Shear wave elastography for breast masses is highly reproducible.

Area of Science:

• Medical Imaging
• Diagnostic Ultrasound
• Elastography

Background:

• Breast mass assessment relies on imaging techniques to differentiate benign from malignant lesions.
• Ultrasound elastography, specifically shear wave elastography (SWE), offers quantitative stiffness measurements.
• Evaluating the reproducibility of SWE is crucial for its clinical adoption in breast imaging.

Purpose of the Study:

• To assess the intra- and interobserver reproducibility of shear wave elastography (SWE) in the evaluation of breast masses.
• To compare the consistency of SWE assessments with traditional B-mode ultrasound features.

Main Methods:

• 758 breast masses were evaluated using SWE, with 144 classified as malignant.
• Intraobserver reproducibility was assessed via repeated measurements by the same observer.
• Interobserver reproducibility was evaluated by a blinded observer reviewing the SWE images.
• Quantitative measurements used intraclass correlation coefficients (ICC), and qualitative features used weighted kappa (κ).

Main Results:

• Intraobserver reliability for quantitative SWE measurements (diameter, area, perimeter) was almost perfect (ICC ≥ 0.94).
• Intraobserver reliability for elasticity measurements was almost perfect (ICC = 0.84-0.87) and substantial for elasticity ratio (ICC = 0.77).
• Interobserver agreement showed moderate to substantial agreement for qualitative SWE features (κ = 0.57-0.66) and fair to moderate for B-mode features (κ = 0.38-0.59).

Conclusions:

• Shear wave elastography (SWE) exhibits high intra- and interobserver reproducibility for assessing breast masses.
• SWE interpretation consistency is comparable to or exceeds that of BI-RADS ultrasound B-mode features.
• SWE provides a reliable method for characterizing breast tissue stiffness, aiding in diagnostic accuracy.