INNOVATIVE APPROACHES IN THE DIAGNOSIS OF FOCAL BREAST LESIONS
BI-RADS 3-4: ROLE AND PROSPECTS OF INTEGRATING CONTRAST-ENHANCED
ULTRASOUND AND ELASTOGRAPHY
Gazonova V.E.1, Zubarev A.V.2, Pulatova I.Z.3
1 - Department of Radiology and Ultrasound Diagnostics, Central State Medical Academyю Moscow, Russia.
2 - Department of Radiology and Radiation Therapy, Central State Medical Academy. Moscow, Russia.
3 - Department of Ultrasound Diagnostics №2, Center for the Development of Professional Qualifications of Medical Workers.
Tashkent, Uzbekistan.
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o explore the capabilities of multiparametric ultrasound with contrast enhancement and elastography in patients with focal breast lesions classified as BI-RADS 3-4 (before biopsy).
Materials and methods. A prospective study included 81 patients aged 26 to 77 years (average age of women was 48±7.7 years) with focal lesions in the breast. Women of reproductive age accounted for 58 (71.6%), while those in menopause made up 23 (28.4%). The diagnostic ultrasound complex included B-mode breast echography, elastography (compression and shear wave), microflow mode, and echocontrast imaging using the contrast agent Sonovue. The studies were conducted using expert-class ultrasound scanners: Logiq E10 (GE Healthcare, Milwaukee, WI, USA), CANON Aplio I 800 (Japan), Samsung RS 85 (Korea), and Mindray Resona 7 (China) with transducers operating in the frequency range of 9-24 MHz.
Results and disscussion. In compression elastography, the average stiffness value for malignant tumors was 5.31±0.4 [3.6-16.2], and for benign tumors, it was 1.76±0.14 [0.8-2.1; p<0.001]. In shear wave elastography, the median stiffness of malignant tumors was 98.4±12.3 kPa, while benign tumors had a median stiffness of 18.2±4.3 kPa (p<0.001). The study of hemodynamic and perfusion parameters in breast lesions showed that compared to benign lesions, the perfusion time (22.45±36.41 sec. versus 36.41±1.4 sec., P<0.01), and the time to reach the peak contrast (TTR) (16.38±3.8 versus 36.41±1.4, P<0.01) were significantly earlier in malignant lesions (P<0.01). The area under the receiver operating characteristic (ROC) curve was 0.845±0.046, with a 95% confidence interval (CI) of 0.755-0.914, and the predictive model was statistically significant (p<0.0001). Elastography in combination with contrast-enhanced ultrasound of the mammary glands had a sensitivity (Se) of 84.5% and specificity (Sp) of 75.5%.
Conclusions. Thus, the use of elastography, microflow, and echocontrast methods improves the accuracy of differential diagnosis of breast tumors in BI-RADS categories 3-4.
Keywords: compression elastography, shear wave elastography, contrast-enhanced ultrasound, breast, BI-RADS, breast cancer.
Corresponding author: Pulatova I.Z., e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript
For citation: Gazonova V.E., Zubarev A.V., Pulatova I.Z. Innovative approaches in the diagnosis of focal breast lesions BI-RADS 3-4: role and prospects of integrating contrast-enhanced ultrasound and elastography. REJR 2025; 15(1):107-118. DOI: 10.21569/2222-7415-2025-15-1-107-118.
Received: 16.11.24 Accepted: 28.02.25