Ultraschall Med 2008; 29 - OP_2_15
DOI: 10.1055/s-2008-1079814

Fat-lesion-ratio vs. elastography score: a new method for sonoelastography in the diagnostics of breast lesions

AA Geaid 1, S Grunwald 1, G Hatzung 1, PO Behrndt 1, R Ohlinger 1
  • 1University Clinic of Greifswald, Department of Gynecology and Obstetrics

Objective: Pathological changes in the breast can influence the elasticity of tissues. The sonoelastography is a method, which displays the realtime tissue elasticity colour-coded in parallel with the B-mode. The elastography-score (ESC) taken out of the colour-coded image was compared to the new sonoelastography measurement, the fat-lesion-ratio (FLR) in terms of sensitivity and specifity.

Materials and methods: From April to October 2007 patients of the breast consulting hours were examined each with one finding. The examination was accomplished with the Hitachi EUB 8500 HV. The ESC (score values 1–5) resulted from the determination of the examiner according to the ultrasound BI-RADS criteria whereas the FLR was measured by the elastography device via the selection of two regions of interest. This FLR is the result of the division of the average fat tissue elasticity through the average elasticity in the finding.

The pathologic survey of each breast lesion happened before or after the elastography examination through the use of high-speed cut biopsy (n=51/57, 89.5%), fine-needle aspiration cytology (n=5/57, 8.8%) or punction (n=1/57, 1.7%). The results were compared and evaluated with the ESC and FLR respectively.

Results: The whole examination included 57 patients in the age of 20 to 81 (average 53 years). The pathological analysis assessed 27 benign and 30 malign lesions. With a cut-off value of 4.16 the FLR reached a sensitivity of 61.6% and a specifity of 76.0%. It turned out that high values appeared predominantly in malign and low values appeared more often in benign lesions. In contrast to the FLR the ESC had clearly a less sensitivity of 46.7% and a higher specifity of 92.3%.

Conclusion: The first results point out bigger advantages of the fat-lesion-ratio compared to the elastography score in the diagnostics of breast lesions. More results can be expected by increasing the patient population.