Comparison of peritumoral stromal tissue stiffness obtained by shear wave elastography between benign and malignant breast lesions

Background Aggressive breast cancers produce abnormal peritumoral stiff areas, which can differ between benign and malignant lesions and between different subtypes of breast cancer. Purpose To compare the tissue stiffness of the inner tumor, tumor border, and peritumoral stroma (PS) between benign and malignant breast masses by shear wave elastography (SWE). Material and Methods We enrolled 133 consecutive patients who underwent preoperative SWE. Using OsiriX commercial software, we generated multiple 2-mm regions of interest (ROIs) in a linear arrangement on the inner tumor, tumor border, and PS. We obtained the mean elasticity value (Emean) of each ROI, and compared the Emean between benign and malignant tumors. Odds ratios (ORs) for prediction of malignancy were calculated. Subgroup analyses were performed among tumor subtypes. Results There were 85 malignant and 48 benign masses. The Emean of the tumor border and PS were significantly different between benign and malignant masses ( P < 0.05 for all). ORs for malignancy were 1.06, 1.08, 1.05, and 1.04 for stiffness of the tumor border, proximal PS, middle PS, and distal PS, respectively ( P < 0.05 for all). Malignant masses with a stiff rim were significantly larger than malignant masses without a stiff rim, and were more commonly associated with the luminal B and triple negative subtypes. Conclusion Stiffness of the tumor border and PS obtained by SWE were significantly different between benign and malignant masses. Malignant masses with a stiff rim were larger in size and associated with more aggressive pathologic subtypes.

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Elastic Modulus and Elasticity Ratio of Malignant Breast Lesions with Shear Wave Ultrasound Elastography: Variations with Different Region of Interest and Lesion Size

Diagnostics ◽

10.3390/diagnostics11061015 ◽

2021 ◽

Vol 11 (6) ◽

pp. 1015

Author(s):

Antonio Bulum ◽

Gordana Ivanac ◽

Eugen Divjak ◽

Iva Biondić Špoljar ◽

Martina Džoić Dominković ◽

...

Keyword(s):

Elastic Modulus ◽

Shear Wave ◽

Large Diameter ◽

Small Diameter ◽

Shear Wave Elastography ◽

Lesion Size ◽

Ultrasound Elastography ◽

Breast Lesions ◽

Malignant Breast ◽

The Impact

Shear wave elastography (SWE) is a type of ultrasound elastography with which the elastic properties of breast tissues can be quantitatively assessed. The purpose of this study was to determine the impact of different regions of interest (ROI) and lesion size on the performance of SWE in differentiating malignant breast lesions. The study included 150 female patients with histopathologically confirmed malignant breast lesions. Minimal (Emin), mean (Emean), maximal (Emax) elastic modulus and elasticity ratio (e-ratio) values were measured using a circular ROI size of 2, 4 and 6 mm diameters and the lesions were divided into large (diameter ≥ 15 mm) and small (diameter < 15 mm). Highest Emin, Emean and e-ratio values and lowest variability were observed when using the 2 mm ROI. Emax values did not differ between different ROI sizes. Larger lesions had significantly higher Emean and Emax values, but there was no difference in e-ratio values between lesions of different sizes. In conclusion, when measuring the Emin, Emean and e-ratio of malignant breast lesions using SWE the smallest possible ROI size should be used regardless of lesion size. ROI size has no impact on Emax values while lesion size has no impact on e-ratio values.

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Shear-wave elastography contributes to accurate tumour size estimation when assessing small breast cancers

Clinical Radiology ◽

10.1016/j.crad.2014.08.002 ◽

2014 ◽

Vol 69 (12) ◽

pp. 1259-1263 ◽

Cited By ~ 12

Author(s):

R. Mullen ◽

J.M. Thompson ◽

O. Moussa ◽

S. Vinnicombe ◽

A. Evans

Keyword(s):

Shear Wave ◽

Tumour Size ◽

Shear Wave Elastography ◽

Breast Cancers ◽

Size Estimation ◽

Small Breast

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Application of 3D and 2D quantitative shear wave elastography (SWE) to differentiate between benign and malignant breast masses

Scientific Reports ◽

10.1038/srep41216 ◽

2017 ◽

Vol 7 (1) ◽

Cited By ~ 7

Author(s):

Jie Tian ◽

Qianqi Liu ◽

Xi Wang ◽

Ping Xing ◽

Zhuowen Yang ◽

...

