Published in:
Open Access
30-08-2023 | Breast
Evaluation of standard breast ultrasonography by adding two-dimensional and three-dimensional shear wave elastography: a prospective, multicenter trial
Authors:
Jinshun Xu, Lei Zhang, Wen Wen, Yushuang He, Tianci Wei, Yanling Zheng, Xiaofang Pan, Yuhong Li, Yiyun Wu, Fenglin Dong, Heqing Zhang, Wen Cheng, Hongchun Xu, Yingchun Zhang, Lingyun Bao, Xinguo Zhang, Shichu Tang, Jintang Liao, Honghao Luo, Haina Zhao, Jiawei Tian, Yulan Peng
Published in:
European Radiology
|
Issue 2/2024
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Abstract
Objective
To reduce the number of biopsies performed on benign breast lesions categorized as BI-RADS 4–5, we investigated the diagnostic performance of combined two-dimensional and three-dimensional shear wave elastography (2D + 3D SWE) with standard breast ultrasonography (US) for the BI-RADS assessment of breast lesions.
Methods
A total of 897 breast lesions, categorized as BI-RADS 3–5, were subjected to standard breast US and supplemented by 2D SWE only and 2D + 3D SWE analysis. Based on the malignancy rate of less than 2% for BI-RADS 3, lesions assessed by standard breast US were reclassified with SWE assessment.
Results
After standard breast US evaluation, 268 (46.1%) participants underwent benign biopsies in BI-RADS 4–5 lesions. By using separated cutoffs for upstaging BI-RADS 3 at 120 kPa and downstaging BI-RADS 4a at 90 kPa in 2D + 3D SWE reclassification, 123 (21.2%) participants underwent benign biopsy, resulting in a 54.1% reduction (123 versus 268).
Conclusion
Combining 2D + 3D SWE with standard breast US for reclassification of BI-RADS lesions may achieve a reduction in benign biopsies in BI-RADS 4–5 lesions without sacrificing sensitivity unacceptably.
Clinical relevance statement
Combining 2D + 3D SWE with US effectively reduces benign biopsies in breast lesions with categories 4–5, potentially improving diagnostic accuracy of BI-RADS assessment for patients with breast lesions.
Trial registration
ChiCTR1900026556
Key Points
• Reduce benign biopsy is necessary in breast lesions with BI-RADS 4–5 category.
• A reduction of 54.1% on benign biopsies in BI-RADS 4–5 lesions was achieved using 2D + 3D SWE reclassification.
• Adding 2D + 3D SWE to standard breast US improved the diagnostic performance of BI-RADS assessment on breast lesions: specificity increased from 54 to 79%, and PPV increased from 54 to 71%, with slight loss in sensitivity (97.2% versus 98.7%) and NPV (98.1% versus 98.7%).