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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.

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The receiver-operating characteristics (ROC) curves of Emax, Emean, and Eratio shearwave elastography (SWE) measurements in detecting malignant breast lesions. The area under the curves (AUCs) for Emax, Emean, Emin, and Eratio were 0.997, 0.995, 0.997, and 0.979, respectively. Cutoff values deduced from the ROC curves were Emax ≥56 kPa, Emean ≥42 kPa, Emin ≥29 kPa, and ratio ≥2.2.
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Figure 7: The receiver-operating characteristics (ROC) curves of Emax, Emean, and Eratio shearwave elastography (SWE) measurements in detecting malignant breast lesions. The area under the curves (AUCs) for Emax, Emean, Emin, and Eratio were 0.997, 0.995, 0.997, and 0.979, respectively. Cutoff values deduced from the ROC curves were Emax ≥56 kPa, Emean ≥42 kPa, Emin ≥29 kPa, and ratio ≥2.2.

Mentions: The mean values of Emax, Emean, Emin, Eratio, and Standard Deviation were statistically significantly higher in malignant lesions (Table 3, Figure 6). Using these quantitative values, the cutoff points for each parameter were deduced using ROC curves. The areas under the curves (AUCs) were 0.997 for maximum elasticity (Emax), 0.997 for mean elasticity (Emean), and 0.979 for mass/fat elasticity ratio (Eratio) (Figure 7). The optimal cutoff points of Emax, Emean, Emin, and Ratio (independent of B-mode BI-RADS category) were ≥56 kPa, ≥42 kPa, ≥29 kPa, and 2.2, respectively. Emax was the most sensitive (100%) and specific (97.6%) in detecting malignant breast lesions (see Table 4). The results of SWE measurements alone superseded B-mode BI-RADS classification in detecting malignant lesions.


Shearwave Elastography Increases Diagnostic Accuracy in Characterization of Breast Lesions
The receiver-operating characteristics (ROC) curves of Emax, Emean, and Eratio shearwave elastography (SWE) measurements in detecting malignant breast lesions. The area under the curves (AUCs) for Emax, Emean, Emin, and Eratio were 0.997, 0.995, 0.997, and 0.979, respectively. Cutoff values deduced from the ROC curves were Emax ≥56 kPa, Emean ≥42 kPa, Emin ≥29 kPa, and ratio ≥2.2.
© Copyright Policy - open-access
Related In: Results  -  Collection

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getmorefigures.php?uid=PMC4998391&req=5

Figure 7: The receiver-operating characteristics (ROC) curves of Emax, Emean, and Eratio shearwave elastography (SWE) measurements in detecting malignant breast lesions. The area under the curves (AUCs) for Emax, Emean, Emin, and Eratio were 0.997, 0.995, 0.997, and 0.979, respectively. Cutoff values deduced from the ROC curves were Emax ≥56 kPa, Emean ≥42 kPa, Emin ≥29 kPa, and ratio ≥2.2.
Mentions: The mean values of Emax, Emean, Emin, Eratio, and Standard Deviation were statistically significantly higher in malignant lesions (Table 3, Figure 6). Using these quantitative values, the cutoff points for each parameter were deduced using ROC curves. The areas under the curves (AUCs) were 0.997 for maximum elasticity (Emax), 0.997 for mean elasticity (Emean), and 0.979 for mass/fat elasticity ratio (Eratio) (Figure 7). The optimal cutoff points of Emax, Emean, Emin, and Ratio (independent of B-mode BI-RADS category) were ≥56 kPa, ≥42 kPa, ≥29 kPa, and 2.2, respectively. Emax was the most sensitive (100%) and specific (97.6%) in detecting malignant breast lesions (see Table 4). The results of SWE measurements alone superseded B-mode BI-RADS classification in detecting malignant 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