Giorgio Rizzatto, Presenter: Nothing to Disclose

Luca Aiani MD, Abstract Co-Author: Nothing to Disclose

Silvia Baldassarre, Abstract Co-Author: Nothing to Disclose

Andrea Bulzacchi, Abstract Co-Author: Nothing to Disclose

Sabino Della Sala, Abstract Co-Author: Nothing to Disclose

Martina Locatelli, Abstract Co-Author: Nothing to Disclose

Giuseppe Mangialavori, Abstract Co-Author: Nothing to Disclose

Pietro Monno, Abstract Co-Author: Nothing to Disclose

Gianfranco Scaperrotta, Abstract Co-Author: Nothing to Disclose

Cosimo di Maggio MD, Abstract Co-Author: Nothing to Disclose

Gian Marco Giuseppetti, Abstract Co-Author: Nothing to Disclose

Enzo Lattanzio, Abstract Co-Author: Nothing to Disclose

Alberto Martegani MD, Abstract Co-Author: Nothing to Disclose

Irene Floriani, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

To determine the clinical value of real-time sonoelastography (RTSE) in the differential diagnosis of breast lesions.

At 8 institutions, high-resolution ultrasound (US) and RTSE were performed in 784 women (mean age, 52.5 years) who had 874 lesions with a definitive diagnosis (614 benign, 260 malignant). The size was ≤10 mm in 59% and ≤5 mm in 13,2% of the lesions. US images were classified according the BI-RADS criteria for US; RTSE images were assigned an elastographic score (1 to 5) according to the distribution and degree of strain induced by light compression. Statistical analysis was performed by an independent institution.

Considering the receiver operating curves the overall diagnostic performance of US was slightly better than RTSE (area under the curve 0.94 for BI-RADS and 0.90 for RTSE respectively). But RTSE showed a very high specificity in benign lesions, including BI-RADS 3 lesions (329 lesions, 37,6%). With the best cutoff point between elasticity scores 3 and 4 the negative predictive value was 98% for the whole set, 96.3% for all the BI-RADS 3 lesions, and 100% for those with a size ≤5 mm. RTSE scores were insensitive to the thickness and the echogenicity of the breast, and to the depth and the size of the lesion. K indexes of intraobserver (0,93) and interobserver (0,90) agreement were very good.

RTSE scores are accurate and reproducible. They help conventional US in characterizing small breast lesions.

If incorporated in the diagnostic flow chart RTSE scores might avoid using biopsy in BI-RADS 3 for US and postpone to 1 year the follow-up schedule.

Rizzatto, G, Aiani, L, Baldassarre, S, Bulzacchi, A, Della Sala, S, Locatelli, M, Mangialavori, G, Monno, P, Scaperrotta, G, di Maggio, C, Giuseppetti, G, Lattanzio, E, Martegani, A, Floriani, I, et al, , Characterization of Breast Lesions with Real-time Sonoelastography: Results from the Italian Multicenter Clinical Trial.  Radiological Society of North America 2006 Scientific Assembly and Annual Meeting, November 26 - December 1, 2006 ,Chicago IL. http://archive.rsna.org/2006/4430351.html