Elastography-Based Modeling of Breast Non-Mass Lesions: Comparative Diagnostic Performance of Qualitative and Quantitative Metrics


Gundogdu S., Elverici E., GÜNBEY KARABEKMEZ L., Ozsoy A., Kutlu M., Camur E.

Ultrasound quarterly, cilt.42, sa.2, 2026 (SCI-Expanded, Scopus)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 42 Sayı: 2
  • Basım Tarihi: 2026
  • Doi Numarası: 10.1097/ruq.0000000000000741
  • Dergi Adı: Ultrasound quarterly
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE
  • Anahtar Kelimeler: breast cancer, breast ultrasonography, elasticity score, non-mass lesions, strain elastography, strain ratio
  • Ankara Yıldırım Beyazıt Üniversitesi Adresli: Hayır

Özet

This study assessed the diagnostic efficiency of strain elastography in differentiating benign and malignant non-mass breast lesions (NMLs) detected on ultrasonography. A total of 149 patients (mean age, 48.8±10.6 y) with histopathologically confirmed NMLs were retrospectively analyzed. Each lesion was evaluated using B-mode ultrasonography and strain elastography, and both elasticity score and strain ratio were recorded. The mean strain ratio was significantly higher in malignant lesions than in benign ones (3.2±0.96 vs. 1.8±0.9, P<0.001). Receiver operating characteristic curve analysis showed a high diagnostic accuracy for strain ratio (area under the curve=0.863; 95% CI: 0.794-0.931), with a cutoff value of 2.45 yielding 82.8% sensitivity and 77.5% specificity. Lesions with an elasticity score ≥4 were more likely to be malignant (P<0.001). In multivariable modeling, adding elastography parameters to conventional ultrasonography improved diagnostic performance, and decision curve analysis demonstrated superior net clinical benefit for elastography-based models compared with ultrasonography alone. These findings suggest that integrating strain elastography into routine ultrasonographic assessment can enhance diagnostic accuracy and support clinical decision-making in patients with NMLs.