title: Shearwave Elastography Increases Diagnostic Accuracy in Characterization of Breast Lesions.
abstract: The purpose of this study was to investigate the diagnostic efficacy of shearwave elastography (SWE) in differentiating between benign and malignant breast lesions.One hundred and fifty-nine lesions were assessed using B-mode ultrasound (US) and SWE parameters were recorded (Emax, Emean, Emin, Eratio, SD). SWE measurements were then correlated with histopathological diagnosis.The final sample contained 85 benign and 74 malignant lesions. The maximum stiffness (Emax) with a cutoff point of ≥ 56.0 kPa (based on ROC curves) provided sensitivity of 100.0%, specificity of 97.6%, positive predictive value (PPV) of 97.4%, and negative predictive value (NPV) of 100% in detecting malignant lesions. A cutoff of ≥80 kPa managed to downgrade 95.5% of the Breast Imaging-Reporting and Data System (BI-RADS) 4a lesions to BI-RADS 3, negating the need for biopsy. Using a combination of BI-RADS and SWE, the authors managed to improve the PPV from 2.3% to 50% in BI-RADS 4a lesions.SWE of the breast provides highly specific and sensitive quantitative values that are beneficial in the characterization of breast lesions. Our results showed that Emax is the most accurate value for differentiating benign from malignant lesions.
authors.affiliation: From the Department of Biomedical Imaging (WLN, KR, FF, FIR, MNM-S, CJW, AV, YFA), and Department of Pathology (PAC), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Wei Lin
authors.initials: WL
authors.lastname: Ng
authors.forename: Kartini
authors.initials: K
authors.lastname: Rahmat
authors.forename: Farhana
authors.initials: F
authors.lastname: Fadzli
authors.forename: Faizatul Izza
authors.initials: FI
authors.lastname: Rozalli
authors.forename: Mohammad Nazri
authors.initials: MN
authors.lastname: Mohd-Shah
authors.forename: Patricia Ann
authors.initials: PA
authors.lastname: Chandran
authors.forename: Caroline Judy
authors.initials: CJ
authors.lastname: Westerhout
authors.forename: Anushya
authors.initials: A
authors.lastname: Vijayananthan
authors.forename: Yang Faridah
authors.initials: YF
authors.lastname: Abdul Aziz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D000071060:Breast Density; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D002648:Child; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D042361:Mammary Glands, Human / Q000002:abnormalities; D008875:Middle Aged; D012680:Sensitivity and Specificity; D016217:Ultrasonography, Mammary / Q000379:methods*; D055815:Young Adult