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Diagnostic performance of shear wave elastography in discriminating malignant and benign breast lesions

Our experience with QelaXtoTM software

  • Original Paper
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Abstract

Study aims

We sought to evaluate the diagnostic performance of quantitative elastography (shear wave elastography) and to establish the optimal cutoff value to differentiate malignant and benign breast lesions using QelaXtoTM software.

Methods

We conducted a retrospective observational study of adult women with suspicious breast lesions (BIRADS 3, 4 or 5) who underwent programmed ultrasound-guided core biopsies. Breast lesions were assessed using quantitative elastography combined with B-mode ultrasound. Histopathology was used as reference standard. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were estimated, and a ROC curve analysis was conducted. Three elastography cutoff values were considered: 36, 50 and 80 kPa.

Results

We included 143 women (mean age of 56 years) with a total of 145 breast lesions: 68 benign tumors (47.26%) and 77 malignancies (52.74%). Mean elasticity measurements of benign and malignant lesions were significantly different (24.6 kPa, SD 28.47, vs. 101.49 kPa, SD 47.38, \(p<0.0001\)). Using the 50 kPa cutoff, elastography showed a global sensitivity of 87% to discriminate malignant lesions (AUC = 0.897). Moreover, sensitivity was 90.7% when lesions were located 5–40 mm below the skin surface (optimal elastographic field of view). Our false positive rate was 17.65%, comprised mainly of fibroepithelial neoplasms, fibroadenomas and fibrosis.

Conclusions

Quantitative elastography can differentiate malignant and benign breast lesions with acceptable to excellent performance. In our sample, the QelaXtoTM software showed a lower optimal cutoff than other ultrasound systems.

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Notes

  1. For example, Lee et al. informed that the elastographic values for malignant masses were on average 119.0 (\(\pm 52.2\)) kPa and the benign lesions were 41.4 (\(\pm 32.1\)) kPa, whereas the elastographic values published by Chang et al. were slightly superior. The malignant masses had a medium elasticity of 153.3 (\(\pm 58.1\)) kPa and the benign, 46.1 (\(\pm 42.9\) kPa).

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Funding

This Study was founded by the Radiology Department of the Hospital Italiano de Buenos Aires.

Author information

Authors and Affiliations

  1. Breast Imaging and Interventional Radiology Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina

    Karina Pesce, María José Chico, María Paz Swiecicki & Diana Herbas Galindo

  2. Department of Health Informatics, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina

    Fernando Binder

  3. Research Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina

    Sergio Terrasa

Authors
  1. Karina Pesce
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  2. Fernando Binder
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  3. María José Chico
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  4. María Paz Swiecicki
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  5. Diana Herbas Galindo
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  6. Sergio Terrasa
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Corresponding author

Correspondence to Karina Pesce.

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Conflict of interest

The authors declare no conflicts of interest.

Ethical standards

This study was conducted in accordance with the Helsinki Declaration of 1975 and its late amendments. The study protocol was approved by the institutional Ethics Committee, with IRB approval number 3797.

Informed consent

As we worked with de-identified retrospective data, informed consent was waived for this retrospective study.

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All authors expressed explicit consent for the publication of this manuscript.

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Data-analysis code is available upon request.

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Pesce, K., Binder, F., Chico, M.J. et al. Diagnostic performance of shear wave elastography in discriminating malignant and benign breast lesions. J Ultrasound 23, 575–583 (2020). https://doi.org/10.1007/s40477-020-00481-8

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  • DOI: https://doi.org/10.1007/s40477-020-00481-8

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