Diagnosis Value Of Virtual Touch Tissue Quantification In Differential Diagnosis Of Breast Tumors

ObjectiveTo use conventional ultrasound(US)and virtual touch tissue quantification(VTQ)in analyzing the features of breast lumps.To explore the application value of VTQ in the differential diagnosis of benign and malignant breast masses.MethodsA total of 102 female patients with 107 breast lesions during June 2014 to August 20-15 underwent ultrasound examination and pathology confirmed.At first,all breast lesions were performed by US to analyze all kind of features for BI-RADS classification,includeing size,shape,orientation,margin,lesion boundary,echo pattern,calcifications,posterior acoustic,surrounding tissues and blood flow characteristics.Then all breast lesions were examined by means of VTQ technique.The shear wave velocity(SWV)was measured within the lesion(SWVi),in the boundary zone(SWVb)and in the normal glandular tissues(SWVg).Each site was measured at least three times.The pathological diagnosis as the gold standard,receiver operating characteristic(ROC)curve was used to evaluate the diagnosis value of VTQ,US and combined diagnosis in differentiating malignant from benign lesions.ResultsThe pathology tests showed 43 malignant cases and 64 benign cases.Considering BIRADS grading 4A or higher as positive for breast cancer,the sensitivity,specificity,accuracy,positive predictive value,negative predictive value were 93.0%,75.0%,82.2%,71.4%,94.1% respectively.The SWVi was higher than SWVb and SWVg,SWVb was higher than SWVg in both malignant and benign groups(P<0.05).There was no statistical difference in SWVg between malignant group and benign group.The SWVi and SWVb in malignant group were(6.70±1.75)m/s,(4.58±1.38)m/s,and in benign group were(3.52±1.52)m/s,(2.80±0.97)m/s,respectively.There were significant differences between benign group and malignant group(P<0.01).The sensitivity,specificity,accuracy,positive predictive values,negative predictive values of SWVi in differentiating between malignant and benign nodules were83.7%,85.9%,85.0%,80.0%,88.7% respectively based on the cut-off point as 5.06 m/s.Those of SWVb were 79.1%,81.2%,80.3%,73.9%,85.2% respectively based on cut-off point as 3.51m/s.The data of AUC by using SWVi,SWVb were 0.904(95%CI: 0.845,0.963),0.870(95%CI: 0.804,0.937)respectively and their difference was not statistically significant(P>0.05).The sensitivity,specificity,accuracy,positive predictive value,negative predictive value of US combined with VTQ diagnosis were 90.7%,87.5%,88.8%,83.0%,93.3% respectively.Compared with US,US combined with VTQ can elevate the diagnosis specificity,but there was no significant difference in sensitivity.ConclusionsBoth US and VTQ(include the shear wave velocity within the lesion and in the boundary zone)have a certain differential diagnostic value of breast tumors.But there were no significant differences between US and VTQ.US combined with VTQ can improve the specificity of US.It can improve the early diagnosis of malignant tumor and avoid the unnecessary biopsy and surgery.