Advertisement

European Radiology

, Volume 23, Issue 7, pp 1803–1811 | Cite as

Diagnostic performances of shear wave elastography: which parameter to use in differential diagnosis of solid breast masses?

  • Eun Jung Lee
  • Hae Kyoung Jung
  • Kyung Hee Ko
  • Jong Tae Lee
  • Jung Hyun YoonEmail author
Breast

Abstract

Objective

To evaluate which shear wave elastography (SWE) parameter proves most accurate in the differential diagnosis of solid breast masses.

Methods

One hundred and fifty-six breast lesions in 139 consecutive women (mean age: 43.54 ± 9.94 years, range 21–88 years), who had been scheduled for ultrasound-guided breast biopsy, were included. Conventional ultrasound and SWE were performed in all women before biopsy procedures. Ultrasound BI-RADS final assessment and SWE parameters were recorded. Diagnostic performance of each SWE parameter was calculated and compared with those obtained when applying cut-off values of previously published data. Performance of conventional ultrasound and ultrasound combined with each parameter was also compared.

Results

Of the 156 breast masses, 120 (76.9 %) were benign and 36 (23.1 %) malignant. Maximum stiffness (Emax) with a cut-off of 82.3 kPa had the highest area under the receiver operating characteristics curve (Az) value compared with other SWE parameters, 0.860 (sensitivity 88.9 %, specificity 77.5 %, accuracy 80.1 %). Az values of conventional ultrasound combined with each SWE parameter showed lower (but not significantly) values than with conventional ultrasound alone.

Conclusions

Maximum stiffness (82.3 kPa) provided the best diagnostic performance. However the overall diagnostic performance of ultrasound plus SWE was not significantly better than that of conventional ultrasound alone.

Key Points

SWE offers new information over and above conventional breast ultrasound

Various SWE parameters were explored regarding distinction between benign and malignant lesions

An elasticity of 82.3 kPa appears optimal in differentiating solid breast masses

However, ultrasound plus SWE was not significantly better than conventional ultrasound alone

