title: Comb-push ultrasound shear elastography of breast masses: initial results show promise.
abstract: OBJECTIVE
  To evaluate the performance of Comb-push Ultrasound Shear Elastography (CUSE) for classification of breast masses.
  
  
  METHODS
  CUSE is an ultrasound-based quantitative two-dimensional shear wave elasticity imaging technique, which utilizes multiple laterally distributed acoustic radiation force (ARF) beams to simultaneously excite the tissue and induce shear waves. Female patients who were categorized as having suspicious breast masses underwent CUSE evaluations prior to biopsy. An elasticity estimate within the breast mass was obtained from the CUSE shear wave speed map. Elasticity estimates of various types of benign and malignant masses were compared with biopsy results.
  
  
  RESULTS
  Fifty-four female patients with suspicious breast masses from our ongoing study are presented. Our cohort included 31 malignant and 23 benign breast masses. Our results indicate that the mean shear wave speed was significantly higher in malignant masses (6 ± 1.58 m/s) in comparison to benign masses (3.65 ± 1.36 m/s). Therefore, the stiffness of the mass quantified by the Young's modulus is significantly higher in malignant masses. According to the receiver operating characteristic curve (ROC), the optimal cut-off value of 83 kPa yields 87.10% sensitivity, 82.61% specificity, and 0.88 for the area under the curve (AUC).
  
  
  CONCLUSIONS
  CUSE has the potential for clinical utility as a quantitative diagnostic imaging tool adjunct to B-mode ultrasound for differentiation of malignant and benign breast masses.
authors.affiliation: Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine, Rochester, Minnesota, United States of America.
authors.forename: Max
authors.initials: M
authors.lastname: Denis
authors.affiliation: Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine, Rochester, Minnesota, United States of America.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Mehrmohammadi
authors.affiliation: Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine, Rochester, Minnesota, United States of America.
authors.forename: Pengfei
authors.initials: P
authors.lastname: Song
authors.affiliation: Department of Radiology, Mayo Clinic College of Medicine, Rochester, Minnesota, United States of America.
authors.forename: Duane D
authors.initials: DD
authors.lastname: Meixner
authors.affiliation: Department of Radiology, Mayo Clinic College of Medicine, Rochester, Minnesota, United States of America.
authors.forename: Robert T
authors.initials: RT
authors.lastname: Fazzio
authors.affiliation: Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, United States of America.
authors.forename: Sandhya
authors.initials: S
authors.lastname: Pruthi
authors.affiliation: Department of Radiology, Mayo Clinic College of Medicine, Rochester, Minnesota, United States of America.
authors.forename: Dana H
authors.initials: DH
authors.lastname: Whaley
authors.affiliation: Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine, Rochester, Minnesota, United States of America.
authors.forename: Shigao
authors.initials: S
authors.lastname: Chen
authors.affiliation: Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine, Rochester, Minnesota, United States of America.
authors.forename: Mostafa
authors.initials: M
authors.lastname: Fatemi
authors.affiliation: Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine, Rochester, Minnesota, United States of America; Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, United States of America.
authors.forename: Azra
authors.initials: A
authors.lastname: Alizad
mesh_terms: D000328:Adult; D000368:Aged; D001940:Breast / Q000473:pathology*; D001943:Breast Neoplasms / Q000175:diagnosis*; D003937:Diagnosis, Differential; D055119:Elastic Modulus; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D012372:ROC Curve; D016217:Ultrasonography, Mammary / Q000379:methods*