Ultrasound (US) elastography is a valuable imaging technique for tissue characterization. Two main types of elastography, strain and shear-wave, are commonly used to image breast tissue. The use of elastography is expected to increase, particularly with the increased use of US for breast screening. Recently, the US elastographic features of breast masses have been incorporated into the 2nd edition of the Breast Imaging Reporting and Data System (BI-RADS) US lexicon as associated findings. This review suggests practical guidelines for breast US elastography in consensus with the Korean Breast Elastography Study Group, which was formed in August 2013 to perform a multicenter prospective study on the use of elastography for US breast screening. This article is focused on the role of elastography in combination with B-mode US for the evaluation of breast masses. Practical tips for adequate data acquisition and the interpretation of elastography results are also presented.

Lee JH, et al. Korean J Radiol. 2022 May;23(5):505-516. https://doi.org/10.3348/kjr.2021.0476

US-guided directional vacuum-assisted removal or US follow-up without intervention could be an alternative to surgical excision for benign breast papilloma without atypia. Background Recent studies suggest that US-guided directional vacuum-assisted removal (DVAR) is a satisfactory alternative to surgery for benign papilloma of the breast and recommend discretionary d...

Objectives: The purpose of this study was to determine the roles of sonography and sonographically guided fine‐needle aspiration biopsy and core‐needle biopsy for initial axillary staging of breast cancer.Methods: Of 220 patients with breast cancer who underwent preoperative or prechemotherapy sonography for axillary staging, 52 patients who underwent sonographically guided fine‐needle aspiration biopsy and core‐needle biopsy for cortical thickening or a compressed hilum of lymph nodes on sonography were prospectively enrolled. Sonography and fine‐needle aspiration biopsy/core‐needle biopsy findings were compared with final pathologic results from sentinel lymph node biopsy or axillary lymph node dissection.Results: Forty‐eight patients met the final study criteria; we excluded 4 who had received primary systemic chemotherapy and showed negative fine‐needle aspiration biopsy/core‐needle biopsy results and negative final postoperative pathologic results. The positive predictive value of axillary sonography was 54%. The sensitivity and specificity of fine‐needle aspiration biopsy were 73% and 100%, respectively, and those of core‐needle biopsy were 77% and 100%. Results did not differ significantly between sonographically guided core‐needle biopsy and fine‐needle aspiration biopsy. The complication rates of fine‐needle aspiration biopsy and core‐needle biopsy were both 4%, and fine‐needle aspiration biopsy and core‐needle biopsy cost $180 and $350, respectively.Conclusions: Both sonographically guided fine‐needle aspiration biopsy and core‐needle biopsy were useful for axillary staging of breast cancer with high sensitivity. However, fine‐needle aspiration biopsy is recommended based on the advantages of low cost and minimal invasiveness.

A biofeedback-based balance training system can be used to provide the compromised sensory information to subjects in order to retrain their sensorimotor function. In this study, the design and evaluation of the low-cost, intuitive biofeedback system developed at Gyeongsang National University is extended to provide multimodal biofeedback for balance training by utilization of visual and haptic modalities. The system consists of a smartphone attached to the waist of the subject to provide information about tilt of the torso, a personal computer running a purpose built software to process the smartphone data and provide visual biofeedback to the subject by means of a dedicated monitor and a dedicated Phantom Omni® device for haptic biofeedback. For experimental verification of the system, eleven healthy young participants performed balance tasks assuming two distinct postures for 30 s each while acquiring torso tilt. The postures used were the one foot stance and the tandem Romberg stance. For both the postures, the subjects stood on a foam platform which provided a certain amount of ground instability. Post-experiment data analysis was performed using MATLAB® to analyze reduction in body sway. Analysis parameters based on the projection of trunk tilt information were calculated in order to ascertain the reduction in body sway and improvements in postural control. Two-way analysis of variance (ANOVA) showed no statistically significant interactions between postures and biofeedback. Post-hoc analysis revealed statistically significant reduction in body sway on provision of biofeedback. Subjects exhibited maximum body sway during no biofeedback trial, followed by either haptic or visual biofeedback and in most of the trials the multimodal biofeedback of visual and haptic together resulted in minimization of body sway, thus indicating that the multimodal biofeedback system worked well to provide significant (p < 0.05) assistance in postural control. A multimodal biofeedback system can offer more customized training methods and hence provide therapists with a comprehensive solution for a diverse array of patients. It is necessary to identify the long-term effects of this novel biofeedback system. In the future, the balance training schemes for individuals with upright balance issues will be studied.