Shear Wave Elastography for Characterization of Breast Lesions in Clinical Routine

Area of Science:

• Medical Imaging
• Oncology
• Biophysics

Background:

• Breast cancer diagnosis faces challenges differentiating benign from malignant lesions using conventional ultrasound, leading to unnecessary biopsies.
• Quantitative tissue stiffness assessment via shear wave elastography (SWE) offers potential to improve diagnostic accuracy.

Purpose of the Study:

• Evaluate the diagnostic accuracy of SWE in clinical practice for breast lesions.
• Determine optimal stiffness cut-off values to differentiate benign from malignant breast lesions.

Main Methods:

• Prospective study of 73 women with BI-RADS 3-5 lesions undergoing SWE before biopsy.
• Stiffness measurements (kPa, m/s) obtained; histopathology as reference standard.
• Receiver-operating characteristic (ROC) analysis for diagnostic performance and threshold determination; assessed reproducibility.

Main Results:

• Malignant lesions were significantly stiffer (mean 56.7 kPa) than benign lesions (mean 18.7 kPa).
• SWE achieved excellent diagnostic accuracy (AUC 0.932) with optimal cut-off at 40.03 kPa (3.6 m/s), yielding 88% sensitivity and 95% specificity.
• High intra- and interobserver reproducibility observed for stiffness measurements.

Conclusions:

• SWE is an accurate method for differentiating benign from malignant breast lesions, enhancing specificity.
• This technique may reduce the rate of unnecessary breast biopsies.
• Standardization of SWE protocols is recommended for broader clinical implementation.