Value of Shear Wave Elastography for the Differentiation of Benign and Malignant Microcalcifications of the Breast

Chamming’s, Foucauld; Mesurolle, Benoı̂t; Antonescu, Raluca; Aldis, Ann; Kao, Ellen; Thériault, Mélanie; Ömeroğlu, Atilla; Pinel-Giroux, Fanny; Seidler, Matthew; Solorzano, Silma; Reinhold, Caroline; Gallix, B.

doi:10.2214/ajr.18.20899

Cited by 12 publications

(12 citation statements)

References 30 publications

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“…In this study, BI-RADS category 4c invasive lobular carcinoma on B-mode US imaging appeared benign on both shear wave and strain elastography. Small malignant lesions on a shear wave and strain elastography may produce false-negative results (Chamming's et al, 2019). Shear wave elastography is more reliable as compared to strain elastography; however high wave speed is induced due to precompression and may lead to false-positive results.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Strain Elastography and Shear Wave Elastography for Differentiating Malignant From Benign Breast Masses

JAMAL¹,

Nighat

IRUM

et al. 2022

Biol Clin Sci Res J

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To compare the diagnostic performance of shear wave and strain elastography in distinguishing benign and malignant breast lesions. A prospective study carried out from 20th March 2020 to 20th March 2021 at department of Radiology of Sahiwal, Multan, Lahore. The study included women who were lined for surgical excision or core needle biopsy and were examined using B-mode ultrasound and shear and strain wave elastography. A total of 30 female patients with 40 breast lesions were included in the study. Lesions were categorized on B-mode ultrasound as 3 BI-RADS 3, 18 BI-RADS 4A, 5 BI-RADS 4B, 7 BI-RADS 4C, and 7 BI-RADS 5. After performing a B-mode Ultrasound examination, US elastography was done. A 14-MHz transducer was used to obtain high-resolution images. For comparing the diagnostic performance of both, an area under the ROI curve (AUC) from data sets of shear and strain wave elastography was compared. The McNemar test was used for the comparison of sensitivity and specificity of both data sets. Mean age of the participants was 48.4 years (21-80years). 24 out of 40 lesions were benign while 16 were malignant. B mode US imaging showed the diameter of the lesion ranged from 0.5 to 5.2 cm. There was no significant difference between specificity and sensitivity of elastographic images. 6 breast masses showed discrepant results. After category 4a BI-RADs were selectively downgraded on the bases of cutoff values, AUCs showed improvement. Diagnostic performance of shear wave and strain elastography in distinguishing malignant and benign lesions is the same. Combining both has better diagnostic performance than using each individually.

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Section: Discussionmentioning

confidence: 99%

Comparison of Strain Elastography and Shear Wave Elastography for Differentiating Malignant From Benign Breast Masses

JAMAL¹,

Nighat

IRUM

et al. 2022

Biol Clin Sci Res J

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“…Ninety percent of ductal carcinoma in situ (DCIS) cases of the breast present with suspicious microcalcifications (MC) in mammography 1 . On the other hand, only 25% of suspected MC observed in mammography are truly malignant 2 . Stereotactic vacuum‐assisted breast biopsy is the gold standard diagnostic method for evaluating suspicious MC 3 .…”

Section: Introductionmentioning

confidence: 99%

The Diagnostic Role of Shear Wave Elastography and Superb Microvascular Imaging in the Evaluation of Suspicious Microcalcifications

Kayadibi

Deger

Kurt

et al. 2023

J of Ultrasound Medicine

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ObjectivesThe aim of this study was to investigate the role of superb microvascular imaging (SMI) and shear wave elastography (SWE) in the prediction of malignancy and invasiveness of isolated microcalcifications (MC) that can be visualized by ultrasonography (US).Material and MethodsSixty‐seven women with MC, who were considered suspicious on mammography were evaluated. Only those lesions that could be visualized by US and presented as non‐mass lesion were included. They were evaluated by B‐mode US, SMI, and SWE before US‐guided core‐needle biopsy. B‐mode US, SMI (vascular index (SMIvi)), and SWE (E‐mean, E‐ratio) findings were compared with histopathologic features.ResultsPathology confirmed 45 malignant (21 invasive and 24 in situ carcinomas) and 22 benign lesions. There was a statistically significant difference between malignant and benign groups in terms of size (P = .015), distortion (P = .028), cystic component (P < .001), E‐mean (P < .001), E‐ratio (P < .001), and SMIvi (P = .006). For differentiation of invasiveness E‐mean (P = .002), E‐ratio (P = .002), and SMIvi (P = .030) were statistically significant. According to ROC analysis E‐mean (cut‐off point at 38 kPa) was the most sensitive (78%) and the most specific (95%) value among four numeric parameters (size, SMI, E‐mean, and E‐ratio) with AUC = 0.895, PPV = 97%, and NPV = 68% in detecting malignancy. In the evaluation of invasiveness, the most sensitive (71.4%) method was SMI (cut‐off point at 3.4) and the most specific (72%) method was E‐mean (cut‐off point at 91.5 kPa).ConclusionOur study shows that adding SWE and SMI to the sonographic evaluation of MC would be an advantage for US‐guided biopsy. Including suspicious areas according to SMI and SWE in the sampling area can help target the invasive part of the lesion and avoid underestimation of core biopsy.

