Quantitative Ultrasound Elastography of Breast: A Review and Update with Emphasis on Shear Wave Imaging (ARFI)

Elastography is a method which determines the stiffness of tissues with the help of ultrasound technology and exhibits more quantitative data according to palpation that made during physical examination. Elastography has relatively entered to routine use in the breast evaluation with imaging techniques. Although palpation has a very long history, elastography has been used since 1990s. Elastography is used as an adjunct to conventional gray scale ultrasound and can identify the stiffness of the tissues non-invasively. Today, it is used as two separate technological modalities: strain elastography and shear wave elastography. The aims of these modalities are to increase the sensitivity of the separation between malignant and benign lesions, reduce the unnecessary biopsy processes and to provide a more accurate Breast Imaging Reporting and Data System (BIRADS) categorization of the breast lesions. In this article, we aimed to review the clinical utilization and benefits of elastography in differantial diagnosis of breast lesions, BIRADS categorization, and biopsy decision making in the light of current literature.