The diagnostic value of strain elastography for BI-RADS category 4 lesions

Abstract Purpose To investigate the diagnostic value of strain elastography for Breast Imaging Reporting and Data System (BI-RADS) category 4 lesions. Methods We recruited a total of 224 patients (259 lesions in all) who were diagnosed with BI-RADS category 4 lesions from July 2021 to December 2022.The sensitivity (SEN), specificity (SPE), positive predictive value (PPV), negative predictive value (NPV) and accuracy (ACC) of conventional ultrasound (US), the elasticity score method, the strain ratio method, a combined group and logistic regression model for the diagnosis of BI-RADS category 4 lesions were calculated. Compare the area under the curve (AUC) values and evaluate the diagnostic value. P < 0.05 was considered statistically significant. Results Of the 259 BI-RADS category 4 lesions,163 were benign and 96 were malignant. The AUC values of five methods: Logistic regression model > combined group > strain ratio method > conventional US > elasticty score method. The combined group was higher than that for the conventional US and elasticity score method. The AUC of the strain ratio method was higher than that of the elasticity score method, and the AUC of the logistic regression model was higher than the strain ratio method; these differences were all significant (P < 0.05). Conclusion Strain elastography has high diagnostic value for BI-RADS category 4 lesions, and the strain ratio method was superior to elasticity score method. The efficacy of conventional US when combined with the elasticity score for the diagnosis of BI-RADS category 4 lesions was better than that of either method alone.