ABSTRACT
Background Breast elastography is a non-invasive and widely accessible method used in the differential diagnostic procedure in addition to B-mode imaging. Purpose To assess the role of elastographic features in the differentiation of breast lesions and to evaluate the importance of depth in the choice of reference fat tissue for the calculation of strain ratio. Material and Methods From January to August 2015, 242 breast lesions were evaluated using elastographic assessment based on qualitative and semi-quantitative parameters (color map, strain ratio, length ratio) as well as elastographic analysis. Histological findings were considered as gold-standard. Results Sensitivity and specificity of B-mode ultrasound imaging were 90% and 60%, respectively. Color map sensitivity was 98% and specificity 46%; strain ratio sensitivity 81% and specificity 70%; length ratio sensitivity 64% and specificity 76%. Combined analysis of these three elastographic features improved the overall diagnostic performance of any of the three parameters alone, yielded sensitivity similar to that of color map (95%) and specificity comparable to strain ratio and length ratio (70%). There was no significant difference in strain ratio obtained from the reference fat tissue at the same depth as the lesion and at a different depth (sensitivity 77% versus 84%; specificity 70% versus 68%; P < 0.001). Conclusion In our experience, elastography can improve ultrasound characterization of the lesion, particularly if elastographic analysis is performed.
Subject(s)
Breast Neoplasms/diagnostic imaging , Elasticity Imaging Techniques/methods , Ultrasonography, Mammary/methods , Adult , Aged , Aged, 80 and over , Breast/diagnostic imaging , Diagnosis, Differential , Female , Humans , Middle Aged , ROC Curve , Reproducibility of Results , Sensitivity and Specificity , Young AdultABSTRACT
OBJECTIVES: to assess the incidence of fatal and non-fatal major cardiovascular diseases and cancers in people with different cardiovascular risk profile of a longitudinal cohort. DESIGN: longitudinal study carried out in a large sample of general population, with a median follow-up of 17.7 years. SETTING AND PARTICIPANTS: MATISS longitudinal cohort, 7,491 men and women aged 20-75 years, free of cancer or cardiovascular diseases at baseline. Two cardiovascular risk groups (low-intermediate cardiovascular risk and high cardiovascular risk) and two educational levels (low level: primary school; middle/high level: middle/high school, university) have been considered. MAIN OUTCOME MEASURES: for both cancer and cardiovascular events the standardized incidence rates have been calculated, taking into account the cardiovascular risk profile and the educational level. RESULTS: people with a high-risk profile have higher incidence of major cardiovascular diseases and cancers. Furthermore, incidence rates are higher in people with lower educational level, except for cardiovascular diseases in men. CONCLUSIONS: this study shows that, in the considered population, cancer incidence rates are higher than cardiovascular diseases rates; moreover, cancer incidence is higher in people with high-risk cardiovascular profile. The increase of prevalence of favourable risk profile in the general population could represent effective community strategies for prevention of cardiovascular diseases and cancer. Major attention should be dedicated towards people at lower socioeconomical level.
