Original Research

Diagnostic role of shear wave elastography for differentiating benign and malignant breast masses

Nichanametla Sravani, Ananthakrishnan Ramesh, Sathasivam Sureshkumar, Chellappa Vijayakumar, K.M. Abdulbasith, Gopal Balasubramanian, Pampa Ch Toi
South African Journal of Radiology | Vol 24, No 1 | a1999 | DOI: https://doi.org/10.4102/sajr.v24i1.1999 | © 2020 Nichanametla Sravani, Ananthakrishnan Ramesh, Sathasivam Sureshkumar, Chellappa Vijayakumar, K.M. Abdulbasith, Gopal Balasubramanian, Pampa Ch Toi | This work is licensed under CC Attribution 4.0
Submitted: 19 September 2020 | Published: 21 December 2020

About the author(s)

Nichanametla Sravani, Department of Radiodiagnosis, Faculty of Health Science, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
Ananthakrishnan Ramesh, Department of Radiodiagnosis, Faculty of Health Science, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
Sathasivam Sureshkumar, Department of Surgery, Faculty of Health Science, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
Chellappa Vijayakumar, Department of Surgery, Faculty of Health Science, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
K.M. Abdulbasith, Department of Surgery, Faculty of Health Science, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
Gopal Balasubramanian, Department of Surgery, Faculty of Health Science, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
Pampa Ch Toi, Department of Pathology, Faculty of Health Science, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India


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Abstract

Background: Use of B-mode ultrasound (US) may not obviate the need for diagnosis by histopathology, which is an invasive technique and remains the gold standard. These limitations are being overcome with the advent of shear wave elastography (SWE).

Objectives: To assess the diagnostic role of SWE parameters and combined SWE and B-mode US in diagnosing malignant breast lesions.

Method: This cross-sectional study included all patients with a breast mass on clinical examination. A B-mode US with a Breast Imaging Reporting and Data System (BI-RADS) assessment and SWE evaluation (distance ratio [DR], area ratio [AR] and shear wave velocity [SWV]) in the lesion and healthy breast tissue of all recruited patients was performed. Cut-offs for SWE parameters were derived by receiver operating characteristic (ROC) analysis. The diagnostic performance of the B-mode US, the SWE parameters and the combined imaging in diagnosing malignancy was assessed.

Results: This study included a total of 175 breast masses. The median values of the SWE parameters were significantly higher (p < 0.001) in the malignant breast masses (DR, 1.29 vs. 1.03; AR, 1.69 vs. 1.06; and SWV, 9.1 metre per second [m/s] vs. 2.1 m/s). The ROC cut-off for malignancy was derived at 1.135 m/s, 1.18 m/s and 3.18 m/s, respectively, for DR, AR and SWV. The area under the ROC curve was highest for the DR (0.930), whilst this value was 0.914 and 0.901 for the SWV and AR, respectively. Amongst the respective sensitivities and specificities of the B-mode US (90.6% and 90%), SWE (97.6% and 61.1%), SWE (excluding AR) (96.5% and 77.8%) and combined imaging (100% and 72.2%), the highest sensitivity was noted for the combined method.

Conclusion: All the SWE parameters were significantly higher in the malignant breast masses, compared to the benign lesions. On combining SWE and B-mode US, there was a significant increase in sensitivity but a decrease in specificity.


Keywords

elastography; B-mode ultrasonography; BI-RADS; diagnostic value; non-invasive imaging; breast carcinoma.

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