Abstract
Background
Shear wave elastography (SWE) is an important method in the diagnosis of breast lesions. The purpose of this study was to evaluate the value of tissue stiffness around breast lesion and stiff rim sign for the differentiation of benign and malignant lesions.
Methods
192 patients (mean age, 44.6 ± 13.6 years) with 199 breast lesions proven by pathological examination underwent shear wave elastography (SWE). We first observed if there was a stiff rim sign. Then the shell around the breast lesion on SWE was automatically drawn by machine, with width of 1mm, 2mm and 3mm. Elasticity modulus of the lesion and surrounding tissue were recorded, including maximum elasticity (Emax), mean elasticity (Emean), minimum elasticity (Emin) and elasticity ratio (shell/lesion ratio). The optimal thresholds of elasticity modulus were calculated according to receiver operating characteristic (ROC) curve.
Results
There were 75 malignant lesions and 124 benign lesions. The average Emax, Emean of lesion and shell were significantly higher in the malignant group than in the benign group (P<0.05). The optimal cut-off value of Emax for diagnosing malignant lesion was 101.7 Kpa, with a sensitivity of 66.3% and specificity of 87.9%. The optimal cut-off value of Emean was 29.1 Kpa, with a sensitivity of 65.3% and specificity of 79.8%. The stiff rim sign had a highest diagnostic performance for malignancy than other elastic parameters, with an accuracy of 88.4%. However, measuring peritumoral tissue stiffness can achieve a relatively high sensitivity, whereas specificity was not improved significantly.
Conclusion
The stiffness of tissue surrounding breast malignancy was significantly higher than benign lesion. Stiff rim sign has the potential to improve the diagnostic performance of breast lesions.
The value of peri-lesional tissue stiffness and stiff rim sign in the differential diagnosis between benign and malignant breast lesions
