touch tissue imaging quantification, breast lesions

DOI: 10.3233/CH-170249

Journal: Clinical Hemorheology and Microcirculation, vol. 67, no. 1, pp. 59-68, 2017