Related Experiment Video
Updated: May 11, 2026
Clinical Imaging of Microwave Mammography
Published on: November 14, 2025
Diagnostic value of commercially available shear-wave elastography for breast cancers: integration into BI-RADS
Ji Hyun Youk1, Hye Mi Gweon, Eun Ju Son
1Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-Gu, Seoul, 135-720, South Korea, jhyouk@yuhs.ac.
Objectives:
To evaluate the diagnostic performance of shear-wave elastography (SWE) for breast cancer and to determine whether the integration of SWE into BI-RADS with subcategories of category 4 improves the diagnostic performance.
Methods:
A total of 389 breast masses (malignant 120, benign 269) in 324 women who underwent SWE before ultrasound-guided core biopsy or surgery were included. The qualitative SWE feature was assessed using a four-colour overlay pattern. Quantitative elasticity values including the lesion-to-fat elasticity ratio (Eratio) were measured. Diagnostic performance of B-mode ultrasound, SWE, or their combined studies was compared using the area under the ROC curve (AUC).
Results:
AUC of Eratio (0.952) was the highest among elasticity values (mean, maximum, and minimum elasticity, 0.949, 0.939, and 0.928; P = 0.04) and AUC of colour pattern was 0.947. AUC of combined studies was significantly higher than for a single study (P < 0.0001). When adding SWE to category 4 lesions, lesions were dichotomised according to % of malignancy: 2.1 % vs. 43.2 % (category 4a) and 0 % vs. 100 % (category 4b) for Eratio and 2.4 % vs. 25.8 % (category 4a) for colour pattern (P < 0.05).
Conclusions:
Shear-wave elastography showed a good diagnostic performance. Adding SWE features to BI-RADS improved the diagnostic performance and may be helpful to stratify category 4 lesions.
Key Points:
• Quantitative and qualitative shear-wave elastography provides further diagnostic information during breast ultrasound. • The elasticity ratio (E ratio ) showed the best diagnostic performance in SWE. • E ratio and four-colour overlay pattern significantly differed between benign and malignant lesions. • SWE features allowed further stratification of BI-RADS category 4 lesions.
