Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
European Radiology
Published in: European Radiology 9/2017

01-09-2017 | Breast

Shear wave elastography in the diagnosis of breast non-mass lesions: factors associated with false negative and false positive results

Authors: So Yoon Park, Ji Soo Choi, Boo-Kyung Han, Eun Young Ko, Eun Sook Ko

Published in: European Radiology | Issue 9/2017

Login to get access

Abstract

Objective

To investigate factors related to false shear wave elastography (SWE) results for breast non-mass lesions (NMLs) detected by B-mode US.

Methods

This retrospective study enrolled 152 NMLs detected by B-mode US and later pathologically confirmed (79 malignant, 73 benign). All lesions underwent B-mode US and SWE. Quantitative (mean elasticity [E mean]) and qualitative (maximum stiffness colour) SWE parameters were assessed, and ‘E mean > 85.1 kPa’ or ‘stiff colour (green to red)’ determined malignancy. Final SWE results were matched to pathology results. Multivariate logistic regression analysis identified factors associated with false SWE results for diagnosis of breast NMLs.

Results

Associated calcifications (E mean: odds ratio [OR] = 7.60, P < 0.01; maximum stiffness colour: OR = 6.30, P = 0.02), in situ cancer compared to invasive cancer (maximum stiffness colour: OR = 5.29, P = 0.02), and lesion size (E mean: OR = 0.90, P < 0.01; maximum stiffness colour: OR = 0.91, P = 0.01) were significantly associated with false negative SWE results for malignant NMLs. Distance from the nipple (E mean: OR = 0.84, P = 0.03; maximum stiffness colour: OR = 0.93, P = 0.04) was significantly associated with false positive SWE results for benign NMLs.

Conclusions

Presence of associated calcifications, absence of the invasive component, and smaller lesion size for malignant NMLs and shorter distance from the nipple for benign NMLs are factors significantly associated with false SWE results.

