Related Experiment Video
Updated: Jul 31, 2025
Author Spotlight: Integrating High-Resolution Intravital Imaging and MRI to Enhance Stereotactic Body Radiation Therapy Planning
Published on: April 12, 2024
The Diagnostic Role of Shear Wave Elastography and Superb Microvascular Imaging in the Evaluation of Suspicious
Yasemin Kayadibi1, Enes Deger1, Seda Aladag Kurt1
1Cerrahpasa Medical Faculty, Department of Radiology, Istanbul University-Cerrahpasa, Istanbul, Turkey.
Objectives:
The aim of this study was to investigate the role of superb microvascular imaging (SMI) and shear wave elastography (SWE) in the prediction of malignancy and invasiveness of isolated microcalcifications (MC) that can be visualized by ultrasonography (US).
Material And Methods:
Sixty-seven women with MC, who were considered suspicious on mammography were evaluated. Only those lesions that could be visualized by US and presented as non-mass lesion were included. They were evaluated by B-mode US, SMI, and SWE before US-guided core-needle biopsy. B-mode US, SMI (vascular index (SMIvi)), and SWE (E-mean, E-ratio) findings were compared with histopathologic features.
Results:
Pathology confirmed 45 malignant (21 invasive and 24 in situ carcinomas) and 22 benign lesions. There was a statistically significant difference between malignant and benign groups in terms of size (P = .015), distortion (P = .028), cystic component (P < .001), E-mean (P < .001), E-ratio (P < .001), and SMIvi (P = .006). For differentiation of invasiveness E-mean (P = .002), E-ratio (P = .002), and SMIvi (P = .030) were statistically significant. According to ROC analysis E-mean (cut-off point at 38 kPa) was the most sensitive (78%) and the most specific (95%) value among four numeric parameters (size, SMI, E-mean, and E-ratio) with AUC = 0.895, PPV = 97%, and NPV = 68% in detecting malignancy. In the evaluation of invasiveness, the most sensitive (71.4%) method was SMI (cut-off point at 3.4) and the most specific (72%) method was E-mean (cut-off point at 91.5 kPa).
Conclusion:
Our study shows that adding SWE and SMI to the sonographic evaluation of MC would be an advantage for US-guided biopsy. Including suspicious areas according to SMI and SWE in the sampling area can help target the invasive part of the lesion and avoid underestimation of core biopsy.
Insights
Superb microvascular imaging (SMI) and shear wave elastography (SWE) improve ultrasound-guided biopsy accuracy for suspicious microcalcifications (MC). These techniques help identify malignancy and invasiveness, potentially avoiding underestimation in core biopsies.
Area of Science:
- Radiology
- Medical Imaging
- Oncology
Background:
- Microcalcifications (MC) visualized by ultrasonography (US) can be suspicious for malignancy.
- Accurate assessment of MC malignancy and invasiveness is crucial for guiding biopsy decisions.
- Novel imaging techniques like SMI and SWE may enhance diagnostic capabilities for MC.
Purpose of the Study:
- To evaluate the efficacy of superb microvascular imaging (SMI) and shear wave elastography (SWE) in predicting malignancy and invasiveness of ultrasonographically visualized isolated microcalcifications (MC).
- To compare the diagnostic performance of SMI and SWE with traditional B-mode US in differentiating benign from malignant MC.
Main Methods:
- Sixty-seven women with mammographically suspicious MC, visualized as non-mass lesions on US, were included.
- Lesions were assessed using B-mode US, SMI (vascular index - SMIvi), and SWE (E-mean, E-ratio) prior to US-guided core-needle biopsy.
- Imaging findings were correlated with histopathologic results.
Main Results:
- Pathology revealed 45 malignant (21 invasive, 24 in situ) and 22 benign lesions.
- Significant differences between malignant and benign groups were observed in size, distortion, cystic component, E-mean, E-ratio, and SMIvi (p < 0.05).
- For malignancy detection, E-mean (cut-off 38 kPa) showed the highest sensitivity (78%) and specificity (95%) with an AUC of 0.895. For invasiveness, SMI (cut-off 3.4) was most sensitive (71.4%) and E-mean (cut-off 91.5 kPa) was most specific (72%).
Conclusions:
- Integrating SWE and SMI into the sonographic evaluation of MC enhances diagnostic accuracy for US-guided biopsy.
- Utilizing suspicious areas identified by SMI and SWE can improve targeting of invasive components, thereby reducing the risk of underestimation in core biopsies.
Related Concept Videos
01:20Imaging Studies for Cardiovascular System II:Types of Echocardiography
Types of Echocardiography
Transthoracic Echocardiography (TTE)
TTE is the most common type of echocardiogram which involves placing a transducer on the patient's chest, emitting sound waves to create heart images. TTE is invaluable for evaluating the heart's size, structure, and motion, making it particularly useful for...
01:20Imaging Studies for Cardiovascular System III: X-Ray
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
01:17Ultrasonography
During an ultrasonography procedure, a handheld device called...
01:25Ultrasound II: Endoscopic Ultrasound and FibroScan
Endoscopic Ultrasound (EUS):
01:24Imaging Studies II: Ultrasonography