Added Value of Different Types of Elastography in Evaluating Ultrasonography Detected Breast Lesions: A Compared Study With Mammography

The purpose of this study was to compare the diagnostic performance of ultrasonography (US) and mammography in the differential diagnosis of breast lesions after adding different types of elastography to US. We enrolled patients with 316 breast lesions, which were evaluated with conventional US, elastography, and mammography before biopsy or surgery. Elastography, including elasticity imaging, virtual touch tissue imaging, and virtual touch imaging quantification were used to downgrade US Breast Imaging-Reporting and Data System category 4A lesions. The results showed that the sensitivity of US was significantly higher than that of mammography, but the specificity of US was significantly lower than that of mammography. The addition of different types of elastography to US could improve the diagnostic performance in the differential diagnosis of breast lesions when compared with mammography. Background: The purpose of this study was to compare the diagnostic performance of ultrasonography (US) and mammography in the differential diagnosis of breast lesions after adding different types of elastography to US. Patients and Methods: This institutional review board-approved study included 316 breast lesions in 289 women between July 2016 and July 2018. All these lesions were evaluated with conventional US, elastography, and mammography before biopsy or surgery. Elastography, including elasticity imaging (EI), virtual touch tissue imaging (VTI), and virtual touch imaging quantification (VTIQ), were used to downgrade US Breast Imaging-Reporting and Data System category 4A lesions. Diagnostic performances were calculated for mammography, US elastography, and the combination of US and elastography. Results: The sensitivity of US (100%) was significantly higher than that of mammography (84.6%; P <.001), but the specificity of US (14.5%) was significantly lower than that of mammography (59.1%; P <.001). After adding EI, VTI, and VTIQ to US, the specificity was significantly increased from 14.5% to 69.4%, 72.6%, and 78.0%, respectively (P <.001), and were significantly higher than that of mammography (P = .043, P =.006, and P <.001, respectively). The sensitivity of US thorn EI (96.2%) and US thorn VTI (96.2%) was lower than that of US alone, although not significantly (100%; P =.063 and P =.063, respectively). Conclusion: The addition of different types of elastography to US improved the diagnostic performance in the differential diagnosis of breast lesions when compared with mammography.