Artifacts and pitfalls in breast elastoultrasonography: a pictorial essay

Abstract

Elastography allows real-time strain image visualisation using a free-hand probe with concurrent conventional B mode imaging. It has various applications, mainly in prostate, pancreatic cancer, the thyroid and the breast [1, 2], In the breast, it appears to be useful in BI-RADS 3 and 4 lesions in which it reduces the number of benign biopsies [3, 4].Studies published until now have been focused on the sensitivity and the specificity of the method, with special attention on the beneficial role of elastography in the reduction of the number of percutaneous biopsies. To the best of our knowledge there has been no study regarding the technique itself, how it should be performed and what the repercussions of an inadequate technique on the final elastographic score in breast pathology would be. The purpose of this paper is to present the technical factors and/or lesion characteristics which influence the elastographic examination and the final elastographic score in breast nodules.