Abstract
Objectives
To evaluate the interobserver agreement and the diagnostic performance of 3D shear-wave elastography (SWE) for breast lesions in comparison with 2D SWE.
Methods
A total of 163 breast lesions (malignant 48, benign 115) in 146 women who underwent B-mode ultrasound and SWE before biopsy were included. Two radiologists reviewed six data sets (B-mode, SWE, and a combination of both for 2D and 3D ultrasound). B-mode and SWE features were recorded. BI-RADS category was assigned for B-mode and combined sets. Interobserver variability was assessed using the κ statistic. Diagnostic performance of each data set was evaluated using the area under the ROC curve (AUC).
Results
SWE showed substantial to almost perfect agreement, with Ehomo in 2D SWE being higher than in 3D SWE. The AUC of 2D SWE was higher than 3D SWE for all SWE features, significantly so for Ecol (0.933 vs. 0.867, P = 0.002) and Emax (0.961 vs. 0.874, P = 0.006). After adding SWE to B-mode ultrasound, the AUC in 2D ultrasound increased significantly (0.968 vs. 0.912, P = 0.008), but 3D ultrasound showed no significant difference (0.966 vs. 0.935; P = 0.07).
Conclusion
For 3D SWE, interobserver agreement was good, but the diagnostic performance was inferior to 2D SWE even after adding to B-mode ultrasound.
Key Points
• Shear-wave elastography (SWE) provides further diagnostic information during breast ultrasound.
• 3D SWE diagnostic performance is inferior to 2D SWE.
• In 3D SWE, interobserver agreement was good.
• 2D B-mode ultrasound showed significant diagnostic improvement when combined with 2D SWE.
• 3D B-mode ultrasound performance was not significantly improved when combined with 3D SWE.
Similar content being viewed by others
References
American College of Radiology (2003) Breast imaging reporting and data system-ultrasound, 1st end. American College of Radiology, Reston
Kim EK, Ko KH, Oh KK, Kwak JY, You JK, Kim MJ, Park BW (2008) Clinical application of the BI-RADS final assessment to breast sonography in conjunction with mammography. AJR Am J Roentgenol 190:1209–1215
Chen D-R, Lai H-W (2011) Three-dimensional ultrasonography for breast malignancy detection. Expert Opin Med Diagn 5:253–261
Gordon PB (2002) Ultrasound for breast cancer screening and staging. Radiol Clin North Am 40:431–441
Cho N, Moon WK, Cha JH, Kim SM, Han BK, Kim EK, Kim MH, Chung SY, Choi HY, Im JG (2006) Differentiating benign from malignant solid breast masses: comparison of two-dimensional and three-dimensional US. Radiology 240:26–32
Cho KR, Seo BK, Lee JY, Pisano ED, Je BK, Choi EJ, Chung KB, Whan Oh Y (2005) A comparative study of 2D and 3D ultrasonography for evaluation of solid breast masses. Eur J Radiol 54:365–370
Gong X, Xu Q, Xu Z, Xiong P, Yan W, Chen Y (2011) Real-time elastography for the differentiation of benign and malignant breast lesions: a meta-analysis. Breast Cancer Res Treat 130:11–18
Sadigh G, Carlos RC, Neal CH, Dwamena BA (2012) Ultrasonographic differentiation of malignant from benign breast lesions: a meta-analytic comparison of elasticity and BIRADS scoring. Breast Cancer Res Treat 133:23–35
Sadigh G, Carlos RC, Neal CH, Dwamena BA (2012) Accuracy of quantitative ultrasound elastography for differentiation of malignant and benign breast abnormalities: a meta-analysis. Breast Cancer Res Treat 134:923–931
Tanter M, Bercoff J, Athanasiou A, Deffieux T, Gennisson JL, Montaldo G, Muller M, Tardivon A, Fink M (2008) Quantitative assessment of breast lesion viscoelasticity: initial clinical results using supersonic shear imaging. Ultrasound Med Biol 34:1373–1386
Comstock C (2011) Ultrasound elastography of breast lesions. Ultrasound Clin 6:407–415
Athanasiou A, Tardivon A, Tanter M, Sigal-Zafrani B, Bercoff J, Deffieux T, Gennisson JL, Fink M, Neuenschwander S (2010) Breast lesions: quantitative elastography with supersonic shear imaging–preliminary results. Radiology 256:297–303
