Cargando…

Ultrasound real-time elastography can predict malignancy in BI-RADS(®)-US 3 lesions

BACKGROUND: Lesions of the breast that are classified BI-RADS(®)-US 3 by ultrasound are probably benign and observation is recommended, although malignancy may occasionally occur. In our study, we focus exclusively on BI-RADS(®)-US 3 lesions and hypothesize that sonoelastography as an adjunct to con...

Descripción completa

Detalles Bibliográficos
Autores principales: Wojcinski, Sebastian, Boehme, Esther, Farrokh, André, Soergel, Philipp, Degenhardt, Friedrich, Hillemanns, Peter
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3618252/
https://www.ncbi.nlm.nih.gov/pubmed/23530903
http://dx.doi.org/10.1186/1471-2407-13-159
_version_ 1782265386960420864
author Wojcinski, Sebastian
Boehme, Esther
Farrokh, André
Soergel, Philipp
Degenhardt, Friedrich
Hillemanns, Peter
author_facet Wojcinski, Sebastian
Boehme, Esther
Farrokh, André
Soergel, Philipp
Degenhardt, Friedrich
Hillemanns, Peter
author_sort Wojcinski, Sebastian
collection PubMed
description BACKGROUND: Lesions of the breast that are classified BI-RADS(®)-US 3 by ultrasound are probably benign and observation is recommended, although malignancy may occasionally occur. In our study, we focus exclusively on BI-RADS(®)-US 3 lesions and hypothesize that sonoelastography as an adjunct to conventional ultrasound can identify a high-risk-group and a low-risk-group within these patients. METHODS: A group of 177 breast lesions that were classified BI-RADS(®)-US 3 were additionally examined with real-time sonoelastography. Elastograms were evaluated according to the Tsukuba Elasticity Score. Pretest and posttest probability of disease (POD), sensitivity (SE), specificity (SP), positive (PPV) and negative predictive values (NPV) and likelihood-ratios (LR) were calculated. Furthermore, we analyzed the false-negative and false-positive cases and performed a model calculation to determine how elastography could affect the proceedings in population screening. RESULTS: In our collection of BI-RADS(®)-US 3 cases there were 169 benign and eight malignant lesions. The pretest POD was 4.5% (95% confidence interval (CI): 2.1–9.0). In patients with a suspicious elastogram (high-risk group), the posttest POD was significantly higher (13.2%, p = 0.041) and the positive LR was 3.2 (95% CI: 1.7–5.9). With a benign elastogram (low-risk group), the posttest POD decreased to 2.2%. SE, SP, PPV and NPV for sonoelastography in BI-RADS(®)-US 3 lesions were 62.5% (95% CI: 25.9–89.8), 80.5% (95% CI: 73.5–86.0), 13.2% (95% CI: 5.0–28.9) and 97.8% (95% CI: 93.3–99.4), respectively. CONCLUSIONS: Sonoelastography yields additional diagnostic information in the evaluation of BI-RADS(®)-US 3 lesions of the breast. The examiner can identify a low-risk group that can be vigilantly observed and a high-risk group that should receive immediate biopsy due to an elevated breast cancer risk.
format Online
Article
Text
id pubmed-3618252
institution National Center for Biotechnology Information
language English
publishDate 2013
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-36182522013-04-07 Ultrasound real-time elastography can predict malignancy in BI-RADS(®)-US 3 lesions Wojcinski, Sebastian Boehme, Esther Farrokh, André Soergel, Philipp Degenhardt, Friedrich Hillemanns, Peter BMC Cancer Research Article BACKGROUND: Lesions of the breast that are classified BI-RADS(®)-US 3 by ultrasound are probably benign and observation is recommended, although malignancy may occasionally occur. In our study, we focus exclusively on BI-RADS(®)-US 3 lesions and hypothesize that sonoelastography as an adjunct to conventional ultrasound can identify a high-risk-group and a low-risk-group within these patients. METHODS: A group of 177 breast lesions that were classified BI-RADS(®)-US 3 were additionally examined with real-time sonoelastography. Elastograms were evaluated according to the Tsukuba Elasticity Score. Pretest and posttest probability of disease (POD), sensitivity (SE), specificity (SP), positive (PPV) and negative predictive values (NPV) and likelihood-ratios (LR) were calculated. Furthermore, we analyzed the false-negative and false-positive cases and performed a model calculation to determine how elastography could affect the proceedings in population screening. RESULTS: In our collection of BI-RADS(®)-US 3 cases there were 169 benign and eight malignant lesions. The pretest POD was 4.5% (95% confidence interval (CI): 2.1–9.0). In patients with a suspicious elastogram (high-risk group), the posttest POD was significantly higher (13.2%, p = 0.041) and the positive LR was 3.2 (95% CI: 1.7–5.9). With a benign elastogram (low-risk group), the posttest POD decreased to 2.2%. SE, SP, PPV and NPV for sonoelastography in BI-RADS(®)-US 3 lesions were 62.5% (95% CI: 25.9–89.8), 80.5% (95% CI: 73.5–86.0), 13.2% (95% CI: 5.0–28.9) and 97.8% (95% CI: 93.3–99.4), respectively. CONCLUSIONS: Sonoelastography yields additional diagnostic information in the evaluation of BI-RADS(®)-US 3 lesions of the breast. The examiner can identify a low-risk group that can be vigilantly observed and a high-risk group that should receive immediate biopsy due to an elevated breast cancer risk. BioMed Central 2013-03-27 /pmc/articles/PMC3618252/ /pubmed/23530903 http://dx.doi.org/10.1186/1471-2407-13-159 Text en Copyright © 2013 Wojcinski et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Wojcinski, Sebastian
Boehme, Esther
Farrokh, André
Soergel, Philipp
Degenhardt, Friedrich
Hillemanns, Peter
Ultrasound real-time elastography can predict malignancy in BI-RADS(®)-US 3 lesions
title Ultrasound real-time elastography can predict malignancy in BI-RADS(®)-US 3 lesions
title_full Ultrasound real-time elastography can predict malignancy in BI-RADS(®)-US 3 lesions
title_fullStr Ultrasound real-time elastography can predict malignancy in BI-RADS(®)-US 3 lesions
title_full_unstemmed Ultrasound real-time elastography can predict malignancy in BI-RADS(®)-US 3 lesions
title_short Ultrasound real-time elastography can predict malignancy in BI-RADS(®)-US 3 lesions
title_sort ultrasound real-time elastography can predict malignancy in bi-rads(®)-us 3 lesions
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3618252/
https://www.ncbi.nlm.nih.gov/pubmed/23530903
http://dx.doi.org/10.1186/1471-2407-13-159
work_keys_str_mv AT wojcinskisebastian ultrasoundrealtimeelastographycanpredictmalignancyinbiradsus3lesions
AT boehmeesther ultrasoundrealtimeelastographycanpredictmalignancyinbiradsus3lesions
AT farrokhandre ultrasoundrealtimeelastographycanpredictmalignancyinbiradsus3lesions
AT soergelphilipp ultrasoundrealtimeelastographycanpredictmalignancyinbiradsus3lesions
AT degenhardtfriedrich ultrasoundrealtimeelastographycanpredictmalignancyinbiradsus3lesions
AT hillemannspeter ultrasoundrealtimeelastographycanpredictmalignancyinbiradsus3lesions