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Advanced Ultrasound in Diagnosis and Therapy ›› 2023, Vol. 7 ›› Issue (4): 394-400.doi: 10.37015/AUDT.2023.220041

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  • 收稿日期:2022-11-15 修回日期:2023-02-15 接受日期:2023-03-21 出版日期:2023-12-30 发布日期:2023-10-23

The Value of VTTQ Combined with B-mode US for Distinguishing Benign from Malignant Breast Masses by Comparing with SE: A Clinical Research

Lujing Li, MDa, Zuofeng Xu, MDa,*()   

  1. aDepartment of Ultrasound, the Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong, China
  • Received:2022-11-15 Revised:2023-02-15 Accepted:2023-03-21 Online:2023-12-30 Published:2023-10-23
  • Contact: Department of Ultrasound, the Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong, China. e-mail: lilujing@mail2.sysu.edu.cn

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Abstract:

Objective The purpose of this study was to compare the diagnostic performance of virtual touch tissue quantification (VTTQ) combined with B-mode ultrasonograpgy (US), strain elastography (SE) combined with B-mode US and B-mode US alone in differentiating the properties of breast lesions.

Methods A retrospective database was queried for 283 healthy subjects and 100 consecutive patients with 130 breast lesions. All the cases were examined by B-mode US, VTTQ and SE. Histological diagnosis was used as the reference standard. The area under the receiver operating curve (AUC) values of each data set was compared.

Results Twenty-two lesions were determined as malignant and 108 as benign. The best cutoff point of VTTQ was 7.82 m/s. The AUC of B-mode US combined with VTTQ or SE was greater than that of B-mode US alone (0.913 or 0.918 vs. 0.797) (P = 0.007 and 0.012).

Conclusion Both VTTQ and SE could give help to B-mode US in distinguishing benign from malignant breast lesions about elastography values. There was no difference between them.

Key words: B-mode ultrasonography, Virtual touch tissue quantification, Strain elastography

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Benign lesions (n =108) Malignant lesions (n = 22)
Histopathologic diagnosis n Histopathologic diagnosis n
Fibroadenoma 74 Invasive ductal carcinoma 16
Fibrocystic mastopathy 19 Ductal carcinoma in situ 1
Benign phyllodes tumor 5 Mucinous carcinoma 1
Intraductal papilloma 4 Invasive micropapillary carcinoma 1
Tubular adenoma of breast 4 Malignant phyllodes tumor 1
Hyperplasia 1 Lobular carcinoma in situ 1
Chronic inflammation 1 Neuroendocrine carcinoma 1

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Lesion type Class 2 Class 3 Class 4 Class 5 Total
Benign, n 16 53 39 0 108
Malignant, n 0 1 7 14 22
Total 16 54 46 14 130

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Benign lesions (n =108) Malignant lesions (n = 22)
Histopathologic diagnosis Median SWVs (m/s) Histopathologic diagnosis Median SWVs (m/s)
Fibroadenoma 3.07 ± 1.21 Invasive ductal carcinoma 8.57 ± 1.71
Fibrocystic mastopathy 3.35 ± 2.15 Ductal carcinoma in situ 9.00
Benign phyllodes tumor 2.30 ± 0.33 Mucinous carcinoma 9.00
Intraductal papilloma 4.31 ± 3.16 Invasive micropapillary carcinoma 9.00
Tubular adenoma of breast 2.98 ± 0.69 Malignant phyllodes tumor 0.60
Hyperplasia 2.81 Lobular carcinoma in situ 3.13
Chronic inflammation 1.89 Neuroendocrine carcinoma 9.00

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Lesion type Score 1 Score 2 Score 3 Score 4 Score 5 Total
Benign, n 58 41 3 6 0 108
Malignant, n 1 1 1 13 6 22
Total 59 42 4 19 6 130

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Item Sensitivity (%) Specificity (%) Accuracy (%) PPV (%) NPV (%)
B-mode US 95.5 63.9 69.2 35 98.6
B-mode US combined with VTTQ 86.4 96.3* 94.6* 82.6 97.2
B-mode US combined with SE 90.9 92.6* 92.3* 71.4 98.0

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