Diagnostic performance of elastography for breast non-mass lesions: A systematic review and meta-analysis

Abstract

This systematic review and meta-analysis aimed to evaluate the diagnostic performance of ultrasound elastography in the differentiation of benign and malignant breast non-mass lesions (NMLs). Methods: PubMed, Cochrane Library, and Embase databases were searched for eligible studies up to end of June 2021. The diagnostic performance of elastography for NMLs was investigated using pooled sensitivity and specificity, likelihood ratio, diagnostic odds ratio (DOR), post-test probability, and the area under hierarchical summary receiver operating characteristic curve (HSROC). Results: Eleven studies involving 812 NMLs (malignant 414) were included. The pooled sensitivity, specificity, DOR, positive likelihood ratio, and negative likelihood of elastography for the differentiation of benign and malignant breast NMLs were 79% (95 %CI: 71-85), 86% (95 %CI: 79-91), ), and 0.24 (95 %CI: 0.17-0.34), respectively. No significant publication bias existed. The area under the HSROC curve was 90% (95 %CI: 87-92). Fagan plots demonstrated good clinical utility. However, substantial heterogeneity existed. Country, measurement index, and number of lesions served as potential sources of heterogeneity. Conclusions:The results of this study suggest that elastography has high diagnostic accuracy in differentiating between malignant and benign NMLs. Elastography can be a feasible and non-invasive tool for breast NMLs.

Value of sonoelastography for diagnosis of breast non-mass lesions and comparison with BI-RADS: A systematic review and meta-analysis

“…A similar meta-analysis about sonoelastography for breast non-mass lesions was reported in 2021. [ 31 ] In comparison to the 2021 meta-analysis, our study had the following differences: First, the literature included in our study was different. Two articles were excluded: one because the main text was written in Italian, [ 32 ] and the other because 2 studies were conducted in the same department, [ 19 , 29 ] which may have some duplicate data, and the article with fewer lesions was excluded.…”

Beyond BI-RADS: Nonmass Abnormalities on Breast Ultrasound

“…Information on elasticity by either strain or shear-wave elastography can be used to characterize benign and malignant lesions in nonmass hypoechoic or distorted areas [ 56 ]. In strain elastography, elasticity is scored from 1 (soft) to 5 (hard) by light compression, where scores of 4 and 5 indicate malignancy [ 57 ].…”

Non-mass Findings on Breast Ultrasonography and Differential Diagnosis

“…Hong ve ark. [27] 2021 yılında yayınladıkları derlemede KDB gösteren lezyonlarda elastografinin benign malign ayırımında duyarlılığını %79 ve özgüllüğünü %86 olarak rapor etmişlerdir. Doppler US'de malign KDB lezyonlarda daha yüksek oranda vaskülerite bildirilmiştir [3,19].…”