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Comparison and Combination of Strain and Shear Wave Elastography of Breast Masses for Differentiation of Benign and Malignant Lesions by Quantitative Assessment: Preliminary Study

Authors
Seo, MirinaeAhn, Hye ShinPark, Sung HeeLee, Jong BeumChoi, Byung IhnSohn, Yu-MeeShin, So Youn
Issue Date
Jan-2018
Publisher
WILEY
Keywords
breast; diagnostic performance; elastography; shear wave elastography; strain elastography
Citation
JOURNAL OF ULTRASOUND IN MEDICINE, v.37, no.1, pp 99 - 109
Pages
11
Journal Title
JOURNAL OF ULTRASOUND IN MEDICINE
Volume
37
Number
1
Start Page
99
End Page
109
URI
https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/1353
DOI
10.1002/jum.14309
ISSN
0278-4297
1550-9613
Abstract
ObjectivesTo compare the diagnostic performance of strain and shear wave elastography of breast masses for quantitative assessment in differentiating benign and malignant lesions and to evaluate the diagnostic accuracy of combined strain and shear wave elastography. MethodsBetween January and February 2016, 37 women with 45 breast masses underwent both strain and shear wave ultrasound (US) elastographic examinations. The American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) final assessment on B-mode US imaging was assessed. We calculated strain ratios for strain elastography and the mean elasticity value and elasticity ratio of the lesion to fat for shear wave elastography. Diagnostic performances were compared by using the area under the receiver operating characteristic curve (AUC). ResultsThe 37 women had a mean age of 47.4 years (range, 20-79 years). Of the 45 lesions, 20 were malignant, and 25 were benign. The AUCs for elasticity values on strain and shear wave elastography showed no significant differences (strain ratio, 0.929; mean elasticity, 0.898; and elasticity ratio, 0.868; P>.05). After selectively downgrading BI-RADS category 4a lesions based on strain and shear wave elastographic cutoffs, the AUCs for the combined sets of B-mode US and elastography were improved (B-mode+strain, 0.940; B-mode+shear wave; 0.964; and B-mode, 0.724; P<.001). Combined strain and shear wave elastography showed significantly higher diagnostic accuracy than each individual elastographic modality (P=.031). ConclusionsThese preliminary results showed that strain and shear wave elastography had similar diagnostic performance. The addition of strain and shear wave elastography to B-mode US improved diagnostic performance. The combination of strain and shear wave elastography results in a higher diagnostic yield than each individual elastographic modality.
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