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Streaming detection for evaluation of indeterminate sonographic breast masses: a pilot study.

Publication ,  Journal Article
Soo, MS; Ghate, SV; Baker, JA; Rosen, EL; Walsh, R; Warwick, BN; Ramachandran, AR; Nightingale, KR
Published in: AJR Am J Roentgenol
May 2006

OBJECTIVE: Streaming detection is a novel sonography technique that uses ultrasonic energy to induce movement in cyst fluid that is detected on Doppler sonography. This pilot study evaluates the utility of streaming detection for differentiating cysts from solid masses in breast lesions that are indeterminate on sonography. SUBJECTS AND METHODS: Thirty-nine lesions-11 simple cysts and seven solid masses (control group) and 21 masses with indeterminate findings for the diagnosis of a cyst versus a solid lesion (study group)-in 34 patients were evaluated using streaming detection. All lesions underwent cyst aspiration or biopsy (n = 35) or were diagnosed simple cysts (n = 4) on sonography. Lesion size and depth were recorded. Streaming detection software was placed on conventional sonography units. Acoustic pulses were focused on the lesion, and if fluid movement was generated, it was seen on the spectral Doppler display as velocity away from the transducer. Lesions were then aspirated or underwent biopsy, and the viscosity of the aspirated fluid was recorded. The sensitivity and specificity of the technique and the effect of cyst size, cyst depth, and fluid viscosity in diagnosing fluid-filled cysts were assessed. RESULTS: Overall, 31 cysts and eight solid masses (seven benign, one carcinoma) were diagnosed in the study and control groups. Aspiration of indeterminate lesions resulted in 20 cysts and one solid mass. Lesions ranged in size from 4 to 47 mm and in depth from 4 to 29 mm. In the control group, streaming detection correctly showed nine of the 11 simple cysts (sensitivity, 82%; positive predictive value, 100%), and acoustic streaming was absent in all seven solid masses (specificity, 100%; negative predictive value, 78%). Of the indeterminate lesions, streaming detection allowed correct identification of 10 of 20 cysts (sensitivity, 50%; positive predictive value, 100%). Acoustic streaming was not detected in the one solid study group lesion. Neither cyst size or depth nor fluid viscosity had a significant effect on the ability to detect fluid. CONCLUSION: The streaming detection technique improved differentiation of cysts from solid masses in indeterminate lesions and has potential for reducing the number of recommended cyst aspirations for the diagnosis of indeterminate breast masses.

Duke Scholars

Published In

AJR Am J Roentgenol

DOI

EISSN

1546-3141

Publication Date

May 2006

Volume

186

Issue

5

Start / End Page

1335 / 1341

Location

United States

Related Subject Headings

  • Ultrasonography, Mammary
  • Prospective Studies
  • Pilot Projects
  • Nuclear Medicine & Medical Imaging
  • Middle Aged
  • Humans
  • Female
  • Diagnosis, Differential
  • Breast Neoplasms
  • Breast Cyst
 

Citation

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ICMJE
MLA
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Soo, M. S., Ghate, S. V., Baker, J. A., Rosen, E. L., Walsh, R., Warwick, B. N., … Nightingale, K. R. (2006). Streaming detection for evaluation of indeterminate sonographic breast masses: a pilot study. AJR Am J Roentgenol, 186(5), 1335–1341. https://doi.org/10.2214/AJR.05.0005
Soo, Mary Scott, Sujata V. Ghate, Jay A. Baker, Eric L. Rosen, Ruth Walsh, Brenda N. Warwick, A. R. Ramachandran, and Kathryn R. Nightingale. “Streaming detection for evaluation of indeterminate sonographic breast masses: a pilot study.AJR Am J Roentgenol 186, no. 5 (May 2006): 1335–41. https://doi.org/10.2214/AJR.05.0005.
Soo MS, Ghate SV, Baker JA, Rosen EL, Walsh R, Warwick BN, et al. Streaming detection for evaluation of indeterminate sonographic breast masses: a pilot study. AJR Am J Roentgenol. 2006 May;186(5):1335–41.
Soo, Mary Scott, et al. “Streaming detection for evaluation of indeterminate sonographic breast masses: a pilot study.AJR Am J Roentgenol, vol. 186, no. 5, May 2006, pp. 1335–41. Pubmed, doi:10.2214/AJR.05.0005.
Soo MS, Ghate SV, Baker JA, Rosen EL, Walsh R, Warwick BN, Ramachandran AR, Nightingale KR. Streaming detection for evaluation of indeterminate sonographic breast masses: a pilot study. AJR Am J Roentgenol. 2006 May;186(5):1335–1341.

Published In

AJR Am J Roentgenol

DOI

EISSN

1546-3141

Publication Date

May 2006

Volume

186

Issue

5

Start / End Page

1335 / 1341

Location

United States

Related Subject Headings

  • Ultrasonography, Mammary
  • Prospective Studies
  • Pilot Projects
  • Nuclear Medicine & Medical Imaging
  • Middle Aged
  • Humans
  • Female
  • Diagnosis, Differential
  • Breast Neoplasms
  • Breast Cyst