Stamatia V. Destounis MD, Presenter: Research Consultant, Carestream Health, Inc Medical Advisory Board, Siemens AG Investigator, Siemens AG Investigator, FUJIFILM Holdings Corporation Investigator, Hologic, Inc Investigator, U-Systems, Inc

Andrea Lynn Arieno BS, Abstract Co-Author: Nothing to Disclose

Melissa Nicole Skolny MS, Abstract Co-Author: Nothing to Disclose

Renee Morgan RT, Abstract Co-Author: Nothing to Disclose

Patricia Somerville MD, Abstract Co-Author: Investigator, FUJIFILM Holdings Corporation Investigator, Koning Corporation Investigator, Hologic, Inc

Philip F. Murphy MD, Abstract Co-Author: Investigator, FUJIFILM Holdings Corporation Investigator, Koning Corporation Investigator, Hologic, Inc

Posy Jane Seifert DO, Abstract Co-Author: Investigator, FUJIFILM Holdings Corporation Investigator, Koning Corporation Investigator, Hologic, Inc

Wende W. Young MD, Abstract Co-Author: Investigator, FUJIFILM Holdings Corporation Investigator, Koning Corporation Investigator, Hologic, Inc

00030490-DMT et al, Abstract Co-Author: Nothing to Disclose

To evaluate elasticity imaging in the assessment of breast lesions and its potential impact on the biopsy rate.

Under institutional review board approval, all study patients signed informed consent to have EI at the time of hand-held breast ultrasound using a Siemens Sonoline Antares with a 13.5 VFX transducer ultrasound unit. All solid lesions went on to needle core or fine needle aspiration biopsy. Images acquired included standard B-mode and EI ultrasound images. Cine clip Dual Display images and EI color mapping images were obtained. B-mode size, EI size, percentage likelihood of malignancy based on B-mode and EI, ratio measurements between the EI and B-mode image, and concordance from B-mode to EI were documented. Data was recorded on lesion laterality and location, and mammographic and sonographic characteristics. Data recorded for biopsied lesions included type of biopsy, biopsy results, and open surgical biopsy results. Patient demographics, breast density, and follow-up visits were also recorded.

One hundred and thirty-five patients comprised the study cohort, yielding 139 elastogram studies. Subjects ranged in age from 18 to 92 (mean 55.1 years). Lesion types were 2 architectural distortion, 26 cyst, 10 fibroadenoma, 1 lymph node and 100 mass. Average size of lesions on B-mode was 1.2cm (range 0.3-3.5cm), average size of lesions on EI was 1.4cm (range 0.1-4.4cm). Total of 108 biopsies were performed; 8% (n=9) Fine needle aspiration, 36% (n=39) stereotactic, 56% (n=60) ultrasound guided. Of the 108 biopsies, 45 cancers were revealed. Image concordance when comparing B-mode to EI for cancerous findings consisted of 98% (n=44) concordance; one case was a false negative. Fifty-five benign findings were observed. Seven patients underwent cyst aspiration. Image concordance when comparing B-mode to EI for benign findings consisted of 76% (n= 42) concordance. 7% (n=4) were not concordant, and 9 cases were unclear. There was one atypical finding of atypical papillary neoplasm.

EI was effective at identifying cancerous breast lesions, as it properly identified 98% of lesions biopsied as having malignant findings. With biopsied benign lesions, EI properly identified 76% of the lesions; EI could have impacted the decision to forgo biopsy in these cases.

Clinical experience of elasticity imaging in the evaluation of palpable and non-palpable breast lesions.

Destounis, S, Arieno, A, Skolny, M, Morgan, R, Somerville, P, Murphy, P, Seifert, P, Young, W, et al, 0, The Role of Elasticity Imaging (EI) in a Large Community-based Breast Imaging Center.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8003134.html