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Shearwave Elastography Increases Diagnostic Accuracy in Characterization of Breast Lesions

View Article: PubMed Central - PubMed

ABSTRACT

The purpose of this study was to investigate the diagnostic efficacy of shearwave elastography (SWE) in differentiating between benign and malignant breast lesions.

One hundred and fifty-nine lesions were assessed using B-mode ultrasound (US) and SWE parameters were recorded (Emax, Emean, Emin, Eratio, SD). SWE measurements were then correlated with histopathological diagnosis.

≥≥: The final sample contained 85 benign and 74 malignant lesions. The maximum stiffness (Emax) with a cutoff point of 56.0 kPa (based on ROC curves) provided sensitivity of 100.0%, specificity of 97.6%, positive predictive value (PPV) of 97.4%, and negative predictive value (NPV) of 100% in detecting malignant lesions. A cutoff of 80 kPa managed to downgrade 95.5% of the Breast Imaging-Reporting and Data System (BI-RADS) 4a lesions to BI-RADS 3, negating the need for biopsy. Using a combination of BI-RADS and SWE, the authors managed to improve the PPV from 2.3% to 50% in BI-RADS 4a lesions.

SWE of the breast provides highly specific and sensitive quantitative values that are beneficial in the characterization of breast lesions. Our results showed that Emax is the most accurate value for differentiating benign from malignant lesions.

No MeSH data available.


Related in: MedlinePlus

Shearwave elastography (SWE) of a Breast Imaging-Reporting and Data System (BI-RADS) 5 lesion in a 65-year-old woman with a palpable lump. (A) Shearwave imaging showed a heterogeneous color map and Emax of 300 kPa. Photo insert shows a gray scale B-mode ultrasound of an irregular lobulated hypoechoic lesion (taller than wider). (B) Right breast digital mammograms in MLO and CC views showing a high-density spiculated lesion with associated microcalcifications at the right upper inner quadrant. (C) Photomicrograph (H and E, ×40) of surgical excision specimen of an infiltrating ductal carcinoma.
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Figure 5: Shearwave elastography (SWE) of a Breast Imaging-Reporting and Data System (BI-RADS) 5 lesion in a 65-year-old woman with a palpable lump. (A) Shearwave imaging showed a heterogeneous color map and Emax of 300 kPa. Photo insert shows a gray scale B-mode ultrasound of an irregular lobulated hypoechoic lesion (taller than wider). (B) Right breast digital mammograms in MLO and CC views showing a high-density spiculated lesion with associated microcalcifications at the right upper inner quadrant. (C) Photomicrograph (H and E, ×40) of surgical excision specimen of an infiltrating ductal carcinoma.

Mentions: Benign lesions generally showed a uniform homogeneity on the color map with no difference in lesion color map size compared to B-mode. Examples of benign lesions are shown in Figures 2 and 3, whereas malignant lesions are shown in Figures 4 and 5.


Shearwave Elastography Increases Diagnostic Accuracy in Characterization of Breast Lesions
Shearwave elastography (SWE) of a Breast Imaging-Reporting and Data System (BI-RADS) 5 lesion in a 65-year-old woman with a palpable lump. (A) Shearwave imaging showed a heterogeneous color map and Emax of 300 kPa. Photo insert shows a gray scale B-mode ultrasound of an irregular lobulated hypoechoic lesion (taller than wider). (B) Right breast digital mammograms in MLO and CC views showing a high-density spiculated lesion with associated microcalcifications at the right upper inner quadrant. (C) Photomicrograph (H and E, ×40) of surgical excision specimen of an infiltrating ductal carcinoma.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4998391&req=5

Figure 5: Shearwave elastography (SWE) of a Breast Imaging-Reporting and Data System (BI-RADS) 5 lesion in a 65-year-old woman with a palpable lump. (A) Shearwave imaging showed a heterogeneous color map and Emax of 300 kPa. Photo insert shows a gray scale B-mode ultrasound of an irregular lobulated hypoechoic lesion (taller than wider). (B) Right breast digital mammograms in MLO and CC views showing a high-density spiculated lesion with associated microcalcifications at the right upper inner quadrant. (C) Photomicrograph (H and E, ×40) of surgical excision specimen of an infiltrating ductal carcinoma.
Mentions: Benign lesions generally showed a uniform homogeneity on the color map with no difference in lesion color map size compared to B-mode. Examples of benign lesions are shown in Figures 2 and 3, whereas malignant lesions are shown in Figures 4 and 5.

View Article: PubMed Central - PubMed

ABSTRACT

The purpose of this study was to investigate the diagnostic efficacy of shearwave elastography (SWE) in differentiating between benign and malignant breast lesions.

One hundred and fifty-nine lesions were assessed using B-mode ultrasound (US) and SWE parameters were recorded (Emax, Emean, Emin, Eratio, SD). SWE measurements were then correlated with histopathological diagnosis.

≥≥: The final sample contained 85 benign and 74 malignant lesions. The maximum stiffness (Emax) with a cutoff point of 56.0 kPa (based on ROC curves) provided sensitivity of 100.0%, specificity of 97.6%, positive predictive value (PPV) of 97.4%, and negative predictive value (NPV) of 100% in detecting malignant lesions. A cutoff of 80 kPa managed to downgrade 95.5% of the Breast Imaging-Reporting and Data System (BI-RADS) 4a lesions to BI-RADS 3, negating the need for biopsy. Using a combination of BI-RADS and SWE, the authors managed to improve the PPV from 2.3% to 50% in BI-RADS 4a lesions.

SWE of the breast provides highly specific and sensitive quantitative values that are beneficial in the characterization of breast lesions. Our results showed that Emax is the most accurate value for differentiating benign from malignant lesions.

No MeSH data available.


Related in: MedlinePlus