Author: Richard G. Barr M.D., Ph.D

Southwoods X-Ray and Open MRI, Youngstown, Ohio

Authored date:2006-11-21

Patient History

A routine screening mammogram of a 45-year-old female patient identified a 5mm lesion. The patient was referred for an ultrasound study and ultrasound-guided core biopsy. The initial ultrasound revealed a mass with a solid appearance and irregular margin, which was classified as a BIRAD 4 lesion and suspected malignancy. Prior to performing the biopsy, an elastogram was done to provide additional information.

Clinical Images

The 2D-mode ultrasound image shows 5mm lesion with solid appearance and irregular margins. Classified as BIRAD 4, this lesion would be biopsied. The elastogram image demonstrates a “bull’s eye” pattern (yellow arrows) with posterior high signal (black arrow), indicative of a cyst pattern.

Clinical Outcome

The elasticity exam indicated that her lesion had characteristics of a complex cyst and not solid. Knowing this guided the decision to perform a fine needle aspiration rather than a core biopsy. The lesion was aspirated with complete resolution of the cyst and pathology confirmed a benign cyst.

Ultrasound Solution

Mammography, ultrasound, and MRI have low specificity in determining if lesions are benign or malignant, resulting in biopsy of many benign lesions. An imaging technique with higher specificity could help eliminate a large number of biopsies while still detecting all the breast cancers.*

eSie Touch™ elasticity imaging is a new method that employs specialized software to visualize the relative stiffness of tissue. It is performed with a conventional ultrasound unit and a standard, high-frequency linear ultrasound transducer.

* Source: American Cancer Society

 Ultrasound Elasticity in Breast Imaging[111 KB]