title: Diagnostic performance and color overlay pattern in shear wave elastography (SWE) for palpable breast mass.
abstract: OBJECTIVE
  The purpose of this study is to evaluate the diagnostic performance of SWE in palpable breast mass and to compare with color overlay pattern in SWE with conventional US and quantitative SWE for assessing palpable breast mass.
  
  
  METHODS
  SWE and conventional breast US were performed in 133 women with 156 palpable breast lesions (81 benign, 75 malignant) between August 2013 to June 2014. Either pathology or periodic imaging surveillance more than 2 years was a reference standard. Existence of previous image was blinded to performing radiologists. US BI-RADS final assessment, qualitative and quantitative SWE measurements were evaluated. Diagnostic performances of grayscale US, SWE and US combined to SWE were calculated and compared. Correlation between pattern classification and quantitative SWE was evaluated.
  
  
  RESULTS
  Both color overlay pattern and quantitative SWE improved the specificity of conventional US, from 81.48% to 96.30% (p=0.0005), without improvement in sensitivity. Color overlay pattern was significantly related to all quantitative SWE parameters and malignancy rate (p<0.0001.). The optimal cutoff of color overlay pattern was between 2 and 3. Emax with optimal cutoff at 45.1 kPa showed the highest Az value, sensitivity, specificity and accuracy among other quantitative SWE parameters (p<0.0001). Echogenic halo on grayscale US showed significant correlation with color overlay pattern and pathology (p<0.0001).
  
  
  CONCLUSIONS
  In evaluation of palpable breast mass, conventional US combine to SWE improves specificity and reduces the number of biopsies that ultimately yield a benign result. Color overlay pattern classification is more quick and easy and may represent quantitative SWE measurements with similar diagnostic performances.
authors.affiliation: Department of Radiology, Korea University Guro Hospital, 148, Gurodong-ro, Guro-gu, Seoul 152-703, Republic of Korea.
authors.forename: Jiyoon
authors.initials: J
authors.lastname: Park
authors.affiliation: Department of Radiology, Korea University Guro Hospital, 148, Gurodong-ro, Guro-gu, Seoul 152-703, Republic of Korea. Electronic address: wokhee@korea.ac.kr.
authors.forename: Ok Hee
authors.initials: OH
authors.lastname: Woo
authors.affiliation: Department of Radiology, Korea University Guro Hospital, 148, Gurodong-ro, Guro-gu, Seoul 152-703, Republic of Korea.
authors.forename: Hye Seon
authors.initials: HS
authors.lastname: Shin
authors.affiliation: Department of Radiology, Korea University Anam Hospital, Inchon-ro 73, Seongbuk-gu 136-705, Seoul 136-750, Republic of Korea.
authors.forename: Kyu Ran
authors.initials: KR
authors.lastname: Cho
authors.affiliation: Department of Radiology, Korea University Ansan Hospital, Jeokgeum-ro 123, Danwon-gu, Gyeonggi-do 425-707, Republic of Korea.
authors.forename: Bo Kyoung
authors.initials: BK
authors.lastname: Seo
authors.affiliation: Department of Radiology, Korea University Guro Hospital, 148, Gurodong-ro, Guro-gu, Seoul 152-703, Republic of Korea.
authors.forename: Eun Young
authors.initials: EY
authors.lastname: Kang
mesh_terms: D000328:Adult; D001707:Biopsy, Needle / Q000379:methods; D001932:Brain Neoplasms / Q000000981:diagnostic imaging; D001940:Breast / Q000473:pathology; D001941:Breast Diseases / Q000000981:diagnostic imaging; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D002278:Carcinoma in Situ / Q000000981:diagnostic imaging; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging; D018275:Carcinoma, Lobular / Q000000981:diagnostic imaging; D015331:Cohort Studies; D003116:Color; D054459:Elasticity Imaging Techniques / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008875:Middle Aged; D010173:Palpation; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D018084:Ultrasonography, Interventional / Q000379:methods; D016217:Ultrasonography, Mammary / Q000379:methods* / Q000706:statistics & numerical data
keywords: Breast; Elastography; Palpable breast masses; Shear wave; Ultrasound