Two-dimensional shear wave elastography for differential diagnosis between mastitis and breast malignancy

Area of Science:

• Radiology
• Medical Imaging
• Oncology

Background:

• Differentiating between benign inflammatory conditions like mastitis and malignant breast lesions can be challenging using conventional imaging.
• Accurate diagnosis is crucial for timely and appropriate patient management.

Purpose of the Study:

• To evaluate the diagnostic performance of conventional ultrasound (US) and two-dimensional shear wave elastography (2D SWE) in distinguishing mastitis from breast malignancy.
• To compare the diagnostic efficacy of US alone versus the combination of US and 2D SWE.

Main Methods:

• A study involving 105 patients with pathologically proven breast lesions was conducted between January 2016 and March 2017.
• Conventional US and 2D SWE were performed on all lesions, assessing qualitative (stiff rim sign) and quantitative (maximal shear wave velocity - SWV) parameters.
• Diagnostic performance metrics including sensitivity, specificity, and area under the receiver operating characteristic curve (AUROC) were calculated for US and the combined US + 2D SWE method.

Main Results:

• Of 105 lesions, 26 were mastitis and 79 were malignant.
• The maximal SWV cut-off value was determined to be 6.75 m/sec.
• The combination of US and 2D SWE demonstrated significantly improved specificity (96.1% vs. 11.5%) and AUROC (0.752 vs. 0.520) compared to conventional US alone (P < 0.05).

Conclusions:

• The integration of 2D SWE with conventional US significantly enhances diagnostic performance for differentiating breast malignancy from mastitis.
• This combined imaging approach offers superior accuracy compared to conventional US alone.