title: Additional diagnostic value of shear-wave elastography and color Doppler US for evaluation of breast non-mass lesions detected at B-mode US.
abstract: OBJECTIVE
  To evaluate the diagnostic value of shear-wave elastography (SWE) and colour Doppler ultrasound (US) for evaluation of breast non-mass lesions (NMLs) detected by B-mode US.
  
  
  METHODS
  This retrospective study enrolled 116 NMLs (42 benign, 74 malignant). For each lesion, B-mode US, SWE and colour Doppler US were performed. Mean elasticity (E mean), maximum elasticity (E max) and vascularity were assessed by SWE and Doppler US. Diagnostic performances of B-mode US, SWE and Doppler US were calculated to differentiate benign and malignant NMLs.
  
  
  RESULTS
  In benign NMLs, average E mean and E max were lower, and low vascularity (no flow or only one vessel flow) was more frequent (P < 0.001). When BI-RADS category 4a NMLs were downgraded to category 3 with 'E mean of 85.1 kPa or less' and/or 'low vascularity', specificities increased (69.0-90.5 %; P < 0.001), without significant loss in sensitivities (97.3-100 %). When these 4a NMLs were downgraded by the combination of SWE and Doppler US, all downgraded NMLs (59.3 %, 19/32) were confirmed as benign.
  
  
  CONCLUSIONS
  Addition of SWE and colour Doppler US to B-mode US improved diagnostic performances in differentiating benign and malignant NMLs. This study suggests that the combination of SWE and colour Doppler may help patients with BI-RADS category 4a NMLs avoid unnecessary biopsies.
  
  
  CONCLUSIONS
  • B-mode US features of malignant and benign NMLs may overlap. • SWE and colour Doppler provides useful information about breast NMLs. • SWE and colour Doppler may decrease unnecessary biopsies of breast NMLs.
authors.affiliation: Department of Radiology, Breast Cancer Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro Gangnam-gu, Seoul, 135-710, Korea.
authors.forename: Ji Soo
authors.initials: JS
authors.lastname: Choi
authors.affiliation: Department of Radiology, Breast Cancer Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro Gangnam-gu, Seoul, 135-710, Korea. bkhan@skku.edu.
authors.forename: Boo-Kyung
authors.initials: BK
authors.lastname: Han
authors.affiliation: Department of Radiology, Breast Cancer Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro Gangnam-gu, Seoul, 135-710, Korea.
authors.forename: Eun Young
authors.initials: EY
authors.lastname: Ko
authors.affiliation: Department of Radiology, Breast Cancer Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro Gangnam-gu, Seoul, 135-710, Korea.
authors.forename: Eun Sook
authors.initials: ES
authors.lastname: Ko
authors.affiliation: Department of Radiology, Breast Cancer Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro Gangnam-gu, Seoul, 135-710, Korea.
authors.forename: Jung Hee
authors.initials: JH
authors.lastname: Shin
authors.affiliation: Department of Radiology, Breast Cancer Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro Gangnam-gu, Seoul, 135-710, Korea.
authors.forename: Ga Ram
authors.initials: GR
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D018615:Ultrasonography, Doppler, Color / Q000379:methods; D016217:Ultrasonography, Mammary / Q000379:methods*
keywords: Breast; Doppler; Elastography; Non-mass lesion; Shear wave