Future of breast elastography.
Strain; Breast; Shear wave; Breast neoplasms; *Elasticity Imaging Techniques; Strain ratio
Both strain elastography and shear wave elastography have been shown to have high sensitivity and specificity for characterizing breast lesions as benign or malignant. Training is important for both strain and shear wave elastography. The unique feature of benign lesions measuring smaller on elastography than B-mode imaging and malignant lesions appearing larger on elastography is an important feature for characterization of breast masses. There are several artifacts which can contain diagnostic information or alert to technique problems. Both strain and shear wave elastography continue to have improvements and new techniques will soon be available for clinical use that may provide additional diagnostic information. This paper reviews the present state of breast elastography and discusses future techniques that are not yet in clinical practice.
Barr Richard Gary
Ultrasonography (Seoul, Korea)
2019
2019-04
<a href="http://doi.org/10.14366/usg.18053" target="_blank" rel="noreferrer noopener">10.14366/usg.18053</a>
Editorial Comment.
Humans; Male; Prospective Studies; *Elasticity Imaging Techniques; *Prostatic Neoplasms
Barr Richard G
The Journal of urology
2018
2018-09
<a href="http://doi.org/10.1016/j.juro.2018.03.165" target="_blank" rel="noreferrer noopener">10.1016/j.juro.2018.03.165</a>
Liver Elastography Still in Its Infancy.
*Elasticity Imaging Techniques; *Liver; Humans; Liver Cirrhosis
Barr Richard G
Radiology
2018
2018-07
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1148/radiol.2018180777" target="_blank" rel="noreferrer noopener">10.1148/radiol.2018180777</a>
Real-time ultrasound elasticity of the breast: initial clinical results.
*Elasticity Imaging Techniques; *Image Processing; Adult; Aged; Biopsy; Breast; Breast – Pathology; Breast Diseases/diagnostic imaging/pathology; Breast Neoplasms – Diagnosis; Breast Neoplasms/*diagnostic imaging/*pathology; Computer-Assisted; Data Analysis Software; Diagnosis; Differential; Elasticity; Equipment and Supplies; Female; Humans; Immunohistochemistry; Mammary/*methods; Middle Aged; Needle; Ohio; Sensitivity and Specificity; Ultrasonography
PURPOSE: To determine the sensitivity and specificity of a real-time elasticity imaging (EI) ultrasound (US) system in the characterization of breast lesions as benign or malignant. METHODS: A total of 208 patients with 251 lesions were scheduled to undergo a US-guided breast biopsy for a mass identified on B-mode US, and each received a real-time elasticity image of the lesion before the biopsy. The lesion size measurements were obtained, and the EI/B-mode size ratio was obtained. The pathology report was obtained and correlated with the EI/B-mode ratio. An EI/B-mode ratio equal to or greater than 1 was considered malignant lesion, whereas EI/B-mode ratios of less than 1 were considered benign. Sensitivity, specificity, positive predictive values, and negative predictive values were calculated. RESULTS: Of the 251 lesions biopsied, 197 were pathologically benign, and 54 were malignant. Of the 54 malignant lesions, all had an EI/B-mode ratio equal to or greater than 1. Of the 197 benign lesions, 187 had an EI/B-mode ratio of less than 1. Ten benign lesions had an EI/B-mode ratio of greater than 1. The benign lesions that had an EI/B-mode ratio of greater than 1 were lesions with dense fibrosis, and in addition, a characteristic artifact was identified, which was visualized in all simple and complex cysts. The results correspond with a sensitivity of 100%, specificity of 95%, a positive predictive value of 84%, and a negative predictive value of 100%. CONCLUSIONS: Initial results of a real-time EI system for characterization of breast lesions suggest this technique can provide significant new diagnostic information. As a result, this information may significantly improve the ability to select patients for breast biopsy, resulting in a reduction in the number of benign breast biopsies.
Barr Richard G
Ultrasound quarterly
2010
2010-06
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1097/RUQ.0b013e3181dc7ce4" target="_blank" rel="noreferrer noopener">10.1097/RUQ.0b013e3181dc7ce4</a>
Foreword to the Second Set of WFUMB Guidelines and Recommendations on the Clinical Use of Ultrasound Elastography.
*Elasticity Imaging Techniques; *Guidelines as Topic; Humans; International Relations; Internationality; Medical; Medical Organizations; Practice Guidelines; Scales; Societies; Ultrasonography
Barr Richard G
Ultrasound in medicine & biology
2017
2017-01
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.ultrasmedbio.2016.08.027" target="_blank" rel="noreferrer noopener">10.1016/j.ultrasmedbio.2016.08.027</a>
Transcutaneous Ultrasound: Elastographic Lymph Node Evaluation. Current Clinical Applications and Literature Review.
*Elasticity Imaging Techniques; Elastography; Humans; Imaging; Lymph node; Lymph Nodes – Ultrasonography; Lymph Nodes/*diagnostic imaging; Lymphatic Diseases – Ultrasonography; Lymphatic Diseases/*diagnostic imaging; Scales; Shear wave elastography; Staging; Strain; Ultrasonics; Ultrasonography; Ultrasound
Distinguishing malignant versus benign lymphadenopathies is a major diagnostic dilemma in clinical medicine. Metastatic deposits in normal-sized lymph nodes (LNs) can be smaller than a millimeter, thus presenting a diagnostic challenge. In most clinical settings, however, enlarged LNs detected on imaging need to be classified as malignant or benign. Ultrasound seems to be a very reliable method for LN characterization because of the high resolution, especially in the subcutaneous areas. However, B-mode and Doppler-ultrasound criteria for characterization of a lymphadenopathy as benign or malignant are lacking specificity. Newer methods such as elastography seem to be valuable for identifying metastatic deposits within LNs and may help discriminate malignant and benign LNs. This review summarizes the different elastographic methods available and provides an overview of the relevant publications. According to the literature, elastography can be used for identifying metastatic deposits, to guide fine needle aspiration and to non-invasively choose the most suspicious LN of a group of enlarged LNs for targeted biopsy.
Chiorean Liliana; Barr Richard G; Braden Barbara; Jenssen Christian; Cui Xin-Wu; Hocke Michael; Schuler Andreas; Dietrich Christoph F
Ultrasound in medicine & biology
2016
2016-01
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.ultrasmedbio.2015.09.005" target="_blank" rel="noreferrer noopener">10.1016/j.ultrasmedbio.2015.09.005</a>