Adult ; Aged ; Aged, 80 and over ; Breast/pathology ; Breast Neoplasms/diagnosis* ; Breast Neoplasms/diagnostic imaging* ; Diagnosis, Differential ; Elasticity ; Elasticity Imaging Techniques/methods* ; Female ; Humans ; Image Processing, Computer-Assisted ; Middle Aged ; ROC Curve ; Reproducibility of Results ; Sensitivity and Specificity ; Ultrasonography, Mammary/methods* ; Young Adult
Keywords
Ultrasound ; Elastography ; Shear wave ; Breast ; Neoplasm
Abstract
OBJECTIVE:
To evaluate which shear wave elastography (SWE) parameter proves most accurate in the differential diagnosis of solid breast masses.
METHODS:
One hundred and fifty-six breast lesions in 139 consecutive women (mean age: 43.54 ± 9.94 years, range 21-88 years), who had been scheduled for ultrasound-guided breast biopsy, were included. Conventional ultrasound and SWE were performed in all women before biopsy procedures. Ultrasound BI-RADS final assessment and SWE parameters were recorded. Diagnostic performance of each SWE parameter was calculated and compared with those obtained when applying cut-off values of previously published data. Performance of conventional ultrasound and ultrasound combined with each parameter was also compared.
RESULTS:
Of the 156 breast masses, 120 (76.9 %) were benign and 36 (23.1 %) malignant. Maximum stiffness (Emax) with a cut-off of 82.3 kPa had the highest area under the receiver operating characteristics curve (Az) value compared with other SWE parameters, 0.860 (sensitivity 88.9 %, specificity 77.5 %, accuracy 80.1 %). Az values of conventional ultrasound combined with each SWE parameter showed lower (but not significantly) values than with conventional ultrasound alone.
CONCLUSIONS:
Maximum stiffness (82.3 kPa) provided the best diagnostic performance. However the overall diagnostic performance of ultrasound plus SWE was not significantly better than that of conventional ultrasound alone. KEY POINTS : • SWE offers new information over and above conventional breast ultrasound • Various SWE parameters were explored regarding distinction between benign and malignant lesions • An elasticity of 82.3 kPa appears optimal in differentiating solid breast masses • However, ultrasound plus SWE was not significantly better than conventional ultrasound alone.