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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

Boxplot showing the distributions of Emean values across different grades of infiltrating ductal carcinoma (IDC) lesions, demonstrating a gradual increase in Emean values as the IDC grades increased. Kuskal-Wallis test P value 0.031.
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Figure 9: Boxplot showing the distributions of Emean values across different grades of infiltrating ductal carcinoma (IDC) lesions, demonstrating a gradual increase in Emean values as the IDC grades increased. Kuskal-Wallis test P value 0.031.

Mentions: Forty-five of 51 IDC cases (6 results were not available) were graded based on Bloom-Richardson's grading system. Of these 45 cases, 17.6% were grade 1, 45.1% were grade 2, and 25.5% were grade 3. Using Kruskal-Wallis tests for independent samples, we were able to determine that there was a significant difference in the distributions of Emax and Emean values between the different IDC grades, with P values of 0.022 and 0.031, respectively. The results also reported a trend wherein the higher IDC grades tended to have higher SWE values (Figures 8 and 9).


Shearwave Elastography Increases Diagnostic Accuracy in Characterization of Breast Lesions
Boxplot showing the distributions of Emean values across different grades of infiltrating ductal carcinoma (IDC) lesions, demonstrating a gradual increase in Emean values as the IDC grades increased. Kuskal-Wallis test P value 0.031.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 9: Boxplot showing the distributions of Emean values across different grades of infiltrating ductal carcinoma (IDC) lesions, demonstrating a gradual increase in Emean values as the IDC grades increased. Kuskal-Wallis test P value 0.031.
Mentions: Forty-five of 51 IDC cases (6 results were not available) were graded based on Bloom-Richardson's grading system. Of these 45 cases, 17.6% were grade 1, 45.1% were grade 2, and 25.5% were grade 3. Using Kruskal-Wallis tests for independent samples, we were able to determine that there was a significant difference in the distributions of Emax and Emean values between the different IDC grades, with P values of 0.022 and 0.031, respectively. The results also reported a trend wherein the higher IDC grades tended to have higher SWE values (Figures 8 and 9).

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