Key points

• Calcification and size are associated with false negative SWE in malignant NMLs.
• In situ cancer is associated with false negative SWE in malignant NMLs.
• Distance from the nipple is associated with false positive SWE in benign NMLs.
• These factors need consideration when performing SWE on breast NMLs.
Literature
1.
Uematsu T (2012) Non-mass-like lesions on breast ultrasonography: a systematic review. Breast Cancer 19:295–301CrossRefPubMed
2.
Wang ZL, Li N, Li M, Wan WB (2015) Non-mass-like lesions on breast ultrasound: classification and correlation with histology. Radiol Med 120:905–910CrossRefPubMed
3.
D’Orsi CJ, Sickles EA, Mendelson EB, Morris EA et al (2013) ACR BI-RADS® Atlas Breast Imaging Reporting and Data System. American College of Radiology, Reston, VA
4.
Berg WA, Cosgrove DO, Dore CJ et al (2012) Shear-wave elastography improves the specificity of breast US: the BE1 multinational study of 939 masses. Radiology 262:435–449CrossRefPubMed
5.
Choi JS, Han BK, Ko EY, Ko ES, Shin JH, Kim GR (2016) Additional diagnostic value of shear-wave elastography and color Doppler US for evaluation of breast non-mass lesions detected at B-mode US. Eur Radiol
6.
Ko KH, Jung HK, Kim SJ, Kim H, Yoon JH (2014) Potential role of shear-wave ultrasound elastography for the differential diagnosis of breast non-mass lesions: preliminary report. Eur Radiol 24:305–311CrossRefPubMed
7.
Shin HJ, Kim HH, Kim SM, Kwon GY, Gong G, Cho OK (2008) Screening-detected and symptomatic ductal carcinoma in situ: differences in the sonographic and pathologic features. AJR Am J Roentgenol 190:516–525CrossRefPubMed
8.
Ko KH, Hsu HH, Yu JC et al (2015) Non-mass-like breast lesions at ultrasonography: feature analysis and BI-RADS assessment. Eur J Radiol 84:77–85CrossRefPubMed
9.
Balleyguier C, Ciolovan L, Ammari S et al (2013) Breast elastography: the technical process and its applications. Diagn Interv Imaging 94:503–513CrossRefPubMed
10.
Youk JH, Son EJ, Park AY, Kim JA (2014) Shear-wave elastography for breast masses: local shear wave speed (m/sec) versus Young modulus (kPa). Ultrasonography 33:34–39CrossRefPubMed
11.
Chang JM, Moon WK, Cho N et al (2011) Clinical application of shear wave elastography (SWE) in the diagnosis of benign and malignant breast diseases. Breast Cancer Res Treat 129:89–97CrossRefPubMed
12.
Lee S, Jung Y, Bae Y (2016) Clinical application of a color map pattern on shear-wave elastography for invasive breast cancer. Surg Oncol 25:44–48CrossRefPubMed
13.
Cosgrove DO, Berg WA, Dore CJ et al (2012) Shear wave elastography for breast masses is highly reproducible. Eur Radiol 22:1023–1032CrossRefPubMed
14.
Evans A, Whelehan P, Thomson K et al (2012) Differentiating benign from malignant solid breast masses: value of shear wave elastography according to lesion stiffness combined with greyscale ultrasound according to BI-RADS classification. Br J Cancer 107:224–229CrossRefPubMedPubMedCentral
15.
Evans A, Whelehan P, Thomson K et al (2012) Invasive breast cancer: relationship between shear-wave elastographic findings and histologic prognostic factors. Radiology 263:673–677CrossRefPubMed
16.
Gweon HM, Youk JH, Son EJ, Kim JA (2013) Visually assessed colour overlay features in shear-wave elastography for breast masses: quantification and diagnostic performance. Eur Radiol 23:658–663CrossRefPubMed
17.
Lee SH, Chang JM, Kim WH et al (2014) Added value of shear-wave elastography for evaluation of breast masses detected with screening US imaging. Radiology 273:61–69CrossRefPubMed
18.
Yoon JH, Jung HK, Lee JT, Ko KH (2013) Shear-wave elastography in the diagnosis of solid breast masses: what leads to false-negative or false-positive results? Eur Radiol 23:2432–2440CrossRefPubMed
19.
Chang JM, Moon WK, Cho N, Kim SJ (2011) Breast mass evaluation: factors influencing the quality of US elastography. Radiology 259:59–64CrossRefPubMed
20.
Chang JM, Park IA, Lee SH et al (2013) Stiffness of tumours measured by shear-wave elastography correlated with subtypes of breast cancer. Eur Radiol 23:2450–2458CrossRefPubMed
21.
Vinnicombe SJ, Whelehan P, Thomson K et al (2014) What are the characteristics of breast cancers misclassified as benign by quantitative ultrasound shear wave elastography? Eur Radiol 24:921–926CrossRefPubMed
22.
Berg WA, Cosgrove DO, Dore CJ et al (2012) Appendix E1, shear-wave elastography improves the specificity of breast US: the BE1 multinational study of 939 masses. Radiology:1-9
23.
Gregory A, Mehrmohammadi M, Denis M et al (2015) Effect of calcifications on breast ultrasound shear wave elastography: an investigational study. PLoS One 10, e0137898CrossRefPubMedPubMedCentral
24.
Bae JS, Chang JM, Lee SH, Shin SU, Moon WK (2016) Prediction of invasive breast cancer using shear-wave elastography in patients with biopsy-confirmed ductal carcinoma in situ. Eur Radiol
25.
Kim SJ, Ko KH, Jung HK, Kim H (2015) Shear wave elastography: is it a valuable additive method to conventional ultrasound for the diagnosis of small (</= 2 cm) breast cancer? Medicine (Baltimore) 94, e1540CrossRef
26.
Lee SH, Chang JM, Cho N et al (2014) Practice guideline for the performance of breast ultrasound elastography. Ultrasonography 33:3–10CrossRefPubMed
Metadata
Title
Shear wave elastography in the diagnosis of breast non-mass lesions: factors associated with false negative and false positive results
Authors
So Yoon Park
Ji Soo Choi
Boo-Kyung Han
Eun Young Ko
Eun Sook Ko
Publication date
01-09-2017
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 9/2017
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-017-4763-6

Other articles of this Issue 9/2017

European Radiology 9/2017 Go to the issue

Head and Neck

Digital subtraction CT angiography for the detection of posterior inferior cerebellar artery aneurysms: comparison with digital subtraction angiography

Neuro

Intermediate analysis of magnesium alloy covered stent for a lateral aneurysm model in the rabbit common carotid artery

Paediatric

Patient radiation doses and reference levels in pediatric interventional radiology

Cardiac

Association between duration of coronary occlusion and high-intensity signal on T1-weighted magnetic resonance imaging among patients with angiographic total occlusion

Interventional

Evolution of patency rates of self-expandable bare metal stents for endovascular treatment of femoro-popliteal arterial occlusive disease: Does stent design matter?

Gastrointestinal

Diagnostic performance of imaging modalities in chronic pancreatitis: a systematic review and meta-analysis