Evans A, Whelehan P, Thomson K, McLean D, Brauer K, Purdie C, Jordan L, Baker L, Thompson A (2010) Quantitative shear wave ultrasound elastography: initial experience in solid breast masses. Breast Cancer Res 12:R104
Tozaki M, Fukuma E (2011) Pattern classification of ShearWave elastography images for differential diagnosis between benign and malignant solid breast masses. Acta Radiol 52:1069–1075
Chang JM, Moon WK, Cho N, Yi A, Koo HR, Han W, Noh DY, Moon HG, Kim SJ (2011) Clinical application of shear wave elastography (SWE) in the diagnosis of benign and malignant breast diseases. Breast Cancer Res Treat 129:89–97
Berg WA, Cosgrove DO, Dore CJ, Schafer FK, Svensson WE, Hooley RJ, Ohlinger R, Mendelson EB, Balu-Maestro C, Locatelli M, Tourasse C, Cavanaugh BC, Juhan V, Stavros AT, Tardivon A, Gay J, Henry JP, Cohen-Bacrie C (2012) Shear-wave elastography improves the specificity of breast US: the BE1 multinational study of 939 masses. Radiology 262:435–449
McDonald DN (2011) 3-dimensional breast ultrasonography: what have we been missing? Ultrasound clin 6:381–406
Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174
Lazarus E, Mainiero MB, Schepps B, Koelliker SL, Livingston LS (2006) BI-RADS lexicon for US and mammography: interobserver variability and positive predictive value. Radiology 239:385–391
Berg WA, Blume JD, Cormack JB, Mendelson EB (2006) Operator dependence of physician-performed whole-breast US: lesion detection and characterization. Radiology 241:355–365
Abdullah N, Mesurolle B, El-Khoury M, Kao E (2009) Breast imaging reporting and data system lexicon for US: interobserver agreement for assessment of breast masses. Radiology 252:665–672
Lee HJ, Kim EK, Kim MJ, Youk JH, Lee JY, Kang DR, Oh KK (2008) Observer variability of breast imaging reporting and data system (BI-RADS) for breast ultrasound. Eur J Radiol 65:293–298
Park CS, Lee JH, Yim HW, Kang BJ, Kim HS, Jung JI, Jung NY, Kim SH (2007) Observer agreement using the ACR breast imaging reporting and data system (BI-RADS)-ultrasound, first edition (2003). Korean J Radiol 8:397–402
Cosgrove DO, Berg WA, Dore CJ, Skyba DM, Henry JP, Gay J, Cohen-Bacrie C (2012) Shear wave elastography for breast masses is highly reproducible. Eur Radiol 22:1023–1032
Shin HJ, Kim HH, Cha JH, Park JH, Lee KE, Kim JH (2011) Automated ultrasound of the breast for diagnosis: interobserver agreement on lesion detection and characterization. AJR Am J Roentgenol 197:747–754
Zhang J, Lai XJ, Zhu QL, Wang HY, Jiang YX, Liu H, Dai Q, You SS, Xiao MS, Sun Q (2012) Interobserver agreement for sonograms of breast lesions obtained by an automated breast volume scanner. Eur J Radiol 81:2179–2183
Yoon JH, Kim MH, Kim EK, Moon HJ, Kwak JY, Kim MJ (2011) Interobserver variability of ultrasound elastography: how it affects the diagnosis of breast lesions. AJR Am J Roentgenol 196:730–736
Watermann DO, Foldi M, Hanjalic-Beck A, Hasenburg A, Lughausen A, Prompeler H, Gitsch G, Stickeler E (2005) Three-dimensional ultrasound for the assessment of breast lesions. Ultrasound Obstet Gynecol 25:592–598
Youk JH, Jung I, Kim EK, Kim MJ, Son EJ, Moon HJ, Kwak JY (2012) US follow-up protocol in concordant benign result after US-guided 14-gauge core needle breast biopsy. Breast Cancer Res Treat 132:1089–1097
Acknowledgements
This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (2011–0007602).
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Youk, J.H., Gweon, H.M., Son, E.J. et al. Three-dimensional shear-wave elastography for differentiating benign and malignant breast lesions: comparison with two-dimensional shear-wave elastography. Eur Radiol 23, 1519–1527 (2013). https://doi.org/10.1007/s00330-012-2736-3
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00330-012-2736-3