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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) 4a lesion in a 27-year-old woman with a palpable lump and nipple discharge. (A) Shearwave imaging showed a heterogeneous color map and Emax of 95.6 kPa. (B) Gray scale ultrasound showed a lobulated hypoechoic lesion continuous with a dilated duct. (C) Photomicrograph (H and E, ×40) of surgical excision specimen of an intraductal papilloma.
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Figure 10: Shearwave elastography (SWE) of a Breast Imaging-Reporting and Data System (BI-RADS) 4a lesion in a 27-year-old woman with a palpable lump and nipple discharge. (A) Shearwave imaging showed a heterogeneous color map and Emax of 95.6 kPa. (B) Gray scale ultrasound showed a lobulated hypoechoic lesion continuous with a dilated duct. (C) Photomicrograph (H and E, ×40) of surgical excision specimen of an intraductal papilloma.

Mentions: All lesions in the BI-RADS 3 category had a NPV of 100% based on both gray-scale US and when used in combination with SWE, using a cutoff point of Emax ≥56 kPa. However, in BI-RADS 4a category lesions, the PPV was 2.3% for conventional US alone. This percentage increased to 50% after applying a combination of B-mode imaging with SWE, using a cutoff point of ≥80 kPa. Two lesions in BI-RADS 4a showed ≥80 kPa on SWE. These 2 lesions were an intraductal papilloma with an Emax of 95.6kPa (false-positive) (Figure 10) and an infiltrating ductal carcinoma with an Emax of 275.30 kPa (true positive).


Shearwave Elastography Increases Diagnostic Accuracy in Characterization of Breast Lesions
Shearwave elastography (SWE) of a Breast Imaging-Reporting and Data System (BI-RADS) 4a lesion in a 27-year-old woman with a palpable lump and nipple discharge. (A) Shearwave imaging showed a heterogeneous color map and Emax of 95.6 kPa. (B) Gray scale ultrasound showed a lobulated hypoechoic lesion continuous with a dilated duct. (C) Photomicrograph (H and E, ×40) of surgical excision specimen of an intraductal papilloma.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 10: Shearwave elastography (SWE) of a Breast Imaging-Reporting and Data System (BI-RADS) 4a lesion in a 27-year-old woman with a palpable lump and nipple discharge. (A) Shearwave imaging showed a heterogeneous color map and Emax of 95.6 kPa. (B) Gray scale ultrasound showed a lobulated hypoechoic lesion continuous with a dilated duct. (C) Photomicrograph (H and E, ×40) of surgical excision specimen of an intraductal papilloma.
Mentions: All lesions in the BI-RADS 3 category had a NPV of 100% based on both gray-scale US and when used in combination with SWE, using a cutoff point of Emax ≥56 kPa. However, in BI-RADS 4a category lesions, the PPV was 2.3% for conventional US alone. This percentage increased to 50% after applying a combination of B-mode imaging with SWE, using a cutoff point of ≥80 kPa. Two lesions in BI-RADS 4a showed ≥80 kPa on SWE. These 2 lesions were an intraductal papilloma with an Emax of 95.6kPa (false-positive) (Figure 10) and an infiltrating ductal carcinoma with an Emax of 275.30 kPa (true positive).

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