Does Shear Wave Elastography Score Over Strain Elastography in Breast Masses or Vice Versa?

Area of Science:

• Medical Imaging
• Diagnostic Ultrasound
• Breast Imaging

Background:

• Elastography techniques, including strain elastography (SE) and shear-wave elastography (SWE), are increasingly used in breast mass characterization.
• Accurate differentiation between benign and malignant breast lesions is crucial for appropriate patient management.

Purpose of the Study:

• To compare the diagnostic performance of various strain elastography (SE) and shear-wave elastography (SWE) parameters for differentiating benign from malignant breast masses.
• To determine the optimal cut-off values for these parameters to maximize sensitivity and specificity.

Main Methods:

• B-mode ultrasound (USG), SE, and SWE were performed on 199 breast masses.
• SE parameters included a 5-point visual score and strain ratio (SE_{strain ratio}).
• SWE parameters included mean and maximum elasticity values (kPa) and shear wave ratio, averaged across two orthogonal planes (SWE_{mean avg}, SWE_{max avg}, SWE_{ratio avg}).
• All elastography parameters were correlated with histopathology results.

Main Results:

• The areas under the receiver operating characteristic curves (AUC) for SE_{visual score}, SE_{strain ratio}, SWE_{mean avg}, SWE_{max avg}, and SWE_{ratio avg} were 0.815, 0.814, 0.846, 0.846, and 0.799, respectively.
• Optimal cut-off values were identified: SE_{strain ratio} (3.91), SWE_{mean avg} (113 kPa), SWE_{max avg} (123.5 kPa), and SWE_{ratio avg} (7.32).

Conclusions:

• Quantitative strain elastography parameters exhibit diagnostic performance comparable to quantitative shear-wave elastography parameters in differentiating breast masses.
• The established cut-off values can aid in the accurate classification of breast lesions using both SE and SWE techniques.