European Radiology

, Volume 26, Issue 10, pp 3542–3549 | Cite as

Additional diagnostic value of shear-wave elastography and color Doppler US for evaluation of breast non-mass lesions detected at B-mode US

  • Ji Soo Choi
  • Boo-Kyung Han
  • Eun Young Ko
  • Eun Sook Ko
  • Jung Hee Shin
  • Ga Ram Kim



To evaluate the diagnostic value of shear-wave elastography (SWE) and colour Doppler ultrasound (US) for evaluation of breast non-mass lesions (NMLs) detected by B-mode US.


This retrospective study enrolled 116 NMLs (42 benign, 74 malignant). For each lesion, B-mode US, SWE and colour Doppler US were performed. Mean elasticity (E mean), maximum elasticity (E max) and vascularity were assessed by SWE and Doppler US. Diagnostic performances of B-mode US, SWE and Doppler US were calculated to differentiate benign and malignant NMLs.


In benign NMLs, average E mean and E max were lower, and low vascularity (no flow or only one vessel flow) was more frequent (P < 0.001). When BI-RADS category 4a NMLs were downgraded to category 3 with ‘E mean of 85.1 kPa or less’ and/or ‘low vascularity’, specificities increased (69.0–90.5 %; P < 0.001), without significant loss in sensitivities (97.3–100 %). When these 4a NMLs were downgraded by the combination of SWE and Doppler US, all downgraded NMLs (59.3 %, 19/32) were confirmed as benign.


Addition of SWE and colour Doppler US to B-mode US improved diagnostic performances in differentiating benign and malignant NMLs. This study suggests that the combination of SWE and colour Doppler may help patients with BI-RADS category 4a NMLs avoid unnecessary biopsies.

Key Points

B-mode US features of malignant and benign NMLs may overlap.

SWE and colour Doppler provides useful information about breast NMLs.

SWE and colour Doppler may decrease unnecessary biopsies of breast NMLs.


Non-mass lesion Shear wave Elastography Doppler Breast 



Core needle biopsy


Mean elasticity


Maximum elasticity


Non-mass lesion


Shear-wave elastography




Ultrasonographic elastography


Vacuum-assisted biopsy



The scientific guarantor of this publication is Boo-Kyung Han. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Institutional review board approval was obtained. Written informed consent was waived by the institutional review board. No study subjects or cohorts have been previously reported. Methodology: retrospective, diagnostic or prognostic study, performed at one institution.


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Copyright information

© European Society of Radiology 2016

Authors and Affiliations

  • Ji Soo Choi
    • 1
  • Boo-Kyung Han
    • 1
  • Eun Young Ko
    • 1
  • Eun Sook Ko
    • 1
  • Jung Hee Shin
    • 1
  • Ga Ram Kim
    • 1
  1. 1.Department of Radiology, Breast Cancer Center, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulKorea

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