The value of virtual touch tissue imaging quantification in the differential diagnosis between benign and malignant breast lesions.

ABSTRACT

PURPOSE: To evaluate the value and diagnostic performance of virtual touch tissue imaging quantification (VTIQ) and to determine the optimum cut-off value for differential diagnosis between benign and malignant breast lesions. METHODS: Conventional ultrasonography (US) and VTIQ were performed in 454 patients with 466 breast lesions with a Siemens Acuson S3000 ultrasound machine. All lesions were assessed by an ultrasound Breast Imaging Reporting and Data System (BI-RADS) and confirmed by histopathology. The maximum, mean, and minimum shear wave velocity (SWV) values were quantitatively measured in m/s within the regions of interest (ROIs) and ranged from 0.5 to 10 m/s. The sensitivity, specificity, accuracy, and area under the receiver operating curve (AUC) of the VTIQ, BI-RADS, and combined data were compared. RESULTS: Among the 466 breast lesions, 266 were benign and 200 were malignant. All of the SWV values of the malignant lesions were significantly greater than those of the benign ones (P < 0.05). The optimal cut-off values for SWVmax, SWVmin, SWVmean, and SWVmax/SWVmin obtained from ROC analysis were 5.37 m/s, 3.08 m/s, 4.04 m/s, and 1.83, respectively. Logistic regression analysis revealed that BI-RADS was an independent risk factor for the differential diagnosis of breast lesions, whereas SWV values were not independent risk factors. CONCLUSIONS: VTIQ is useful in the differential diagnosis between benign and malignant breast lesions. The combination of VTIQ and ultrasonic BI-RADS can improve the diagnostic performance.