Reproducibility and diagnostic performance of shear wave elastography in evaluating breast solid mass

Hong, Sun; Woo, Ok Hee; Shin, Hye Seon; Hwang, Soon Young; Cho, Kyu Ran; Seo, Bo Kyoung

doi:10.1016/j.clinimag.2017.03.022

Cited by 21 publications

(9 citation statements)

References 12 publications

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“…Some SWE parameter values would have probably been different if they had been measured by independent radiologists. Nevertheless, previous studies (33,34) have confirmed that quantitative SWE measurements are highly reproducible with good interobserver agreement. A further limitation is that the same radiologist performed the gray scale ultrasound and obtained the SWE without being blinded to the gray scale ultrasound results.…”

Section: Discussionmentioning

confidence: 90%

Diagnostic performance of qualitative and quantitative shear wave elastography in differentiating malignant from benign breast masses, and association with the histological prognostic factors

Suvannarerg¹,

Chitchumnong²,

Apiwat³

et al. 2019

Quant. Imaging Med. Surg

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Background: To determine the diagnostic performance of qualitative and quantitative shear wave elastography (SWE) and the optimal cutoff values of the quantitative SWE parameters in differentiating malignant from benign breast masses, and to evaluate the association between the quantitative SWE parameters and histological prognostic factors. Methods: A gray scale ultrasound and SWE were prospectively performed on a total of 244 breast masses (148 benign, and 96 malignant) in 228 consecutive patients before an ultrasound-guided needle biopsy. The qualitative SWE and quantitative SWE parameters (the mean elasticity, maximum elasticity, and elasticity ratio) were measured in each mass. The diagnostic performance of SWE and the optimal cutoff values of the quantitative SWE parameters were obtained. An association analysis of the parameters and histological prognostic factors was performed. Results: The malignant masses had a more heterogeneous pattern on the qualitative SWE than benign masses (P<0.001). The quantitative SWE parameters of the malignant masses were higher than those of the benign masses (P<0.001); the mean elasticity, maximum elasticity, and elasticity ratio of the benign masses were 19.73 kPa, 23.98 kPa, and 2.78, respectively; and the mean elasticity, maximum elasticity, and elasticity ratio of the malignant masses were 88.13 kPa, 98.48 kPa, and 10.64, respectively. The optimal cutoff value of the mean elasticity was 30 kPa, of the maximum elasticity was 36 kPa, and of the elasticity ratio was 4.5. The maximum elasticity had the highest AUC. Combining the three SWE parameters to differentiate between the malignant and benign masses increased the negative predictive value (NPV), which correctly downgraded 72.73% of BI-RADS category 4A masses to BI-RADS category 3. No statistically significant association was found between the quantitative SWE parameters and the tumor grading, tumor types, axillary lymph node statuses, or molecular subtypes of the breast cancers (P>0.05). Conclusions: The qualitative and quantitative SWE provided good diagnostic performance in differentiating malignant and benign masses. The maximum elasticity of the quantitative SWE parameters had the best diagnostic performance. Adding the three combined quantitative SWE parameters to the BI-RADS category 4A masses potentially downgraded them to BI-RADS category 3 and avoided unnecessary biopsies. No statistically significant association was found between the quantitative SWE parameters and the histological prognostic factors.

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Section: Discussionmentioning

confidence: 90%

Diagnostic performance of qualitative and quantitative shear wave elastography in differentiating malignant from benign breast masses, and association with the histological prognostic factors

Suvannarerg¹,

Chitchumnong²,

Apiwat³

et al. 2019

Quant. Imaging Med. Surg

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show abstract

“…Although SWE has been used to quantify the stiffness of the skin, liver, and breast masses, and the consistency analysis results have been optimistic (28)(29)(30), no previous studies have investigated the reliability and repeatability of SWE measurements on lung surface stiffness. In the present study, intra-and inter-group consistency for examining the lung surface stiffness of the mid-anterior lung site of 20 volunteers was performed and the results were excellent.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of connective tissue disease-related interstitial lung disease using ultrasound elastography: a preliminary study

