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European Radiology
Published in: European Radiology 10/2013

01-10-2013 | Breast

Diagnostic value of commercially available shear-wave elastography for breast cancers: integration into BI-RADS classification with subcategories of category 4

Authors: Ji Hyun Youk, Hye Mi Gweon, Eun Ju Son, Kyung Hwa Han, Jeong-Ah Kim

Published in: European Radiology | Issue 10/2013

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Abstract

Objectives

To evaluate the diagnostic performance of shear-wave elastography (SWE) for breast cancer and to determine whether the integration of SWE into BI-RADS with subcategories of category 4 improves the diagnostic performance.

Methods

A total of 389 breast masses (malignant 120, benign 269) in 324 women who underwent SWE before ultrasound-guided core biopsy or surgery were included. The qualitative SWE feature was assessed using a four-colour overlay pattern. Quantitative elasticity values including the lesion-to-fat elasticity ratio (Eratio) were measured. Diagnostic performance of B-mode ultrasound, SWE, or their combined studies was compared using the area under the ROC curve (AUC).

Results

AUC of Eratio (0.952) was the highest among elasticity values (mean, maximum, and minimum elasticity, 0.949, 0.939, and 0.928; P = 0.04) and AUC of colour pattern was 0.947. AUC of combined studies was significantly higher than for a single study (P < 0.0001). When adding SWE to category 4 lesions, lesions were dichotomised according to % of malignancy: 2.1 % vs. 43.2 % (category 4a) and 0 % vs. 100 % (category 4b) for Eratio and 2.4 % vs. 25.8 % (category 4a) for colour pattern (P < 0.05).

Conclusions

Shear-wave elastography showed a good diagnostic performance. Adding SWE features to BI-RADS improved the diagnostic performance and may be helpful to stratify category 4 lesions.

Key points

• Quantitative and qualitative shear-wave elastography provides further diagnostic information during breast ultrasound.
• The elasticity ratio (E ratio ) showed the best diagnostic performance in SWE.
• E ratio and four-colour overlay pattern significantly differed between benign and malignant lesions.
• SWE features allowed further stratification of BI-RADS category 4 lesions.
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Metadata
Title
Diagnostic value of commercially available shear-wave elastography for breast cancers: integration into BI-RADS classification with subcategories of category 4
Authors
Ji Hyun Youk
Hye Mi Gweon
Eun Ju Son
Kyung Hwa Han
Jeong-Ah Kim
Publication date
01-10-2013
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 10/2013
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-013-2873-3

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