Relevance of sonographic B-mode criteria and computer-aided ultrasonic tissue characterization in differential/diagnosis of solid breast masses

We aimed to evaluate the differential diagnostic value of a method of compu ter-assisted texture analysis in comparison to established ultrasonographic B-mode characteristics in the examination of solid breast masses. At two c enters, 77 patients presenting with a solid mass on B-mode scan were studie d at 7.5 MHz. Description of B-mode appearance included assessment of tumor shape, borders, presence of an echogenic rim, tissue architecture, interna l echo structure, absorption and elasticity. For statistical pattern recogn ition, the following parameters were used: form factor, mean grey level, si gnal-to-noise ratio, mean gradient and correlation from the co-occurrence m atrix. At center 1, the most decisive parameter for differential diagnosis was distortion of tissue architecture (sensitivity, SN, 83%; specificity, S P, 92%) and, at center 2, relation to the adjacent tissue (SN 93%, SP 92%). Among texture parameters, best discrimination was achieved for correlation from the co-occurrence matrix at center 1 (SN 58%, SP 73%) and for form fa ctor at center 2 (SN 93%, SP 77%). Among sonographic criteria, the highest contribution to the diagnosis was found for an unsharp border (odds ratio, OR, 12.2), architectural distortion (OR, 8.6), fixation to skin or chest wa ll (OR, 9.0) and fixation to adjacent breast parenchyma (OR, 8.8), accordin g to texture analysis for parameters form factor (OR 4.0) and correlation f rom the co-occurrence matrix (OR 4.7). Ultrasonographic texture analysis ca n be helpful as an additional parameter in differential diagnosis of breast tumors, but did not reach differential diagnostic accuracy of sonomorpholo gic features. (C) 2000 World Federation for Ultrasound in Medicine & Biolog y.