Added value of Virtual Touch IQ shear wave elastography in the ultrasound assessment of breast lesions |
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Authors: | Victor Ianculescu Laura Maria Ciolovan Ariane Dunant Philippe Vielh Chafika Mazouni Suzette Delaloge Clarisse Dromain Alexandru Blidaru Corinne Balleyguier |
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Institution: | 1. Radiology Department, Gustave Roussy, Villejuif, France;2. Department of Statistics, Gustave Roussy, Villejuif, France;3. Department of Biopathology, Gustave Roussy, Villejuif, France;4. Department of Surgery, Gustave Roussy, Villejuif, France;5. Department of Oncology, Gustave Roussy, Villejuif, France;6. Department of Surgery, Bucharest Institute of Oncology, Bucharest, Romania;g UMR 8081, IR4M, Paris-Sud University, 91405 Orsay, France |
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Abstract: | PurposeTo determine the diagnostic performance of Acoustic Radiation Force Impulse (ARFI) Virtual Touch IQ shear wave elastography in the discrimination of benign and malignant breast lesions.Materials and methodsConventional B-mode and elasticity imaging were used to evaluate 110 breast lesions. Elastographic assessment of breast tissue abnormalities was done using a shear wave based technique, Virtual Touch IQ (VTIQ), implemented on a Siemens Acuson S3000 ultrasound machine. Tissue mechanical properties were interpreted as two-dimensional qualitative and quantitative colour maps displaying relative shear wave velocity. Wave speed measurements in m/s were possible at operator defined regions of interest. The pathologic diagnosis was established on samples obtained by ultrasound guided core biopsy or fine needle aspiration.ResultsBIRADS based B-mode evaluation of the 48 benign and 62 malignant lesions achieved 92% sensitivity and 62.5% specificity. Subsequently performed VTIQ elastography relying on visual interpretation of the colour overlay displaying relative shear wave velocities managed similar standalone diagnostic performance with 92% sensitivity and 64.6% specificity. Lesion and surrounding tissue shear wave speed values were calculated and a significant difference was found between the benign and malignant populations (Mann–Whitney U test, p < 0.0001). By selecting a lesion cut-off value of 3.31 m/s we achieved 80.4% sensitivity and 73% specificity. Applying this threshold only to BIRADS 4a masses, we reached overall levels of 92% sensitivity and 72.9% specificity.ConclusionVTIQ qualitative and quantitative elastography has the potential to further characterise B-mode detected breast lesions, increasing specificity and reducing the number of unnecessary biopsies. |
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Keywords: | Breast cancer Ultrasound Elastography Shear wave Virtual Touch IQ BIRADS 4a |
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