title: A novel two-dimensional quantitative shear wave elastography for differentiating malignant from benign breast lesions.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the diagnostic performance of a novel quantitative shear wave elastography (SWE) of virtual touch tissue imaging quantification (VTIQ) in diagnosis of breast lesions.
  
  
  METHODS
  The conventional ultrasound (US) and VTIQ images of 133 pathologically proven breast lesions in 98 patients were assessed. The breast lesions were classified by US breast imaging reporting and data system (BI-RADS) category. The maximum, minimum, mean and median shear wave velocity (SWV) values on VTIQ in the lesions were obtained. The area under the receiver operating curve (AUC) was computed.
  
  
  RESULTS
  Twenty-six of 133 lesions were malignant and 107 were benign. The sensitivity and specificity for US BI-RADS assessment were 96.2% and 62.6% respectively. The SWVs in malignant lesions were all significantly higher than those in benign ones (all P < 0.001). The AUC for mean SWV value was slightly higher than AUC for maximum, minimum and median SWV values, whereas no significant differences among them were found (all P > 0.05). The cut-off value of mean SWV was 3.68 m/s, with associated sensitivity and specificity of 93.3% and 79.4% respectively.
  
  
  CONCLUSIONS
  The novel quantitative SWE of VTIQ is helpful in differentiating breast lesions. Adding the quantitative SWE of VTIQ to the US BI-RADS assessment improves the specificity in diagnosing breast lesions without loss of sensitivity.
authors.affiliation: Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Tongji University School of Medicine Shanghai 200072, China ; Department of Ultrasound, Fujian Provincial Hospital Fuzhou 350001, China.
authors.forename: Li
authors.initials: L
authors.lastname: Tang
authors.affiliation: Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Tongji University School of Medicine Shanghai 200072, China ; Department of Ultrasound, Guangdong Medical College Affiliated Hospital Zhanjiang 524001, China.
authors.forename: Hui-Xiong
authors.initials: HX
authors.lastname: Xu
authors.affiliation: Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Tongji University School of Medicine Shanghai 200072, China.
authors.forename: Xiao-Wan
authors.initials: XW
authors.lastname: Bo
authors.affiliation: Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Tongji University School of Medicine Shanghai 200072, China.
authors.forename: Bo-Ji
authors.initials: BJ
authors.lastname: Liu
authors.affiliation: Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Tongji University School of Medicine Shanghai 200072, China.
authors.forename: Xiao-Long
authors.initials: XL
authors.lastname: Li
authors.affiliation: Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Tongji University School of Medicine Shanghai 200072, China.
authors.forename: Rong
authors.initials: R
authors.lastname: Wu
authors.affiliation: Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Tongji University School of Medicine Shanghai 200072, China.
authors.forename: Dan-Dan
authors.initials: DD
authors.lastname: Li
authors.affiliation: Department of Thyroid and Breast Surgery, Shanghai Tenth People's Hospital, Tongji University School of Medicine Shanghai 200072, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Fang
authors.affiliation: Department of Ultrasound, Guangdong Medical College Affiliated Hospital Zhanjiang 524001, China.
authors.forename: Xiao-Hong
authors.initials: XH
authors.lastname: Xu
keywords: Breast lesion; acoustic radiation force impulse; diagnosis; shear wave elastography; ultrasound; virtual touch tissue imaging quantification