Purpose The purpose of this study was to evaluate and compare the diagnostic performance of grayscale ultrasonography (US), US elastography, and US computer-aided diagnosis (US-CAD) in the differential diagnosis of breast masses. benign and 73 (37.8%) were malignant. Breast masses had significantly higher rates of malignancy in BI-RADS categories 4c and 5, elastography patterns 4 and 5, and when the US-CAD assessment was possibly malignant (all P<0.001). Elastography had higher specificity (40.8%, P=0.042) than grayscale US. US-CAD showed the highest specificity (67.5%), positive predictive value (PPV) (61.4%), accuracy (74.1%), and area under the curve (AUC) (0.762, all P<0.05) among the three diagnostic tools. Conclusion US-CAD had higher values for specificity, PPV, accuracy, and AUC than grayscale US or elastography. Computer-based analysis based on the morphologic features of US may be very useful in improving the diagnostic performance of breast US. Keywords: Breast, Ultrasonography, BI-RADS, Elasticity imaging techniques, Diagnosis, computer-assisted Introduction In light of the wide application of breast ultrasonography (US) in daily practice, the American College of Radiology Breast Imaging Reporting and Data System (ACR BI-RADS) for breast US has been universally applied to facilitate communication between radiologists and clinicians and to standardize the management of women with breast abnormalities [1]. Studies have proven the ACR BI-RADS SGX-523 supplier lexicon for US to be an effective system in the differential diagnosis of breast SGX-523 supplier masses and the detection of malignancies [2-4]. However, the US features found in BI-RADS contain an overlap between malignant and harmless breasts people, in category 4 lesions especially, as this category carries a broad spectral range of breasts masses with an array of risk for malignancy (2%-95%) [5]. At the moment, no particular US descriptor or any mix of US descriptors continues to be reported to accurately forecast malignancy in breasts masses recognized on US [6]. With advancements in technology, different tools have already been used and formulated SGX-523 supplier in medical practice to boost the diagnostic performance of breast All of us. For example, US elastography, which actions and visualizes the intrinsic stress of a focus on mass, providing more information for mass characterization, continues to be applied to breasts US [7-9]. Computer-aided analysis (CAD) continues to be applied to breasts US interpretation, offering assistance in the morphologic evaluation of breasts masses based on the US BI-RADS descriptors aswell as last assessments [3,10,11]. These extra diagnostic modalities make use of different features of the prospective mass in lesion evaluation; elastography uses cells tightness, whereas US-CAD uses morphologic features. However, to day, no scholarly research possess likened the diagnostic performance of the additional imaging modalities. The goal of this research was to evaluate the diagnostic efficiency of grayscale US, elastography, and US-CAD in the differential diagnosis of breast masses visualized on US. Materials and Methods This retrospective study was approved by the Institutional Review Board of (Severance Hospital), and the requirement for informed consent was waived. Patients A total of 193 breast lesions in 175 consecutive women who were scheduled for breast US examinations, US-guided biopsy, or surgical excision at our institution from June to August 2015 were included in this study. The mean age of the 175 women was 46.4 years (range, 18 to 81 years). The mean size SGX-523 supplier of the 193 breast masses was 14.9 mm (range, 3 to 52 mm). Of these lesions, 180 (93.3%) were pathologically diagnosed after US-guided core needle biopsy (n=90), vacuum-assisted excision (n=10), or surgical excision (n=80). Thirteen lesions (6.5%) were included based on typically benign US findings; this category included cysts (n=5) and benign masses that had been stable for more than 24 months (n=8). US Examinations and Biopsies US examinations were performed using a 3-12-MHz linear transducer (RS80A with Prestige, Samsung Medison, Co. Ltd., Seoul, Korea). Two staff radiologists (J.H.Y and E.-K.K) with 7 and 19 years of experience SGX-523 supplier in breast imaging, respectively, were involved in image acquisition. The clinical information of the patient, including mammographic findings and prior US examinations, was given to the radiologists before the US examination. Bilateral breast examinations were routinely performed, during which the target breast masses were detected. Biopsies were performed Rabbit polyclonal to beta Catenin of all breast masses classified as BI-RADS category 4 and 5. In addition, 23 masses classified as category 3 were pathologically confirmed on the patients request. For image analysis using US-CAD, a single directional movement covering the entire mass with surrounding breasts parenchyma was documented as a online video. The US-CAD and elastography systems were applied after grayscale US from the same radiologist who performed.