Effectiveness of Sonoelastography and Diffusion MRI ADC Value In Discriminating Between Malignant and Benign Lesions of the Breast

Objective: We aimed to evaluate the diagnostic value and comparison of sonoelastography and diffusion-weighted magnetic resonance imaging in differentiation of benign and malignant breast masses. Method: Forty-five patients who were referred to our Radiology Department for the biopsy of a known breast mass following a breast MRI were evaluated by sonoelastography using a 5-scaled Tsukuba scoring system and measurements of ADC values on diffusion weighted MRIs. Contribution of the Tsukuba scores and ADC values of the masses to the conventional methods were evaluated. Results: Histopathological results of all masses with Tsukuba scores 1 and 2 were evaluated as benign. Histopathological results of 37.5% of patients with a Tsukuba score of 3 were found to be benign and 62.5% of the patients were found to be malignant. Histopathologically 80% of the patients with a Tsukuba score of 4 were evaluated to have malignant, while all (100 %) of the patients with a Tsukuba score of 5 were considered to have malignant disease. Statistically significant correlation was found between the histopathological results and Tsukuba scoring system (p<0.05). Sonoelastographic sensitivity, specificity, positive, and negative predictive values were 83.3%, 96.3%, 93.7% and 89.6%, respectively in the patients with Tsukuba scores of 4 and 5. The mean ADC values of histopathologically proven malignant, and benign masses were 0.95 +/- 0.17x10(-3) mm(2)/sec and 1.37 +/- 0.16x10(-3) mm(2)/sec, respectively. The mean ADC value of histopathologically proven malignant masses was significantly lower than histopathologically proven benign masses (p<0.01). At sonoelastographic evaluation, one false-positive and 5 false-negative results were found. Three out of 4 false-negative results were diagnosed correctly using ADC values. False-negativity was detected in one lesion diagnosed based on both sonoelastographic results, and ADC values. Conclusion: We think solely sonoelastography or ADC evaluations are inadequate, however, can be used in differentiation of benign and malignant breast masses.