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Diagnostic value of commercially available shear-wave elastography for breast cancers: integration into BI-RADS classification with subcategories of category 4

 Ji Hyun Youk  ;  Hye Mi Gweon  ;  Eun Ju Son  ;  Kyung Hwa Han  ;  Jeong-Ah Kim 
 EUROPEAN RADIOLOGY, Vol.23(10) : 2695-2704, 2013 
Journal Title
Issue Date
Adult ; Aged ; Aged, 80 and over ; Algorithms* ; Breast Neoplasms/classification* ; Breast Neoplasms/diagnostic imaging* ; Elasticity Imaging Techniques/methods* ; Female ; Humans ; Image Enhancement/methods ; Image Interpretation, Computer-Assisted/methods* ; Middle Aged ; Reproducibility of Results ; Republic of Korea ; Sensitivity and Specificity ; Severity of Illness Index* ; Systems Integration ; Ultrasonography, Mammary/methods* ; Young Adult
Breast ; Ultrasound ; Elastography ; Shear wave ; BI-RADS
OBJECTIVES: To evaluate the diagnostic performance of shear-wave elastography (SWE) for breast cancer and to determine whether the integration of SWE into BI-RADS with subcategories of category 4 improves the diagnostic performance. METHODS: A total of 389 breast masses (malignant 120, benign 269) in 324 women who underwent SWE before ultrasound-guided core biopsy or surgery were included. The qualitative SWE feature was assessed using a four-colour overlay pattern. Quantitative elasticity values including the lesion-to-fat elasticity ratio (Eratio) were measured. Diagnostic performance of B-mode ultrasound, SWE, or their combined studies was compared using the area under the ROC curve (AUC). RESULTS: AUC of Eratio (0.952) was the highest among elasticity values (mean, maximum, and minimum elasticity, 0.949, 0.939, and 0.928; P = 0.04) and AUC of colour pattern was 0.947. AUC of combined studies was significantly higher than for a single study (P < 0.0001). When adding SWE to category 4 lesions, lesions were dichotomised according to % of malignancy: 2.1 % vs. 43.2 % (category 4a) and 0 % vs. 100 % (category 4b) for Eratio and 2.4 % vs. 25.8 % (category 4a) for colour pattern (P < 0.05). CONCLUSIONS: Shear-wave elastography showed a good diagnostic performance. Adding SWE features to BI-RADS improved the diagnostic performance and may be helpful to stratify category 4 lesions. KEY POINTS: • Quantitative and qualitative shear-wave elastography provides further diagnostic information during breast ultrasound. • The elasticity ratio (E ratio ) showed the best diagnostic performance in SWE. • E ratio and four-colour overlay pattern significantly differed between benign and malignant lesions. • SWE features allowed further stratification of BI-RADS category 4 lesions.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 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
Han, Kyung Hwa(한경화)
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