Elastography for the Characterization of Breast Lesions: Initial Clinical Experience
Elastography for the Characterization of Breast Lesions: Initial Clinical Experience
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DOI：
10.1177/107327481001700303
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发表时间：
2010-07-01
期刊：
影响因子：
2.6
通讯作者：
Szabunio, Margaret M.
中科院分区：
文献类型：
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作者：
Kumm, Todd R.;Szabunio, Margaret M.
背景：虽然乳腺活检仍然是诊断可疑病变的金标准，但很大比例的活检标本显示为良性结果。因此，一种非侵入性和可靠的方法来识别低风险的病变将是一个有价值的工具。方法：我们评估了弹性成像在转诊为活检的患者中的应用和诊断性能。在超声引导下对有明显超声表现的乳腺病变进行活检的受试者包括在本研究中。日立Hi-Vision 900超声仪用于生成弹性成像评分(ES)和应变比(SR)测量的指数测试结果。以14针芯针活检病理结果为参考标准，确定敏感性、特异性、阳性预测值和阴性预测值。结果：288例患者共310个病变纳入本组病例。在310个病变中，良性病变223个(72%)，恶性病变87个(28%)。ES和SR的敏感性分别为0.76和0.79。ES和SR的特异性分别为0.81和0.76。ES和SR的阳性预测值分别为0.60和0.57。ES和SR的阴性预测值分别为0.90和0.90。恶性病变的SR值明显较高(中位数比率分别为10.5和2.7，P<；.001)。结论：虽然弹性成像的初步临床表现显示出减少低风险病变的活检的潜力，但在广泛临床应用之前，有必要进行大规模试验，以确定合适的患者选择、诊断参数和实际应用。
Background: While breast biopsy remains the gold standard for diagnosis of suspicious lesions, a large proportion of biopsy specimens reveal a benign result. Therefore, a noninvasive and reliable method to identify low-risk lesions would be a valuable tool.Methods: We assessed the application and diagnostic performance of elastography for the characterization of breast lesions in patients referred for biopsy. Subjects referred for ultrasound-guided biopsy of sonographically apparent breast lesions were included in this study. The Hitachi Hi-Vision 900 ultrasound was used to generate index test results for elastography scoring (ES) and for strain ratio (SR) measurement. Sensitivity, specificity, and positive and negative predictive values were determined using pathologic results from 14-gauge core needle biopsy as the reference standard.Results: A total of 310 lesions in 288 patients were included in this series. Of these 310 lesions, 223 (72%) were benign and 87 (28%) were malignant. Sensitivity was 0.76 for ES and 0.79 for SR. Specificity was 0.81 for ES and 0.76 for SR. Positive predictive value was 0.60 for ES and 0.57 for SR. Negative predictive value was 0.90 for ES and 0.90 for SR. SR values for malignant lesions were significantly higher (median ratios 10.5 and 2.7, respectively, P < .001).Conclusions: While the initial clinical performance of elastography imaging shows potential to reduce biopsy of low-risk lesions, a large-scale trial addressing appropriate patient selection, diagnostic parameters, and practical application of this technique is necessary prior to widespread clinical use.