Source: DGNews  |  Posted 2 years ago

By Ed Susman

CHICAGO -- December 2, 2009 -- Adding elastography -- a method of determining
the stiffness of a suspect lesion -- to a workup that includes ultrasound could
aid in distinguishing malignant from benign tumours, and could possibly
decrease the need for biopsies in breast cancer patients, researchers stated at
the Radiological Society of North America (RSNA) 95th Annual Meeting.

“There’s a lot of room to improve specificity with ultrasound, and elastography
can help to do that,” explained lead investigator Stamatia V. Destounis, MD,
Elizabeth Wende Breast Care, Rochester, New York, speaking here at a press
briefing on November 30. “Elastography is an easy way to eliminate needle
biopsy for something that’s probably benign.”

“Addition of elastography could potentially help … reduce the need for
additional imaging of benign lesions,” Dr. Destounis stated. Ultrasound is
often used after mammography to further investigate suspicious findings, but it
tends to result in more biopsies because of its relatively low specificity, she
explained. In fact, 80% of biopsied breast lesions turn out to be benign.

The research team examined 193 patients at their centre who had breast
ultrasound and elastography (198 total elastograms) to assess the sensitivity
and specificity of the procedure. They performed biopsies on all solid lesions.

Of 140 biopsies, 59 were cancerous, and elastography correctly identified 98%
of them, missing just 1, Dr. Destounis said.

Among the 69 lesions that turned out to be benign, elastography correctly
identified 78% of them. The remaining lesions were fluid-filled cysts or
cyst-like abnormalities.

Adding elastography is simply a matter of adding or activating software during
an ultrasound. Elastography uses pressure from breathing, heartbeat, or pushing
on the skin to examine the compressibility of a lesion.

“A malignant tumour will be stiffer than surrounding normal breast tissue,” Dr.
Destounis said, explaining that a noncancerous lesion will compress better and
look smaller on a scan. She added that elastography is not a new technology,
but is undergoing somewhat of a resurgence. It can be used in situations that
deal with soft tissue, such as breast and thyroid imaging.

Presentation title: The Role of Elasticity Imaging (EI) in a Large
Community-Based Breast Imaging Center. Abstract LL-BR4059-B04]