title: Combination of two-dimensional shear wave elastography with ultrasound breast imaging reporting and data system in the diagnosis of breast lesions: a new method to increase the diagnostic performance.
abstract: OBJECTIVE
  To evaluate the diagnostic performance of a new method of combined two-dimensional shear wave elastography (i.e. virtual touch imaging quantification, VTIQ) and ultrasound (US) Breast Imaging Reporting and Data System (BI-RADS) in the differential diagnosis of breast lesions.
  
  
  METHODS
  From September 2014 to December 2014, 276 patients with 296 pathologically proven breast lesions were enrolled in this study. The conventional US images were interpreted by two independent readers. The diagnosis performances of BI-RADS and combined BI-RADS and VTIQ were evaluated, including the area under the receiver operating characteristic curve (AUROC), sensitivity and specificity. Observer consistency was also evaluated.
  
  
  RESULTS
  Pathologically, 212 breast lesions were benign and 84 were malignant. Compared with BI-RADS alone, the AUROCs and specificities of the combined method for both readers increased significantly (AUROC: 0.862 vs. 0.693 in reader 1, 0.861 vs. 0.730 in reader 2; specificity: 91.5 % vs. 38.7 % in reader 1, 94.8 % vs. 47.2 % in reader 2; all P < .05). The Kappa value between the two readers for BI-RADS assessment was 0.614, and 0.796 for the combined method.
  
  
  CONCLUSIONS
  The combined VTIQ and BI-RADS had a better diagnostic performance in the diagnosis of breast lesions in comparison with BI-RADS alone.
  
  
  CONCLUSIONS
  • Combination of conventional ultrasound and elastography distinguishes breast cancers more effectively. • Combination of conventional ultrasound and elastography increases observer consistency. • BI-RADS weights more than the 2D-SWE with an increase in malignancy probability.
authors.affiliation: Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Tongji University School of Medicine, No. 301, Yanchangzhong Road, Shanghai, 200072, China.|Ultrasound Research and Education Institute, Tongji University School of Medicine, No. 301, Yanchangzhong Road, Shanghai, 200072, China.
authors.forename: Dan-Dan
authors.initials: DD
authors.lastname: Li
authors.affiliation: Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Tongji University School of Medicine, No. 301, Yanchangzhong Road, Shanghai, 200072, China. xuhuixiong@126.com.|Ultrasound Research and Education Institute, Tongji University School of Medicine, No. 301, Yanchangzhong Road, Shanghai, 200072, China. xuhuixiong@126.com.
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, No. 301, Yanchangzhong Road, Shanghai, 200072, China.|Ultrasound Research and Education Institute, Tongji University School of Medicine, No. 301, Yanchangzhong Road, Shanghai, 200072, China.
authors.forename: Le-Hang
authors.initials: LH
authors.lastname: Guo
authors.affiliation: Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Tongji University School of Medicine, No. 301, Yanchangzhong Road, Shanghai, 200072, China.|Ultrasound Research and Education Institute, Tongji University School of Medicine, No. 301, Yanchangzhong Road, 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, No. 301, Yanchangzhong Road, Shanghai, 200072, China.|Ultrasound Research and Education Institute, Tongji University School of Medicine, No. 301, Yanchangzhong Road, 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, No. 301, Yanchangzhong Road, Shanghai, 200072, China.|Ultrasound Research and Education Institute, Tongji University School of Medicine, No. 301, Yanchangzhong Road, 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, No. 301, Yanchangzhong Road, Shanghai, 200072, China.|Ultrasound Research and Education Institute, Tongji University School of Medicine, No. 301, Yanchangzhong Road, Shanghai, 200072, China.
authors.forename: Jun-Mei
authors.initials: JM
authors.lastname: Xu
authors.affiliation: Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Tongji University School of Medicine, No. 301, Yanchangzhong Road, Shanghai, 200072, China.|Ultrasound Research and Education Institute, Tongji University School of Medicine, No. 301, Yanchangzhong Road, Shanghai, 200072, China.
authors.forename: Yi-Feng
authors.initials: YF
authors.lastname: Zhang
authors.affiliation: Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Tongji University School of Medicine, No. 301, Yanchangzhong Road, Shanghai, 200072, China.|Ultrasound Research and Education Institute, Tongji University School of Medicine, No. 301, Yanchangzhong Road, Shanghai, 200072, China.
authors.forename: Kun
authors.initials: K
authors.lastname: Zhang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D001940:Breast / Q000000981:diagnostic imaging; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D012372:ROC Curve; D011873:Radiology Information Systems; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016217:Ultrasonography, Mammary / Q000379:methods*; D055815:Young Adult
keywords: Breast; Breast Imaging Reporting and Data System (BI-RADS); Cancer; Two-dimensional shear wave elastography; Ultrasound