Ianculescu Victor, Ciolovan Laura Maria, Dunant Ariane, Vielh Philippe, Mazouni Chafika, Delaloge Suzette, Dromain Clarisse, Blidaru Alexandru, Balleyguier Corinne
Radiology Department, Gustave Roussy, Villejuif, France.
Department of Statistics, Gustave Roussy, Villejuif, France.
Eur J Radiol. 2014 May;83(5):773-7. doi: 10.1016/j.ejrad.2014.01.021. Epub 2014 Feb 6.
To 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.
Conventional 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.
BIRADS 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 3.31m/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.
VTIQ qualitative and quantitative elastography has the potential to further characterise B-mode detected breast lesions, increasing specificity and reducing the number of unnecessary biopsies.
确定声辐射力脉冲（ARFI）虚拟触诊组织定量成像剪切波弹性成像在鉴别乳腺良恶性病变中的诊断性能。
采用传统B超和弹性成像技术对110例乳腺病变进行评估。使用基于剪切波的虚拟触诊组织定量成像（VTIQ）技术在西门子Acuson S3000超声仪上对乳腺组织异常进行弹性成像评估。组织力学特性通过二维定性和定量彩色图来解释，显示相对剪切波速度。在操作者定义的感兴趣区域可以测量波速，单位为m/s。通过超声引导下的粗针活检或细针穿刺获取样本，建立病理诊断。
基于乳腺影像报告和数据系统（BIRADS）的B超对48例良性病变和62例恶性病变进行评估，敏感性为92%，特异性为62.5%。随后进行的VTIQ弹性成像依靠对显示相对剪切波速度的彩色叠加图进行视觉解读，其独立诊断性能相似，敏感性为92%，特异性为64.6%。计算病变及周围组织的剪切波速度值，发现良性和恶性人群之间存在显著差异（曼-惠特尼U检验，p<0.0001）。通过选择3.31m/s的病变临界值，敏感性达到80.4%，特异性达到73%。仅将此阈值应用于BIRADS 4a类肿块时，总体敏感性和特异性分别达到92%和72.9%。
VTIQ定性和定量弹性成像有潜力进一步对B超检测出的乳腺病变进行特征描述，提高特异性并减少不必要活检的数量。
