Value Of VTQ And VTIQ On Differentiation Of Benign And Malignant Breast Masses

ObjectiveTo compare the diagnostic value of two elastography techniques,virtual touch tissue quantification(VTQ)and virtual touch tissue imaging quantification(VTIQ),in differentiating benign breast masses from malignant ones.Materials and MethodsA total of 102 breast masses were enrolled from 102 patients who underwent surgery in the Department of Breast Surgery,Qilu Hospita]of Shandong University from January 2015 to August 2017 and were confirmed by postoperative pathology.The patients were 22-71 years of age and mean age(47 ± 12)years old.There were 65 left breast masses and 71 right breast masses with the longest diameter of 0.8-5.0 cm(mean,1.6 ± 0.7 cm).The depth of masses were all less than 5 cm.Routine ultrasound,VTQ and VTIQ examination,VTQ technology to measure shear wave velocity(SWV)marked as SWVVTQ,VTIQ technology to measure the maximum minimum,average of SWV marked as SWVmax,SWVnin,SWVmean separately.Two different operators repeat the operation,the results were recorded separately.Data is processed using SPSS 21.0 software.Analyze the consistency of two different operators(intraclass correlation coefficient,ICC).According to the postoperative pathological findings,the masses were divided into benign group and malignant group according to WHO Breast Cancer Classification 2012(4th edition).The ROC curve was plotted and the area under the curve(AUC)were compared.The sensitivity,specificity,accuracy,positive predictive value(PPV)and negative predictive value(NPV)of the four measurements were respectively calculated.Comparing the size of mass in two-dimensional sonogram and of the high-intensity region in the VTIQ model,the patients were divided into two groups:enlarged group with obvious enlargement of high hardness region in VTIQ mode and non-enlarged group without obvious enlargement,The sensitivity,specificity,PPV and NPV were calculated refer to the pathological results.Results1.The ICC values of the two operators in all four measurements were all greater than 0.80 and both P<0.05.Four ICC measurements were compared:SWVmax>SWVmin>SWVmean>SWVVTQ.2.Significant differences of SWVmax,SWVmin,SWVmean and SWVVTQ between benign and malignant groups were found(P<0.05).3.The area under the ROC curve is compared.Of all these four measurements,the SWVmean was the most valuable measurement(AUC=0.91),the diagnostic sensitivity of SWVmax was the highest(83.0%),and the diagnostic specificity of SWVmean was the strongest(95.2%).4.According to whether VTIQ mode high hardness region of the mass was significantly larger than the mass size in two-dimensional sonogram,the sensitivity,specificity,PPV and NPV of differentiated benign and malignant mass were 32.99%,100%,100%and 40%respectively.Conclusions1.VTQ technology and VTIQ technology both have good stability.The stability of VTIQ is slightly higher than that of VTQ,and the stability of SWVmax is the best.2.VTQ and VTIQ elastography have certain value in the differential diagnosis of benign and malignant breast masses.3.The SWVmean was the most valuable measurement,of these four measurements:,SWVmin,SWVmean and SWVVTQ.4.It was found that the high hardness area of part of malignant masses were significantly enlarged in VTIQ mode,and this phenomenon was not found in all the benign masses,this phenomenon may could be as one basis for the diagnosis of malignant mass to some extent.