Breast Lesion Diameter in VisR Imaging Differs Between Malignant and Benign Masses in Women

The specificity of current clinical screening for identifying malignant breast lesions is as low as 65%, requiring costly and invasive additional tests to rule out false positives [1]. Ultrasound elastography is increasingly being used to augment diagnosis by measuring mechanical properties of the tissue. For this purpose, we investigate the E/B ratio, which compares lesion size on an elastogram to lesion size on B-mode and is reported to be >1 in malignant cases and <1 in benign cases. The E/B ratio is typically measured from stiffness estimate images that are based on tissue displacement after mechanical excitation, like SE or SWE. These stiffness estimation methods fail to account for viscosity, which is diagnostically relevant for breast cancer and can also bias stiffness estimates. We improve on these previous methods by measuring E/B ratio from both stiffness and viscosity VisR images. We found that E/B ratio measured from VisR relative elasticity (RE) and relative viscosity (RV) statistically separated benign and malignant breast lesions and improved AUC and sensitivity compared to E/B ratio measured from ARFI peak displacement.