Ultrasound Strain Elastography for Breast Lesions: Computer-Aided Evaluation with Quantifiable Elastographic Features: Computer-Aided

Abstract

Objectives: To develop and evaluate a set of quantifiable elastographic features based on ultrasound real-time strain elastography (SE) in differentiating between benign and malignant breast lesions. Methods: The SE and conventional B-mode ultrasound images of 226 breast lesions (81 malignant, 145 benign) were obtained from 226 consecutive women. By using a computer-aided tool, four elastographic features (elasticity score, lesion stiffness degree, lesion-to-fat strain ratio, and elastography-to-B-mode lesion area ratio) were respectively calculated and evaluated. Histopathologic results were used as the reference standard. B-mode Breast Imaging Reporting and Data System categorization was used to compare the performances between B-mode ultrasound and SE. Sensitivity, specificity, positive and negative predictive values, and receiver operating characteristic curve analyses were performed to evaluate the diagnostic performances for three data sets (conventional B-mode ultrasound alone, SE features alone, combined SE features). Results: Quantifiable SE features for malignant lesions all showed significantly higher values than those for benign lesions (all P