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Quantitative shear wave ultrasound elastography: initial experience in solid breast masses.

Andrew Evans1, Patsy Whelehan, Kim Thomson

  • 1Centre for Oncology and Molecular Medicine, University of Dundee, Ninewells Hospital & Medical School, Dundee, UK. a.z.evans@dundee.ac.uk

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Shear wave elastography offers reproducible quantitative elasticity data for breast lesions. This new ultrasound method shows diagnostic accuracy comparable to traditional greyscale ultrasound with BI-RADS classification for differentiating benign from malignant masses.

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Area of Science:

  • Medical Imaging
  • Diagnostic Ultrasound
  • Biomedical Engineering

Background:

  • Shear wave elastography (SWE) is an emerging technique for quantitative tissue elasticity assessment in breast ultrasound.
  • Accurate characterization of solid breast masses is crucial for timely diagnosis and treatment.
  • Traditional greyscale ultrasound, often combined with the Breast Imaging Reporting and Data System (BI-RADS), is a standard diagnostic tool.

Purpose of the Study:

  • To evaluate the reproducibility of shear wave elastography in assessing breast lesions.
  • To correlate elasticity values obtained by SWE with histological findings of breast masses.
  • To compare the diagnostic performance of SWE against greyscale ultrasound (BI-RADS) for benign/malignant classification.

Main Methods:

  • Fifty-three solid breast lesions in 52 patients were examined using the Aixplorer® ultrasound system.
  • Two orthogonal elastography images were acquired per lesion, with mean elasticity values calculated.
  • Reproducibility was assessed through inter-observer and inter-operator analyses; lesions were biopsied for histological correlation.

Main Results:

  • High inter-observer (ICC=0.99) and good inter-operator (ICC=0.80) reproducibility were observed for SWE measurements.
  • SWE demonstrated high sensitivity (97%), specificity (83%), PPV (88%), NPV (95%), and accuracy (91%).
  • Diagnostic performance metrics for SWE were comparable to, and in some aspects better than, greyscale ultrasound with BI-RADS.

Conclusions:

  • Shear wave elastography provides quantitative and reproducible elasticity data for solid breast lesions.
  • SWE exhibits diagnostic accuracy for benign/malignant differentiation that is at least as good as greyscale ultrasound with BI-RADS.
  • SWE represents a valuable advancement in breast ultrasound imaging for lesion characterization.