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KMID : 1114620130100020136
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Journal of the Korean Society for Breast Screening
2013 Volume.10 No. 2 p.136 ~ p.144
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Guideline for the Combined Elastography and Color Doppler Ultrasonography Examinations: KSBI/KSFBS 2013-02 Multicenter Study
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Lee Su-Hyun
Koo Hye-Ryoung
Youk Ji-Hyun
Son Eun-Ju
Yi Ann
Kim Seung-Ja
Park Jeong-Seon
Choi Seon -Hyeong
Kook Shin-Ho
Chung Jin
Cha Eun-Suk
Ko Kyung-Hee
Choi Hye-Young
Ryu Eun-Bi
Moon Woo-Kyung
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Abstract
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Purpose: To establish interpretation criteria for ultrasound (US) elastography and color Doppler US findings of breast masses detected at screening US and to suggest a guideline for combined assessments with B-mode US findings which will be used in a multicenter prospective study (KSBI/KSFBS 2013-02).
Materials and Methods: In the KSBI/KSFBS 2013-02 study, US-detected breast masses with BI-RADS category 3 or more are recruited in asymptomatic women who are 30 years of age or older and who showed normal mammograms. Interpretation criteria for US elastography and color Doppler US as well as the guideline for combined assessments with B-mode US were set up by review of literature published between 2001 and 2013 and consensus meeting of radiologists from the 10 participating recruitment sites.
Results: Strain elastographic results are classified as negative when the mass shows even strain (green) across the entire lesion; equivocal when it shows uneven strain (blue and green); and positive when it shows no strain (blue) across the entire lesion. Shear-wave elastographic images are acquired with a default color scale range of 0 (dark blue) to 180 kPa (red) and the results are classified as negative when the mass shows a maximum elasticity color of dark blue or light blue; equivocal when it shows green or yellow colors; and positive when it shows orange or red colors. Color Doppler US results are defined as negative when the mass has no visible vascularity; equivocal when it has one circumferential or central vessel; and positive when it has two or more circumferential or central vessels, or a penetrating vessel. B-mode US BI-RADS categories can be downgraded when either of the two examinations shows negative result and the other shows negative or equivocal result and upgraded when either examination shows positive result and the other shows positive or equivocal result. It is recommended to follow the B-mode US BI-RADS categories when both examinations show equivocal results or opposite (one positive; the other negative) results.
Conclusion: Our guideline can be applied in daily practice of screening breast US when its clinical values are proven by the upcoming multicenter prospective study.
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KEYWORD
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Breast, Screening, Ultrasonography, Elastography, Color Doppler ultrasonography
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