The Value of Ultrasound Elastography in Evaluating Inflammatory Breast Lesions

Abstract Background: Differentiating benign from malignant breast inflammatory conditions is crucial because they have totally different prognosis and management. Ultrasound Elastography can be used as a noninvasive tool for assessing inflammatory breast lesions. Strain Elastography can help pickup malignant inflammatory breast lesions and subsequently guide biopsy, while ruling out benign inflammatory lesions and sparing the patient unnecessary procedures. Aim of Study: Assess the diagnostic performance of strain ultrasound elastography added to the conventional B-mode ultrasound in evaluating inflammatory breast lesions. Patients and Methods: This study includes 33 female patients presenting with mastitis in the time period from September 2018 to October 2019. All breast lesions were assessed by Conventional B-mode ultrasound and Strain Elastography. Qualitative color-coded E-scoring and Semi-quantitative SR (strain ratio) evaluation of the sonoelasto-graphic images were performed. The results were compared to histopathologic diagnoses or follow-up for 2 weeks after antibiotic therapy, serving as reference standard. Sensitivity, specificity, positive predictive values (PPV), negative predictive value (NPV) and total accuracy were calculated for conventional B-mode ultrasound, and Strain elastography separately and then combined together. Statistical analysis was done using IBM© SPSS© Statistics version 22 (IBM© Corp., Armonk, NY, USA). Kappa test tests were two-tailed. A p-value <0.05 was considered signif-icant. Results: Combined US and Elastography yielded the highest accuracy (96.2%) and Specificity (96%). E-score qualitative elastography yielded better accuracy (90.9%) and Specificity (90.3%) than Strain ratio, semiquantitative elas-tography.