title: Breast Lesions: Quantitative Diagnosis Using Ultrasound Shear Wave Elastography-A Systematic Review and Meta--Analysis.
abstract: The aim of this meta-analysis was to estimate the diagnostic performance of shear wave elastography (SWE) in differentiating malignant from benign breast lesions. A literature search of PubMed, Web of Science and Scopus up to November 2014 was conducted. A summary receiver operating characteristic curve was constructed, and pooled weighted estimates of sensitivity and specificity were calculated using a bivariate mixed-effects regression model. Thirty-three studies, which included a total of 5838 lesions (2093 malignant, 3745 benign) from 5397 patients, were finally analyzed. Summary sensitivity and specificity were 0.886 (95% confidence interval [CI], 0.858-0.909) and 0.866 (95% CI, 0.833-0.894), respectively. The pooled diagnostic odds ratio was 50.410 (95% CI, 34.972-72.664). And the area under the receiver operating characteristic curve of SWE was 0.94 (95% CI, 0.91-0.96). No publication bias existed among these studies (p = 0.245). In the subgroup analysis, sensitivity and specificity were 0.862 (95% CI, 0.811-0.901) and 0.875 (95% CI, 0.793-0.928) among 1552 lesions from 1429 patients in the 12 studies using acoustic radiation force impulse imaging and 0.897 (95% CI, 0.863-0.923) and 0.863 (95% CI, 0.831-0.889) among another 4436 lesions from 4097 patients in the 21 studies using supersonic shear imaging. When analysis confined to 9 studies evaluated the diagnostic performance of combination SWE and conventional ultrasound, the area under the curve was 0.96 (95% CI, 0.94-0.97), yielding a sensitivity of 0.971 (95% CI, 0.941-0.986) and specificity of 0.801 (95% CI, 0.733-0.856). SWE seems to be a good quantitative method for differentiating breast lesions, with promise for integration into routine imaging protocols.
authors.affiliation: Division of Interventional Ultrasound, Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, First Affiliated Hospital of Sun Yat-Sen University, Sun Yat-Sen University, Guangzhou, China.
authors.forename: Baoxian
authors.initials: B
authors.lastname: Liu
authors.affiliation: Division of Interventional Ultrasound, Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, First Affiliated Hospital of Sun Yat-Sen University, Sun Yat-Sen University, Guangzhou, China.
authors.forename: Yanling
authors.initials: Y
authors.lastname: Zheng
authors.affiliation: Division of Interventional Ultrasound, Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, First Affiliated Hospital of Sun Yat-Sen University, Sun Yat-Sen University, Guangzhou, China.
authors.forename: Guangliang
authors.initials: G
authors.lastname: Huang
authors.affiliation: Division of Interventional Ultrasound, Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, First Affiliated Hospital of Sun Yat-Sen University, Sun Yat-Sen University, Guangzhou, China.
authors.forename: Manxia
authors.initials: M
authors.lastname: Lin
authors.affiliation: Division of Interventional Ultrasound, Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, First Affiliated Hospital of Sun Yat-Sen University, Sun Yat-Sen University, Guangzhou, China.
authors.forename: Quanyuan
authors.initials: Q
authors.lastname: Shan
authors.affiliation: Division of Interventional Ultrasound, Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, First Affiliated Hospital of Sun Yat-Sen University, Sun Yat-Sen University, Guangzhou, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Lu
authors.affiliation: Division of Interventional Ultrasound, Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, First Affiliated Hospital of Sun Yat-Sen University, Sun Yat-Sen University, Guangzhou, China.
authors.forename: Wenshuo
authors.initials: W
authors.lastname: Tian
authors.affiliation: Division of Interventional Ultrasound, Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, First Affiliated Hospital of Sun Yat-Sen University, Sun Yat-Sen University, Guangzhou, China. Electronic address: xxy1992@live.cn.
authors.forename: Xiaoyan
authors.initials: X
authors.lastname: Xie
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D003937:Diagnosis, Differential; D054459:Elasticity Imaging Techniques / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008875:Middle Aged; D015588:Observer Variation; D015995:Prevalence; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D016217:Ultrasonography, Mammary / Q000706:statistics & numerical data*
keywords: Acoustic radiation force impulse imaging; Breast lesions; Meta-analysis; Shear wave elastography; Supersonic shear imaging; Ultrasound