Shear-wave elastography of the breast: value of a quality measure and comparison with strain elastography.

Title

Shear-wave elastography of the breast: value of a quality measure and comparison with strain elastography.

Creator

Barr Richard G; Zhang Zheng

Publisher

Radiology

Date

2015
2015-04

Description

PURPOSE: To determine whether addition of quality measure (QM) of shear-wave (SW) velocity (Vs) estimation can increase SW elastography sensitivity for breast cancer. MATERIALS AND METHODS: With written informed consent, this institutional review board-approved, HIPAA-compliant study included 143 women (mean age, 48.5 years +/- 8.7) scheduled for breast biopsy. Mean lesion size was 16.4 mm +/- 11.8; 95 (66%) lesions were benign; 48 (34%), malignant. If more than one lesion was present, lesion with highest Breast Imaging Reporting and Data System (BI-RADS) category was chosen. If there were more than one with highest BI-RADS category, a lesion was randomly selected. Conventional ultrasonography (US), strain elastography, and SW elastography were performed with QM. QM assesses SW quality to provide accurate Vs. Lesions were evaluated for Vs and QM (high or low). Lesions with Vs of less than 4.5 m/sec were classified benign; lesions with Vs of 4.5 m/sec or greater, malignant. Results were correlated with pathologic findings. Vs data with or without incorporating QM were used to determine SW elastography diagnostic performance. Binomial proportions and exact 95% confidence intervals (CIs) were calculated. RESULTS: In 95 benign lesions, 13 (14%) had no SW elastography signal; 77 (81%), Vs of less than 4.5 m/sec; and five (5%), Vs of 4.5 m/sec or greater. In 48 malignant lesions, eight (17%) had no SW elastography signal; 20 (42%), Vs of less than 4.5 m/sec; and 20 (42%), V of 4.5 m/sec or greater. QM was low in 17 of 20 (85%) malignant lesions with Vs of less than 4.5 m/sec. Without QM, using Vs of 4.5 m/sec or greater as test positive, SW elastography had lesion-level sensitivity of 50% (95% CI: 34%, 66%); specificity, 94% (95% CI: 86%, 98%); positive predictive value (PPV), 80% (95% CI: 59%, 93%); and negative predictive value (NPV), 79% (95% CI: 70%, 87%). Using QM where additional lesions with both low Vs and low QM were treated as test positive, SW elastography had lesion-level sensitivity of 93% (95% CI: 80%, 98%); specificity, 89% (95% CI: 80%, 95%); PPV, 80% (95% CI: 66%, 91%); and NPV, 96% (95% CI: 89%, 99%). CONCLUSION: Addition of QM can improve SW elastography sensitivity, with no significant change in specificity.

Subject

80 and over; 80 and Over; Adolescence; Adolescent; Adult; Aged; Biopsy; Breast Neoplasms – Pathology; Breast Neoplasms – Radiography; Breast Neoplasms – Ultrasonography; Breast Neoplasms/*diagnostic imaging/pathology; Elasticity Imaging Techniques/*methods; Female; Human; Humans; Mammary/*methods; Mammography; Middle Age; Middle Aged; Needle; Predictive Value of Tests; Sensitivity and Specificity; Signal-To-Noise Ratio; Ultrasonography; Ultrasonography – Methods

Rights

Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).

Pages

45–53

Issue

1

Volume

275

Citation

Barr Richard G; Zhang Zheng, “Shear-wave elastography of the breast: value of a quality measure and comparison with strain elastography.,” NEOMED Bibliography Database, accessed December 1, 2021, https://neomed.omeka.net/items/show/4563.

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