title: Shear-Wave Elastography for the Detection of Residual Breast Cancer After Neoadjuvant Chemotherapy.
abstract: OBJECTIVE
  This study was designed to evaluate the accuracy of shear-wave elastography (SWE) in the detection of residual breast cancer after neoadjuvant chemotherapy (NAC).
  
  
  METHODS
  Seventy-one women with stage II-III breast cancers who underwent B-mode ultrasound (US), SWE, and magnetic resonance imaging (MRI) after NAC were included. The presence of residual cancer was determined on B-mode US and MRI, and the maximum elasticity of residual lesions was assessed on SWE. The sensitivity, specificity, accuracy, and area under the receiver operating characteristic curve (AUC) of B-mode US, SWE, and MRI were compared.
  
  
  RESULTS
  Sixty-one of 71 women (86 %) had residual cancer and showed higher maximum elasticity values (mean 116.0 ± 74.1 kPa) than those without residual cancer (26.4 ± 21.0 kPa; p < 0.001). B-mode US showed 72.1 % (44/61) sensitivity, 50.0 % (5/10) specificity, and 69.0 % (49/71) accuracy. The sensitivity, specificity, and accuracy of SWE were 83.6 % (51/61), 80.0 % (8/10), and 83.1 % (59/71) when a maximum elasticity value of >30 kPa was considered to indicate the presence of residual cancer. The combined AUC of B-mode US and SWE (0.877) was significantly higher than that of B-mode US (0.702) (p = 0.014) and comparable to that of MRI (0.939) (p = 0.147).
  
  
  CONCLUSIONS
  SWE allowed relatively accurate assessment for the presence of residual lesion after NAC and improved the diagnostic performance of B-mode US.
authors: Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
authors: Su Hyun
authors: SH
authors: Lee
authors: Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea. imchangjm@gmail.com.
authors: Jung Min
authors: JM
authors: Chang
authors: Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
authors: Wonshik
authors: W
authors: Han
authors: Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
authors: Hyeong-Gon
authors: HG
authors: Moon
authors: Department of Radiology, Hanyang University Hospital, Seoul, Korea.
authors: Hye Ryoung
authors: HR
authors: Koo
authors: Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors: Hye Mi
authors: HM
authors: Gweon
authors: Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
authors: Won Hwa
authors: WH
authors: Kim
authors: Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
authors: Dong-Young
authors: DY
authors: Noh
authors: Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
authors: Woo Kyung
authors: WK
authors: Moon
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D018365:Neoplasm, Residual / Q000175:diagnosis*; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D016217:Ultrasonography, Mammary / Q000379:methods*