Keywords

Ultrasound Elastography Shear wave Breast Neoplasm 

References

  1. 1.
    Burnside ES, Hall TJ, Sommer AM et al (2007) Differentiating benign from malignant solid breast masses with US strain imaging. Radiology 245:401–410PubMedCrossRefGoogle Scholar
  2. 2.
    Regner DM, Hesley GK, Hangiandreou NJ et al (2006) Breast lesions: evaluation with US strain imaging—clinical experience of multiple observers. Radiology 238:425–437PubMedCrossRefGoogle Scholar
  3. 3.
    Itoh A, Ueno E, Tohno E et al (2006) Breast disease: clinical application of US elastography for diagnosis. Radiology 239:341–350PubMedCrossRefGoogle Scholar
  4. 4.
    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 196:730–736PubMedCrossRefGoogle Scholar
  5. 5.
    Athanasiou A, Tardivon A, Tanter M et al (2010) Breast lesions: quantitative elastography with supersonic shear imaging—preliminary results. Radiology 256:297–303PubMedCrossRefGoogle Scholar
  6. 6.
    Chang JM, Moon WK, Cho N et al (2011) Clinical application of shear wave elastography (SWE) in the diagnosis of benign and malignant breast diseases. Breast Cancer Res Treat 129:89–97PubMedCrossRefGoogle Scholar
  7. 7.
    Cosgrove DO, Berg WA, Dore CJ et al (2012) Shear wave elastography for breast masses is highly reproducible. Eur Radiol 22:1023–1032PubMedCrossRefGoogle Scholar
  8. 8.
    Tozaki M, Fukuma E (2011) Pattern classification of ShearWave Elastography images for differential diagnosis between benign and malignant solid breast masses. Acta Radiol 52:1069–1075PubMedCrossRefGoogle Scholar
  9. 9.
    Berg WA, Cosgrove DO, Dore CJ et al (2012) Shear-wave elastography improves the specificity of breast US: the BE1 multinational study of 939 masses. Radiology 262:435–449PubMedCrossRefGoogle Scholar
  10. 10.
    Evans A, Whelehan P, Thomson K et al (2010) Quantitative shear wave ultrasound elastography: initial experience in solid breast masses. Breast Cancer Res 12:R104PubMedCrossRefGoogle Scholar
  11. 11.
    Gweon HM, Youk JH, Son EJ, Kim JA (2013) Visually assessed colour overlay features in shear-wave elastography for breast masses: quantification and diagnostic performance. Eur Radiol 23:658-663Google Scholar
  12. 12.
    American College of Radiology (2003) Breast imaging reporting and data system. American College of Radiology, RestonGoogle Scholar
  13. 13.
    Balleyguier C, Canale S, Hassen WB et al (2012) Breast elasticity: principles, technique, results: an update and overview of commercially available software. Eur J Radiol. doi: 10.1016/j.ejrad.2012.03.001
  14. 14.
    Evans A, Whelehan P, Thomson K et al (2012) Differentiating benign from malignant solid breast masses: value of shear wave elastography according to lesion stiffness combined with greyscale ultrasound according to BI-RADS classification. Br J Cancer 107:224–229PubMedCrossRefGoogle Scholar
  15. 15.
    Evans A, Whelehan P, Thomson K et al (2012) Invasive breast cancer: relationship between shear-wave elastographic findings and histologic prognostic factors. Radiology 263:673–677PubMedCrossRefGoogle Scholar
  16. 16.
    Tanter M, Bercoff J, Athanasiou A et al (2008) Quantitative assessment of breast lesion viscoelasticity: initial clinical results using supersonic shear imaging. Ultrasound Med Biol 34:1373–1386PubMedCrossRefGoogle Scholar
  17. 17.
    Lee SH, Chang JM, Kim WH et al (2012) Differentiation of benign from malignant solid breast masses: comparison of two-dimensional and three-dimensional shear-wave elastography. Eur Radiol. doi: 10.1007/s00330-012-2686-9
  18. 18.
    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 239:385–391PubMedCrossRefGoogle Scholar
  19. 19.
    Lee HJ, Kim EK, Kim MJ et al (2008) Observer variability of Breast Imaging Reporting and Data System (BI-RADS) for breast ultrasound. Eur J Radiol 65:293–298PubMedCrossRefGoogle Scholar
  20. 20.
    Crystal P, Koretz M, Shcharynsky S, Makarov V, Strano S (2005) Accuracy of sonographically guided 14-gauge core-needle biopsy: results of 715 consecutive breast biopsies with at least two-year follow-up of benign lesions. J Clin Ultrasound 33:47–52PubMedCrossRefGoogle Scholar
  21. 21.
    Youk JH, Kim EK, Kim MJ, Kwak JY, Son EJ (2009) Analysis of false-negative results after US-guided 14-gauge core needle breast biopsy. Eur Radiol 20:782–789PubMedCrossRefGoogle Scholar
  22. 22.
    Youk JH, Kim E, Kim MJ, Oh KK (2008) Sonographically guided 14-gauge core needle biopsy of breast masses: a review of 2,420 cases with long-term follow-up. AJR Am J Roentgenol 190:202–207PubMedCrossRefGoogle Scholar
  23. 23.
    Sadigh G, Carlos RC, Neal CH, Wojcinski S, Dwamena BA (2012) Impact of breast mass size on accuracy of ultrasound elastography vs. conventional B-mode ultrasound: a meta-analysis of individual participants. Eur Radiol. doi: 10.1007/s00330-012-2682-0

Copyright information

© European Society of Radiology 2013

Authors and Affiliations

  • Eun Jung Lee
    • 1
  • Hae Kyoung Jung
    • 1
  • Kyung Hee Ko
    • 1
  • Jong Tae Lee
    • 1
  • Jung Hyun Yoon
    • 1
    • 2
    Email author
  1. 1.Department of Radiology, CHA Bundang Medical CenterCHA University, School of MedicineSeongnam-siKorea
  2. 2.Department of Radiology, Research Institute of Radiological ScienceYonsei University, College of MedicineSeodaemun-guKorea

Personalised recommendations