Shear-wave Elastography Improves the Specificity of Breast US: The BE1 Multinational Study of 939 Masses

Berg, Wendie A.; Cosgrove, David O.; Doré, Caroline J; Schäfer, Fritz K. W.; Svensson, W. E.; Hooley, Regina J.; Öhlinger, R.; Mendelson, Ellen B.; Balu–Maestro, C.; Locatelli, Martina; Tourasse, Christophe; Cavanaugh, Barbara; Juhan, V.; Stavros, A. Thomas; Tardivon, A.; Henry, Jean-Pierre; Cohen‐Bacrie, Claude

doi:10.1148/radiol.11110640

Cited by 730 publications

(604 citation statements)

References 32 publications

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“…As the shear wave is induced by applying an acoustic radiation force, there is no need to move the transducer. A good inter-observer reproducibility can be achieved [2]. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 3 quantitative elasticity of a lesion with SWE is useful for the differentiation of benign and malignant lesions [2] as malignant tissue is generally stiffer than benign tissue [3].…”

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confidence: 87%

“…Therefore the lesions of group A and B dichotomised according to a threshold for each parameter, identified from the literature [2,5,16] as follows: that is an ultrasound diameter of 15 mm, E max of 80 kPa, E mean of 50 kPa and a SD of 7 kPa. Furthermore the sub-groups were divided into all (total), benign and malignant lesions.…”

Section: Correlation With Ultrasound Imaging and Elasticity Charactermentioning

confidence: 99%

“…Large cancers are significantly more anisotropic than small cancers (p≤0.001). The optimal anisotropy cut-off threshold for benign/malignant differentiation of 150 kPa 2 achieves the best sensitivity (74%) with a reasonable specificity (63%). 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 …”

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confidence: 99%

“…1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 3 quantitative elasticity of a lesion with SWE is useful for the differentiation of benign and malignant lesions [2] as malignant tissue is generally stiffer than benign tissue [3]. Berg et al recommended the use of a cut-off threshold for the maximum elasticity, E max of 80 kPa for the optimal benign/malignant differentiation [2]. Evans et al recommend a cut-off threshold for the mean elasticity, E mean of 50 kPa [4].…”

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confidence: 99%

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Anisotropy of Solid Breast Lesions in 2D Shear Wave Elastography is an Indicator of Malignancy

et al. 2016

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Rationale and Objectives: To investigate if anisotropy at 2D Shear Wave Elastography (SWE) suggests malignancy and whether it correlates with prognostic and predictive factors in breast cancer. Materials and Methods: Study-group A of 244 solid breast lesions was imaged with SWE between April 2013 and May 2014. Each lesion was imaged in radial and anti-radial planes and the maximum elasticity Emax, mean elasticity Emean and standard deviation SD were recorded and correlated with benign/malignant status and if malignant, to conventional predictive and prognostic factors. The results were compared to a study-group B of 968 solid breast lesions, which were imaged in sagittal and axial plane between 2010 and 2013.

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mentioning

confidence: 87%

Section: Correlation With Ultrasound Imaging and Elasticity Charactermentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Anisotropy of Solid Breast Lesions in 2D Shear Wave Elastography is an Indicator of Malignancy

et al. 2016

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“…It has been shown to yield accurate information with regard to benign/malignant differentiation of solid breast masses. [1][2][3] SWE allows measurement of the propagation speed of shear waves within the tissue, to locally quantify its stiffness in kilopascals or metre per second. A variety of quantitative measures can be obtained with SWE, including the mean, maximum and "standard deviation" from a user-defined region of interest (ROI).…”

Section: Introductionmentioning

confidence: 99%

Shear-wave elastography and greyscale assessment of palpable probably benign masses: is biopsy always required?

Giannotti¹,

Vinnicombe²,

Thomson³

et al. 2016

BJR

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Objective: To establish if palpable breast masses with benign greyscale ultrasound features that are soft on shear-wave elastography (SWE) (mean stiffness ,50 kPa) have a low enough likelihood of malignancy to negate the need for biopsy or follow-up. Methods: The study group comprised 694 lesions in 682 females (age range 17-95 years, mean age 56 years) presenting consecutively to our institution with palpable lesions corresponding to discrete masses at ultrasound. All underwent ultrasound, SWE and needle core biopsy. Static greyscale images were retrospectively assigned Breast Imaging Reporting and Data System (BI-RADS) scores by two readers blinded to the SWE and pathology findings, but aware of the patient's age. A mean stiffness of 50 kPa was used as the SWE cut-off for calling a lesion soft or stiff. Histological findings were used to establish ground truth. Results:No cancer had benign characteristics on both modalities. 466 (99.8%) of the 467 cancers were classified BI-RADS 4a or above. The one malignant lesion classified as BI-RADS 3 was stiff on SWE. 446 (96%) of the 467 malignancies were stiff on SWE. No cancer in females under 40 years had benign SWE features. 74 (32.6%) of the 227 benign lesions were BI-RADS 3 and soft on SWE; so, biopsy could potentially have been avoided in this group. Conclusion: Lesions which appear benign on greyscale ultrasound and SWE do not require percutaneous biopsy or short-term follow-up, particularly in females under 40 years. Advances in knowledge: None of the cancers had benign characteristics on both greyscale ultrasound and SWE, and 32% of benign lesions were BI-RADS 3 and soft on SWE; lesions that are benign on both ultrasound and SWE may not require percutaneous biopsy or short-term follow-up.

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Supplementary Imaging for Breast Cancer Screening in High-Risk Women—Reply

Berg¹,

Barr²,

Zhang³

2012

JAMA

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Shear-wave Elastography Improves the Specificity of Breast US: The BE1 Multinational Study of 939 Masses

Abstract: Adding SW elastographic features to BI-RADS feature analysis improved specificity of breast US mass assessment without loss of sensitivity.

Cited by 730 publications

References 32 publications

Anisotropy of Solid Breast Lesions in 2D Shear Wave Elastography is an Indicator of Malignancy

Anisotropy of Solid Breast Lesions in 2D Shear Wave Elastography is an Indicator of Malignancy

Shear-wave elastography and greyscale assessment of palpable probably benign masses: is biopsy always required?

Supplementary Imaging for Breast Cancer Screening in High-Risk Women—Reply

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