Naoto Egashira MD, Presenter: Nothing to Disclose

Kazutaka Nakashima MD, Abstract Co-Author: Nothing to Disclose

Akihiko Kanki MD, Abstract Co-Author: Nothing to Disclose

Hiroki Higashi MD, Abstract Co-Author: Nothing to Disclose

Tsutomu Tamada MD, PhD, Abstract Co-Author: Nothing to Disclose

Katsuyoshi Ito MD, Abstract Co-Author: Nothing to Disclose

To evaluate the diagnostic values of real-time ultrasound elastography and diffusion-weighted MR imaging with apparent diffusion coefficient (ADC) value analysis as a noninvasive, functional imaging techniques in the characterization of benign and malignant breast tumors.

A total of 107 patients (mean age: 49.8 years, age range: 18-77 years) with breast tumors who underwent both breast MR imaging including diffusion weighted imaging (DWI) and real-time ultrasound elastography of the breast were included. All lesions were confirmed from the surgically excised specimens. 73 lesions were malignant while 34 were benign. DWI was performed with a single-shot SE EPI sequence using b-value of 0,800sec/mm2, and then, the computed mean ADC values of the breast lesions were measured. Real-time ultrasound elastography was performed to estimate a hardness ratio of the breast lesion to the subcutaneous fatty tissue (fat-lesion ratio; FLR). ADC values in DWI and FLR in ultrasound elastography was evaluated for the diagnostic utility in the characterization of benign and malignant breast tumors.

The ADC values of malignant breast lesions (1.07 ± 0.16 x 10-3mm2/sec) were significantly lower (p<0.0001) than those of benign lesions (1.52 ± 0.16 x 10-3mm2/sec). FLR of malignant lesions (11.3±10.8) in ultrasound elastography was significantly higher (p<0.0001) than those of benign lesions (3.1±0.84). In the ROC analysis, there was no statistically significant difference between DWI and ultrasound elastography in the ability for characterizing benign and malignant breast lesions. When a cutoff level of the ADC value was set at 1.29 X 10-3mm2/sec, the sensitivity and specificity for the correct differentiation were 91.9% and 93% respectively. When a cutoff level of FLR was set at 3.9, the sensitivity and specificity were 93.2% and 94.5% respectively.

Both DWI and real-time ultrasound elastography are useful, noninvasive modality for the differentiation of benign and malignant breast lesions.

Real-time ultrasound elastography and diffusion-weighted MR imaging with ADC value analysis are useful, functional imaging techniques in the characterization of benign and malignant breast tumors.

Egashira, N, Nakashima, K, Kanki, A, Higashi, H, Tamada, T, Ito, K, Characterization of Breast Tumors with Functional Imaging: Evaluation with Real-Time Ultrasound Elastography and Diffusion-weighted MR Imaging with Apparent Diffusion Coefficient (ADC) Value Analysis.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9010741.html