{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T06:09:17Z","timestamp":1790834957841,"version":"4.1.0"},"reference-count":32,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2020,4,24]],"date-time":"2020-04-24T00:00:00Z","timestamp":1587686400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Ultrasound Medicine"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>American College of Radiology Breast Imaging Reporting and Data System (BI\u2010RADS) category 4A lesions can be distinguished from BI\u2010RADS 3 lesions with main ultrasound (US) findings such as a well\u2010defined contour, round\/oval shape, and parallel orientation with a homogeneous echo pattern. Breast Imaging Reporting and Data System 4A solid masses might be diagnosed as simple fibroadenomas (SFAs), complex fibroadenomas (CFAs), or benign phyllodes tumors (BPTs). Complex fibroadenomas have an increased risk of invasive cancer development than SFAs, and BPTs have a risk of borderline\u2010malignant phyllodes tumor transformation; both of them are surgically treated, whereas follow\u2010up procedures are applied in SFAs. It is essential to differentiate SFAs from CFAs and BPTs. Grayscale features of these lesions include a prominent overlap. Texture analyses in breast lesions have contributions in benign\u2010malignant lesion differentiation. In this study, we aimed to use texture analysis of US images to differentiate these benign lesions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Grayscale US features of lesions (32 SFAs, 31 CFAs, and 32 BPTs) were classified according to the BI\u2010RADS. Texture analysis of US images with LIFEx software (<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/www.lifexsoft.org\">http:\/\/www.lifexsoft.org<\/jats:ext-link>) was performed retrospectively. First\u2010 and second\u2010order histogram parameters were evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In grayscale US, the shape, orientation, and posterior acoustic characteristics had statistical significance (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.05). In the statistical analysis, skewness, kurtosis, excess kurtosis, gray\u2010level co\u2010occurrence matrix (GLCM)\u2010energy, GLCM\u2010entropy log 2, and GLCM\u2010entropy log 10 revealed significant differences among all 3 groups (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>As grayscale US features show prominent intersections, and treatment options differ, correct diagnosis is essential in SFAs, CFAs, and BPTs. In this study, we concluded that texture analysis of US images can discriminate SFAs from CFAs and BPTs. Texture analyses of US images is a potential candidate diagnostic tool for these lesions, and accurate diagnoses will preclude patients from undergoing unnecessary biopsies.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jum.15304","type":"journal-article","created":{"date-parts":[[2020,4,24]],"date-time":"2020-04-24T09:38:05Z","timestamp":1587721085000},"page":"1993-2003","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Texture Analysis of Ultrasound Images to Differentiate Simple Fibroadenomas From Complex Fibroadenomas and Benign Phyllodes Tumors"],"prefix":"10.1002","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0786-1490","authenticated-orcid":false,"given":"Isil","family":"Basara Akin","sequence":"first","affiliation":[{"name":"Department of Radiology Dokuz Eylul University School of Medicine  Izmir Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6123-0668","authenticated-orcid":false,"given":"Hakan","family":"Ozgul","sequence":"additional","affiliation":[{"name":"Department of Radiology Dokuz Eylul University School of Medicine  Izmir Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9284-6999","authenticated-orcid":false,"given":"Kursat","family":"Simsek","sequence":"additional","affiliation":[{"name":"Department of Radiology Dokuz Eylul University School of Medicine  Izmir Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0417-7770","authenticated-orcid":false,"given":"Canan","family":"Altay","sequence":"additional","affiliation":[{"name":"Department of Radiology Dokuz Eylul University School of Medicine  Izmir Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7350-2202","authenticated-orcid":false,"given":"Mustafa","family":"Secil","sequence":"additional","affiliation":[{"name":"Department of Radiology Dokuz Eylul University School of Medicine  Izmir Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2425-7631","authenticated-orcid":false,"given":"Pinar","family":"Balci","sequence":"additional","affiliation":[{"name":"Department of Radiology Dokuz Eylul University School of Medicine  Izmir Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,4,24]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1148\/rg.305095144"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2483071786"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.carj.2010.08.004"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.7863\/ultra.33.3.415"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1309\/F523-FMJV-W886-3J38"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19930515)71:10<3020::AID-CNCR2820711022>3.0.CO;2-G"},{"key":"e_1_2_6_8_1","first-page":"27","article-title":"Fibroadenoma versus phyllodes tumor: distinguishing factors in patients diagnosed with fibroepithelial lesions after a core needle biopsy","volume":"20","author":"Wiratkapun C","year":"2014","journal-title":"Diagn Interv Radiol"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.5152\/ejbh.2019.4656"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199407073310103"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-1497.1998.cr188.x"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.11-5-435"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2016.12.017"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.crad.2004.07.008"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.07.2070"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.12111316"},{"key":"e_1_2_6_17_1","first-page":"207","volume-title":"The Handbook of Pattern Recognition and Computer Vision","author":"Tuceryan M","year":"1998"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2015151169"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdx034"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1159\/000444377"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2019.01021"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-017-5005-7"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12880-017-0239-z"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.acra.2009.08.012"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0455.2002.430107.x"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcu.22278"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1093\/jjco\/29.1.8"},{"key":"e_1_2_6_28_1","first-page":"287","article-title":"Imaging findings of complex fibroadenomas of the breast: correlation with pathologic findings","volume":"29","author":"You SK","year":"2010","journal-title":"J Korean Soc Ultrasound Med"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.198.1.8539362"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.2147\/CMAR.S215039"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-018-31906-4"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.24920\/003516"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mri.2003.09.001"}],"container-title":["Journal of Ultrasound in Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fjum.15304","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jum.15304","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jum.15304","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jum.15304","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,5]],"date-time":"2023-09-05T03:59:26Z","timestamp":1693886366000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jum.15304"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,4,24]]},"references-count":32,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2020,10]]}},"alternative-id":["10.1002\/jum.15304"],"URL":"https:\/\/doi.org\/10.1002\/jum.15304","archive":["Portico"],"relation":{},"ISSN":["0278-4297","1550-9613"],"issn-type":[{"value":"0278-4297","type":"print"},{"value":"1550-9613","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,4,24]]},"assertion":[{"value":"2020-02-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-03-26","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-04-24","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}