Shear wave versus strain elastography of breast lesions-The value of incorporating boundary tissue assessment

This prospective study compares the diagnostic performance of strain elastography (SE) based on the elastogram to B-mode (E/B) size ratio to shear-wave elastography (SWE) incorporating assessment of boundary tissue stiffness.

In this prospective study, 81 women consented to undergo ultrasound (US) elastographic assessment prior to biopsy of their mass(es). A total of 101 masses were evaluated with SE and SWE using a single machine (Siemens Acuson S2000). The histopathologic diagnosis was used as the reference standard. The sensitivity, specificity and area under curve (AUC) were obtained for SE and SWE.

The sensitivity and specificity of SE using the E/B ratio was 94.7% (95% CI: 87.6 100) and 81.0% (95% CI: 71.3 90.1) respectively. For SWE the sensitivity and specificity was 73.7% (95% CI: 59.7 87.7) and 82.5% (95% CI: 73.2 91.9) respectively. The AUC for SE was higher (0.878) compared to SWE (0.697).

SE elastography using the E/B ratio yields diagnostic performance which is superior to SWE incorporating assessment of peripheral stiffness.