Huang

Guo

Yuan

et al. 2022

Quant Imaging Med Surg

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Background: Interstitial lung disease (ILD) is a common pulmonary complication of connective tissue disease (CTD), which can lead to shortened survival. This article explores the ability of shear wave elastography (SWE) to assess lung surface elastic properties and to distinguish healthy lungs from diseased lungs with connective tissue disease-related interstitial lung disease (CTD-ILD). We aimed to determine whether SWE can be used to assess the severity of CTD-ILD.Methods: A total of 65 CTD-ILD patients and 60 healthy volunteers were included for the case group and the control group, respectively. All participants underwent lung ultrasound (count of B-line and measurement of pleural line thickness) and SWE [measurement of Young's modulus (Emean) and shear wave velocity (SMV) (Cmean)] examinations at 50 lung sites. All participants also underwent an examination with high-resolution computed tomography (HRCT) and a pulmonary function test (PFT). For SWE assessment, the Q-box was set to its minimum size (1 mm) and manually placed on the pleural line, rather than inside the lung, to measure the stiffness of the lung surface. The intra-and inter-reliability of SWE measurements of healthy controls (HC), the receiver operating characteristic (ROC) curve for SWE for CTD-ILD, and correlations between different assessment methods were analyzed.Results: Excellent intra-and inter-reliability of SWE measurements on the mid-anterior lung site of HCs (correlation coefficient >0.97; P<0.01) were found. The results of the lung ultrasound of case group participants were significantly higher than those of HCs at each site (P<0.001). The SWE results revealed a significant increase in both Emean and Cmean in CTD-ILD patients (P<0.001) compared with HCs at certain sites (P<0.001). The areas under the curve (AUC) of Emean and Cmean for CTD-ILD were 0.646 and 0.647 (P<0.05), respectively, and the cutoff values for Emean and Cmean to distinguish CTD-ILD from healthy lungs were 15.81 kPa and 2.31 m/s, respectively. There was no significant correlation between the SWE measured values and the number of B-lines, or the HRCT and PFT results, respectively (P>0.05).Conclusions: As a noninvasive ultrasound elastography (UE) technique, SWE may provide a novel method to differentiate CTD-ILD-affected lungs and healthy lungs. It is a reliable way to measure the stiffness of a healthy lung surface in the supine position. However, the ability of SWE to evaluate the severity of CTD-ILD may be limited.

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“…However, strain elastography could only provide qualitative information with poor reproducibility and high operator dependence. Conversely, SWE is reproducible (19) and can provide qualitative and quantitative information of tissue elasticity. Nevertheless, not all patients with breast cancer could achieve SWE images of ALNs meeting the diagnostic standard (images without vertical stripe artifacts while presenting the surrounding fat as homogenous) due to the anatomic features of axilla.…”

Section: Discussionmentioning

confidence: 99%

Qualitative Classification of Shear Wave Elastography for Differential Diagnosis Between Benign and Metastatic Axillary Lymph Nodes in Breast Cancer

et al. 2019

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Purpose: To examine diagnostic performance of qualitative shear wave elastography (SWE) for evaluation of status of axillary lymph nodes (ALN) in comparison with conventional ultrasonograghy (US) and quantitative SWE parameters. Methods: A total of 118 patients were enrolled, who were all scheduled for breast cancer surgery and core needle biopsy. Conventional US and SWE were performed before biopsy. Based on qualitative evaluation of each ALN, the SWE images were classified into four color patterns: Color Pattern 1: homogeneous; Color Pattern 2: filling defect within lymph node (LN); Color Pattern 3: homogeneous within LN with a localized colored area at the margin; and Color Pattern 4: filling defect within LN with a localized colored area at the margin. The diagnostic performances of the three methods were compared. Results: There were 60 metastatic nodes and 61 benign nodes in the 121 ALNs. Benign ALNs were presented as Color Pattern 1 while metastatic ALNs usually were presented as Color Pattern 2 to 4 ( p < 0.05). The AUC of qualitative SWE classification was 0.983, higher than that of quantitative SWE parameters and conventional US ( p <0.05). The highest diagnostic performance, with AUC of 0.998, could be achieved if both conventional US and qualitative SWE were applied. Conclusion: The qualitative SWE classification of ALNs proposed in our study exhibited better diagnostic performance than quantitative SWE parameters and conventional US, especially for differentiating metastatic ALNs from benign reactive ALNs. More accurate diagnosis could be reached with this new method and unnecessary biopsy might be avoided in the meantime.

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Reproducibility and diagnostic performance of shear wave elastography in evaluating breast solid mass

Cited by 21 publications

References 12 publications

Diagnostic performance of qualitative and quantitative shear wave elastography in differentiating malignant from benign breast masses, and association with the histological prognostic factors

Diagnostic performance of qualitative and quantitative shear wave elastography in differentiating malignant from benign breast masses, and association with the histological prognostic factors

Evaluation of connective tissue disease-related interstitial lung disease using ultrasound elastography: a preliminary study

Qualitative Classification of Shear Wave Elastography for Differential Diagnosis Between Benign and Metastatic Axillary Lymph Nodes in Breast Cancer

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