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Clinical application of qualitative assessment for breast masses in shear-wave elastography

 Hye Mi Gweon  ;  Ji Hyun Youk  ;  Eun Ju Son  ;  Jeong-Ah Kim 
 EUROPEAN JOURNAL OF RADIOLOGY, Vol.82(11) : 680-685, 2013 
Journal Title
Issue Date
Adult ; Aged ; Aged, 80 and over ; Breast Neoplasms/diagnostic imaging* ; Breast Neoplasms/epidemiology* ; Elasticity Imaging Techniques/statistics & numerical data* ; Female ; Humans ; Middle Aged ; Observer Variation ; Prevalence ; Reproducibility of Results ; Republic of Korea/epidemiology ; Risk Factors ; Sensitivity and Specificity ; Ultrasonography, Mammary/statistics & numerical data*
BI-RADS ; Breast masses ; Breast ultrasound ; Shear wave ; Sonoelastography
PURPOSE: To evaluate the interobserver agreement and the diagnostic performance of various qualitative features in shear-wave elastography (SWE) for breast masses. MATERIALS AND METHODS: A total of 153 breast lesions in 152 women who underwent B-mode ultrasound and SWE before biopsy were included. Qualitative analysis in SWE was performed using two different classifications: E values (Ecol; 6-point color score, Ehomo; homogeneity score and Esha; shape score) and a four-color pattern classification. Two radiologists reviewed five data sets: B-mode ultrasound, SWE, and combination of both for E values and four-color pattern. The BI-RADS categories were assessed B-mode and combined sets. Interobserver agreement was assessed using weighted κ statistics. Areas under the receiver operating characteristic curve (AUC), sensitivity, and specificity were analyzed. RESULTS: Interobserver agreement was substantial for Ecol (κ=0.79), Ehomo (κ=0.77) and four-color pattern (κ=0.64), and moderate for Esha (κ=0.56). Better-performing qualitative features were Ecol and four-color pattern (AUCs, 0.932 and 0.925) compared with Ehomo and Esha (AUCs, 0.857 and 0.864; P<0.05). The diagnostic performance of B-mode ultrasound (AUC, 0.950) was not significantly different from combined sets with E value and with four color pattern (AUCs, 0.962 and 0.954). When all qualitative values were negative, leading to downgrade the BI-RADS category, the specificity increased significantly from 16.5% to 56.1% (E value) and 57.0% (four-color pattern) (P<0.001) without improvement in sensitivity. CONCLUSION: The qualitative SWE features were highly reproducible and showed good diagnostic performance in suspicious breast masses. Adding qualitative SWE to B-mode ultrasound increased specificity in decision making for biopsy recommendation.
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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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