title: Performance of shear wave elastography for differentiation of benign and malignant solid breast masses.
abstract: OBJECTIVE
  To perform a meta-analysis assessing the ability of shear wave elastography (SWE) to identify malignant breast masses.
  
  
  METHODS
  PubMed, the Cochrane Library, and the ISI Web of Knowledge were searched for studies evaluating the accuracy of SWE for identifying malignant breast masses. The diagnostic accuracy of SWE was evaluated according to sensitivity, specificity, and hierarchical summary receiver operating characteristic (HSROC) curves. An analysis was also performed according to the SWE mode used: supersonic shear imaging (SSI) and the acoustic radiation force impulse (ARFI) technique. The clinical utility of SWE for identifying malignant breast masses was evaluated using analysis of Fagan plot.
  
  
  RESULTS
  A total of 9 studies, including 1888 women and 2000 breast masses, were analyzed. Summary sensitivities and specificities were 0.91 (95% confidence interval [CI], 0.88-0.94) and 0.82 (95% CI, 0.75-0.87) by SSI and 0.89 (95% CI, 0.81-0.94) and 0.91 (95% CI, 0.84-0.95) by ARFI, respectively. The HSROCs for SSI and ARFI were 0.92 (95% CI, 0.90-0.94) and 0.96 (95% CI, 0.93-0.97), respectively. SSI and ARFI were both very informative, with probabilities of 83% and 91%, respectively, for correctly differentiating between benign and malignant breast masses following a "positive" measurement (over the threshold value) and probabilities of disease as low as 10% and 11%, respectively, following a "negative" measurement (below the threshold value) when the pre-test probability was 50%.
  
  
  CONCLUSIONS
  SWE could be used as a good identification tool for the classification of breast masses.
authors.affiliation: Institute of Genomic Medicine, Wenzhou Medical University, Wenzhou, P.R. China.
authors.forename: Guiling
authors.initials: G
authors.lastname: Li
authors.forename: De-Wei
authors.initials: DW
authors.lastname: Li
authors.forename: Yu-Xiao
authors.initials: YX
authors.lastname: Fang
authors.forename: Yi-Jiang
authors.initials: YJ
authors.lastname: Song
authors.forename: Zhu-Jun
authors.initials: ZJ
authors.lastname: Deng
authors.forename: Jian
authors.initials: J
authors.lastname: Gao
authors.forename: Yan
authors.initials: Y
authors.lastname: Xie
authors.forename: Tian-Sheng
authors.initials: TS
authors.lastname: Yin
authors.forename: Li
authors.initials: L
authors.lastname: Ying
authors.forename: Kai-Fu
authors.initials: KF
authors.lastname: Tang
mesh_terms: D000328:Adult; D000368:Aged; D001940:Breast / Q000473:pathology*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D003937:Diagnosis, Differential; D054459:Elasticity Imaging Techniques; D005260:Female; D006801:Humans; D008875:Middle Aged; D012372:ROC Curve; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016217:Ultrasonography, Mammary