Breast mass characterization using shear wave elastography and ultrasound

Area of Science:

• Medical Imaging
• Diagnostic Ultrasound
• Elastography

Background:

• Breast mass characterization is crucial for timely diagnosis and treatment.
• Ultrasound is a primary imaging modality, but differentiating indeterminate lesions (BI-RADS 3 and 4a) can be challenging.
• Need for improved diagnostic accuracy to reduce unnecessary invasive procedures.

Purpose of the Study:

• To evaluate the role of shear wave elastography (SWE) in characterizing breast masses.
• To determine if SWE, in addition to ultrasound, can improve the evaluation of BI-RADS 3 and 4a breast masses.
• To assess the potential of SWE to reduce long-term follow-up and unnecessary biopsies for suspicious breast masses.

Main Methods:

• Prospective, cross-sectional study involving 119 women with single breast masses.
• Patients underwent clinical breast examination, ultrasound, SWE, and ultrasound-guided core biopsy.
• Analysis of SWE qualitative (E-color) and quantitative (E-mean, E-max) parameters for differentiation; modified BI-RADS categories were created and compared with standard ultrasound BI-RADS.

Main Results:

• Of 119 masses, 57% were benign and 52% malignant.
• Ultrasound showed 96.8% sensitivity and 70.2% specificity.
• Modified BI-RADS using SWE parameters (E-color, E-mean/E-max) improved specificity to 78.9% and 75.4%, respectively, aiding in differentiating benign from malignant masses.

Conclusions:

• The addition of SWE to ultrasound enhances the characterization of BI-RADS 3 and 4a breast masses.
• SWE parameters, specifically E-max, E-mean, and E-color, are valuable tools for distinguishing between malignant and benign breast lesions.
• SWE shows promise in improving diagnostic accuracy and potentially reducing the need for invasive procedures in breast mass evaluation.