Diagnostic value of ultrasound peritumoral viscoelasticity parameters in breast cancer: enhancing BI-RADS classification performance

OBJECTIVES: Aims to access the diagnostic performance of different regions ultrasound viscoelasticity parameters especially margin of breast cancer and to determine whether the use of margin viscoelasticity can improve its accuracy in the Breast Imaging Reporting and Data System (BI-RADS). MATERIALS & METHODS: 234 benign and 90 malignant lesions were subjected to standard breast ultrasound and viscoelasticity examinations. The doctors selected region of interest (ROI) to measure viscoelasticity. ROI-1, ROI-2, and ROI-3 represent the tumor, peritumoral, and peripheral areas, respectively. The viscosity modulus (VMean, VMin, VMax, VSD) and elasticity modulus (EMean, EMin, EMax, ESD) of 3 ROIs were analyzed. The diagnostic performance of viscoelasticity of three regions was assessed by receiver operating characteristic curves (ROC). Comparison of the effectiveness of B-Mode ultrasound and viscoelastic parameters in BI-RADS diagnosis of breast cancer based on true positive (TP) and false negative (FN). RESULTS: The optimal viscoelasticity-related parameters for differentiating breast lesions were determined to be 2-EMax and 2-VMax, with area under the curve (AUC) values of 0.84 (0.79–0.90) and 0.85 (0.80–0.90), respectively. Using ≥ 30.4 kPa and ≥ 3.3 Pa·s as cutoff values, the BI-RADS classification was then modified. The joint model improves diagnoses of benign lesions in category 4 (69/73). In the same way, 2-EMin + 2-VMin can improve the diagnosis rate of benign lesions (227/234). Viscoelastic parameters have better diagnostic performance than viscosity and elasticity alone. CONCLUSION: Ultrasound quantitative viscoelasticity parameters of breast mass especially lesion margin can show more comprehensive information. Viscoelasticity improves diagnostic accuracy of BI-RADS categories and reduces unnecessary biopsies.