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Performance of shear-wave elastography for breast masses using different region-of-interest (ROI) settings

 Ji Hyun Youk  ;  Eun Ju Son  ;  Kyunghwa Han  ;  Hye Mi Gweon  ;  Jeong-Ah Kim 
 ACTA RADIOLOGICA, Vol.59(7) : 789-797, 2018 
Journal Title
Issue Date
Adult ; Aged ; 80 and over Aged ; Breast/diagnostic imaging ; Breast Neoplasms/*diagnostic imaging ; Differential Diagnosis ; Elasticity Imaging Techniques/*methods ; Female ; Humans ; Middle Aged ; Reproducibility of Results ; Retrospective Studies ; Mammary/*methods Ultrasonography ; Young Adult
Breast cancer ; diagnostic performance ; shear wave ; sonoelastography ; ultrasonography
Background Various size and shape of region of interest (ROI) can be applied for shear-wave elastography (SWE). Purpose To investigate the diagnostic performance of SWE according to ROI settings for breast masses. Material and Methods To measure elasticity for 142 lesions, ROIs were set as follows: circular ROIs 1 mm (ROI-1), 2 mm (ROI-2), and 3 mm (ROI-3) in diameter placed over the stiffest part of the mass; freehand ROIs drawn by tracing the border of mass (ROI-M) and the area of peritumoral increased stiffness (ROI-MR); and circular ROIs placed within the mass (ROI-C) and to encompass the area of peritumoral increased stiffness (ROI-CR). Mean (Emean), maximum (Emax), and standard deviation (ESD) of elasticity values and their areas under the receiver operating characteristic (ROC) curve (AUCs) for diagnostic performance were compared. Results Means of Emean and ESD significantly differed between ROI-1, ROI-2, and ROI-3 ( P < 0.0001), whereas means of Emax did not ( P = 0.50). For ESD, ROI-1 (0.874) showed a lower AUC than ROI-2 (0.964) and ROI-3 (0.975) ( P < 0.002). The mean ESD was significantly different between ROI-M and ROI-MR and between ROI-C and ROI-CR ( P < 0.0001). The AUCs of ESD in ROI-M and ROI-C were significantly lower than in ROI-MR ( P = 0.041 and 0.015) and ROI-CR ( P = 0.007 and 0.004). Conclusion Shear-wave elasticity values and their diagnostic performance vary based on ROI settings and elasticity indices. Emax is recommended for the ROIs over the stiffest part of mass and an ROI encompassing the peritumoral area of increased stiffness is recommended for elastic heterogeneity of mass.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Gweon, Hye Mi(권혜미) ORCID logo https://orcid.org/0000-0002-3054-1532
Kim, Jeong Ah(김정아) ORCID logo https://orcid.org/0000-0003-4949-4913
Son, Eun Ju(손은주) ORCID logo https://orcid.org/0000-0002-7895-0335
Youk, Ji Hyun(육지현) ORCID logo https://orcid.org/0000-0002-7787-780X
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