1 / 15

DOES THE EI/B-MODE LENGTH RATIO PREDICT BREAST CANCER TUMOR GRADE?

DOES THE EI/B-MODE LENGTH RATIO PREDICT BREAST CANCER TUMOR GRADE?. Joseph R. Grajo, MD* Cynthia Peterson, MPH, RDMS Richard G. Barr, MD, PhD. Elastography. Has shown potential to differentiate benign and malignant breast lesions with high sensitivity and specificity. Elastography Techniques.

cortez
Download Presentation

DOES THE EI/B-MODE LENGTH RATIO PREDICT BREAST CANCER TUMOR GRADE?

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. DOES THE EI/B-MODE LENGTH RATIO PREDICT BREAST CANCER TUMOR GRADE? Joseph R. Grajo, MD* Cynthia Peterson, MPH, RDMSRichard G. Barr, MD, PhD

  2. Elastography • Has shown potential to differentiate benign and malignant breast lesions with high sensitivity and specificity

  3. Elastography Techniques • This study utilizes compression elastography • Varying methods include • Change in length • Change in area • Color elastography • Strain ratio measurements • In our lab we choose to use grey scale imaging and length change ratios.

  4. Previous Work • We previously reported a sensitivity of 99% and specificity of 85% in a multicenter study of 635 biopsy-proven lesions • Average E/B ratios were 0.76 for benign lesions (range 0.2 to 1.5) and 1.45 for malignant lesions (range 1.0 to 3.1)

  5. Hypothesis • In reviewing various pathologies from our series, we noticed that more aggressive malignancies demonstrated larger E/B ratios • We hypothesized that the degree of length change correlates with tumor grade

  6. Methods • Equipment • Siemens Antares Ultrasound System • Siemens S2000 Ultrasound System • Philips IU22 Ultrasound System • Simultaneous, side-by-side display of B-mode and elasticity images • “shadow” or “copy” functions used to measure at same location

  7. Methods • We evaluated 134 malignancies diagnosed in 125 patients referred for ultrasound guided core biopsy utilizing a 10 or 13 Hz probe over a 3 year period. • Measurements were made at the time of the clinical examination by the Radiologist performing the study. • Biopsies were subsequently performed with a 14 g Vacuum assisted core needle. FNAs were not included.

  8. Methods • In patients with pre-malignant or malignant diagnoses, pathology reports were reviewed for staging • If the tumor was excised, grading was based on the surgical specimen

  9. Methods • Mean E/B ratio of the tumor and the pathology were recorded for each lesion • E/B ratio of the tumor was compared to Scharf-Bloom-Richardson (SBR) and intraductal carcinoma grade using Pearson correlation coefficient

  10. Scharf-Bloom-Richardson Grading • Tubule Formation • > 75% = 1 • 10-75% = 2 • < 10% = 3 • Nuclear Pleomorphism • Small, uniform cells = 1 • Mod inc size/variation = 2 • Marked variation = 3 • Mitosis Count • Up to 7 = 1 • 8 to 14 = 2 • 15 or more = 3 3, 4, 5 = Low Grade 6 or 7 = Medium Grade 8 or 9 = High Grade

  11. Results • Average patient age was 64 years old (range 36-95) • E/B ratios varied from 1.0 to 3.1 • Pathology • Pre cancerous lesions 2 • Mucinous/colloid 7 • DCIS 13 • IDC 101 • Grade 1 30 • Grade 2 45 • Grade 3 26 • Lobular 11

  12. Results

  13. IDC Results • E/B ratio as compared to the tumor grade in IDC using one-tailed Pearson correlation coefficient (p < 0.05) was 0.078. • E/B ratio as compared to the SBR grade in IDC using one-tailed Pearson correlation coefficient (p < 0.05) was significant at 0.040.

  14. Conclusion • In this small study, E/B ratio correlates with the aggressiveness of breast tumors • In Invasive Ductal Cancers, there is a trend for increased E/B ratio with tumor grade, which was statistically significant • Other aspects and characteristics of the EI image may provide additional diagnostic information not yet recognized

More Related