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“…It has been shown that high elasticity values in breast cancer cases are associated with poor prognostic markers such as high grade, axillary lymph node metastasis, and distant metastasis 20,25 . There are studies demonstrating that SWE is helpful in determining the malignancy risk of not only mass lesions but also microcalcifications, non‐mass lesions, and high‐risk lesions 26–29 …”

Section: Introductionmentioning

confidence: 99%

“…20,25 There are studies demonstrating that SWE is helpful in determining the malignancy risk of not only mass lesions but also microcalcifications, non-mass lesions, and highrisk lesions. [26][27][28][29] Quantitative data of SMI as an indicator of neoangiogenesis and SWE as an indicator of tissue stiffness have not been studied before in the differentiation of intraductal lesions. The aim of this study is to evaluate the accuracy of these parameters in the differentiation of benign from malignant IDPLs and to investigate their contribution to B-mode US.…”

Section: Introductionmentioning

confidence: 99%

The Role of Superb Microvascular Imaging and Shearwave Elastography in the Evaluation of Intraductal Papilloma‐Like Lesions

Kayadibi

Bulut

Kurt

et al. 2021

J of Ultrasound Medicine

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Objectives The aim of this study was to investigate the role of quantitative values obtained by superb microvascular imaging (SMI) and shearwave elastography (SWE) in the prediction of malignancy in intraductal papilloma‐like lesions (IDPL). Methods In the study, 61 patients between the ages of 14 to 73 years (mean age 44) diagnosed with IDPL on ultrasound (US) examination between the years 2020 and 2021 were included. The B‐Mode US findings (shape, margins, size, echo pattern, and accompanying ductal dilatation), SMI vascular index (SMIvi), E‐mean, and SWE‐ratio values were recorded. Results There was a statistically significant difference between malignant (n = 14) and benign (n = 47) groups in terms of symptoms (P = .005), size (P = .042), shape (P = .002), margins (P = .001), echogenicity (P = .023), microcalcifications (P = .009), SMIvi (P = .031), E‐mean (P < .005), and SWE‐ratio (P = .007). According to receiver operating characteristic (ROC) curve analysis, sensitivity, specificity, accuracy, area under the curve (AUC), positive predictive values (PPV), and negative predictive values (NPV) were 57.1%, 87.2%, 80%, 0.722, 57.1%, 87.2% for US; 71.4%, 49%, 55.7%, 0.692, 30.3%, 85.7% for SMIvi; 85.7%, 71%, 74%, 0.864, 46%, 94.3% for E‐mean, and 50%, 75.4%, 83%, 0.707, 91.5%, and 50% for SWE‐ratio, respectively. Best results were obtained when SMI and SWE values were used together, achieving a sensitivity, specificity, accuracy, AUC, PPD, NPD of 78.6%, 93.6%, 93.4%, 0.872, 91.7%, and 93.9%, respectively. Conclusions The SMI and SWE examinations are successful in the differentiation of benign and malignant intraductal lesions. They complement each other and contribute to B‐mode US in managing IDPLs especially when used together. Our study is the first to compare the quantitative data of SWE and SMI in the differentiation of IDPLs.

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Value of Shear Wave Elastography for the Differentiation of Benign and Malignant Microcalcifications of the Breast

Cited by 12 publications

References 30 publications

Comparison of Strain Elastography and Shear Wave Elastography for Differentiating Malignant From Benign Breast Masses

Comparison of Strain Elastography and Shear Wave Elastography for Differentiating Malignant From Benign Breast Masses

The Diagnostic Role of Shear Wave Elastography and Superb Microvascular Imaging in the Evaluation of Suspicious Microcalcifications

The Role of Superb Microvascular Imaging and Shearwave Elastography in the Evaluation of Intraductal Papilloma‐Like Lesions

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