title: Can continuous scans in orthogonal planes improve diagnostic performance of shear wave elastography for breast lesions?
abstract: BACKGROUND
  Static shear wave elastography (SWE) is used to detect breast lesions, but slice and plane selections result in discrepancies.
  
  
  OBJECTIVE
  To evaluate the intraobserver reproducibility of continuous SWE, and whether quantitative elasticities in orthogonal planes perform better in the differential diagnosis of breast lesions.
  
  
  METHODS
  One hundred and twenty-two breast lesions scheduled for ultrasound-guided biopsy were recruited. Continuous SWE scans were conducted in orthogonal planes separately. Quantitative elasticities and histopathology results were collected. Reproducibility in the same plane and diagnostic performance in different planes were evaluated.
  
  
  RESULTS
  The maximum and mean elasticities of the hardest portion, and standard deviation of whole lesion, had high inter-class correlation coefficients (0.87 to 0.95) and large areas under receiver operation characteristic curve (0.887 to 0.899). Without loss of accuracy, sensitivities had increased in orthogonal planes compared with single plane (from 73.17% up to 82.93% at most). Mean elasticity of whole lesion and lesion-to-parenchyma ratio were significantly less reproducible and less accurate.
  
  
  CONCLUSIONS
  Continuous SWE is highly reproducible for the same observer. The maximum and mean elasticities of the hardest portion and standard deviation of whole lesion are most reliable. Furthermore, the sensitivities of the three parameters are improved in orthogonal planes without loss of accuracies.
authors.forename: Pan
authors.initials: P
authors.lastname: Yang
authors.forename: Yulan
authors.initials: Y
authors.lastname: Peng
authors.forename: Haina
authors.initials: H
authors.lastname: Zhao
authors.forename: Honghao
authors.initials: H
authors.lastname: Luo
authors.forename: Ya
authors.initials: Y
authors.lastname: Jin
authors.forename: Yushuang
authors.initials: Y
authors.lastname: He
mesh_terms: D001943:Breast Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging* / Q000473:pathology; D003937:Diagnosis, Differential; D054459:Elasticity Imaging Techniques / Q000379:methods* / Q000592:standards; D005260:Female; D006801:Humans; D012372:ROC Curve; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D018084:Ultrasonography, Interventional
keywords: Shear wave elastography; breast lesion; diagnostic performance; quantitative analysis