Abstract:

INTRODUCTION: The firmness of breast lesions helps to differentiate malignant masses from benign masses. Tissue stiffness can be evaluated quantitatively and objectively by magnetic resonance imaging (MRI) and ultrasonography (USG) using the apparent diffusion coefficient (ADC) and ultrasound elastography techniques, respectively. We aimed to determine the strain ratio (SR) and ADC and their contribution to the diagnosis in malignant breast masses using US elastography and diffusion MR sequences. METHODS: Our study included 50 lesions in 50 female patients over 18 years of age who had invasive breast cancer proven histopathologically by tru-cut biopsy and had breast US elastography and breast MRI examinations before biopsy in the Radiology clinic archive. Sonoelastographic studies were performed with a 13-18 Mhz linear high resolution volumetric probe (Toshiba Aplio 400, Japan, 2014). Imaging and measurements were made by a single practitioner with 10 years of experience in breast radiology. ADC values were measured from different parts of the lesion, not including cystic, necrotic and hemorrhagic areas, using 10-40 mm2 ROI on ADC maps and the lowest ADC value was selected. RESULTS: A significant correlation between the SR and sizes of the masses (p<0.001). A correlation between the mass ADC and the size was found to be inversely proportional to each other, but suggesting statistically low significance (p<0.031). The highest SR and ADC were 92.79 in a single case with mixed intracystic mucinous and ductal carcinoma and 1.49 x10-3 mm2/s in a single case with mucinous carcinoma, respectively. DISCUSSION AND CONCLUSION: Sonoelastography and DWI are relatively new non-invasive methods with high sensitivity and specificity. The use of these methods together with basic methods in breast diseases increases the diagnostic performance in the differentiation of benign and malignant breast lesions.

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