Keyword(s):

Shear Wave ◽

Shear Wave Elastography ◽

Breast Masses ◽

Malignant Breast

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Combination of shear wave elastography and BI-RADS in identification of solid breast masses

BMC Medical Imaging ◽

10.1186/s12880-021-00702-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Xue Zheng ◽

Fei Li ◽

Zhi-Dong Xuan ◽

Yu Wang ◽

Lei Zhang

Keyword(s):

Shear Wave ◽

Breast Imaging ◽

Color Doppler ◽

Shear Wave Elastography ◽

Definitive Diagnosis ◽

Pathological Examination ◽

Diagnostic Specificity ◽

Breast Masses ◽

Malignant Breast ◽

Grade Ii

Abstract Background To explore the value of quantitative shear wave elastography (SWE) plus the Breast Imaging Reporting and Data System (BI-RADS) in the identification of solid breast masses. Methods A total of 108 patients with 120 solid breast masses admitted to our hospital from January 2019 to January 2020 were enrolled in this study. The pathological examination served as the gold standard for definitive diagnosis. Both SWE and BI-RADS grading were performed. Results Out of the 120 solid breast masses in 108 patients, 75 benign and 45 malignant masses were pathologically confirmed. The size, shape, margin, internal echo, microcalcification, lateral acoustic shadow, and posterior acoustic enhancement of benign and malignant masses were significantly different (all P < 0.05). The E mean, E max, SD, and E ratio of benign and malignant masses were significantly different (all P < 0.05). The E min was similar between benign and malignant masses (P > 0.05). The percentage of Adler grade II-III of the benign masses was lower than that of the malignant masses (P < 0.05). BI-RADS plus SWE yielded higher diagnostic specificity and positive predictive value than either BI-RADS or SWE; BI-RADS plus SWE yielded the highest diagnostic accuracy among the three methods (all P < 0.05). Conclusion SWE plus routine ultrasonography BI-RADS has a higher value in differentiating benign from malignant breast masses than color doppler or SWE alone, which should be further promoted in clinical practice.

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Multiparametric ultrasound diagnosis of metastatic and lymphoproliferative changes in lymph nodes in primary-multiple malignant tumors, including breast cancer and lymphoma

Malignant tumours ◽

10.18027/2224-5057-2018-8-4-37-44 ◽

2019 ◽

Vol 8 (4) ◽

pp. 37-44 ◽

Cited By ~ 3

Author(s):

E. V. Kovaleva ◽

T. Yu. Danzanova ◽

G. T. Sinyukova ◽

P. I. Lepedatu ◽

E. A. Gudilina ◽

...

Keyword(s):

Breast Cancer ◽

Differential Diagnosis ◽

Lymph Nodes ◽

Shear Wave ◽

Malignant Tumors ◽

Shear Wave Elastography ◽

Doppler Imaging ◽

Contrast Enhanced Ultrasound ◽

Contrast Enhanced ◽

Multiparametric Ultrasound

In this article, based on two clinical examples, the possibilities of multiparametric ultrasound in the differential diagnosis of metastatic and lymphoproliferative changes in lymph nodes in primary-multiple malignant tumors, including breast cancer and lym - phoma, are evaluated. Multiparameteric ultrasound includes B-mode, color and energy Doppler imaging, strain elastography, shear wave elastography and contrast-enhanced ultrasound (CEUS). Standardization and reproducibility of these ultrasound techniques will allow to objectify the study, obtaining specific indicators of shear wave velocity in the zones of interest and specific signs of contrast enhancement, which can be used as impor tant differential diagnostic tool in oncology.

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Diagnostic role of shear wave elastography for differentiating benign and malignant breast masses

South African Journal of Radiology ◽

10.4102/sajr.v24i1.1999 ◽

2020 ◽

Vol 24 (1) ◽

Author(s):

Nichanametla Sravani ◽

Ananthakrishnan Ramesh ◽

Sathasivam Sureshkumar ◽

Chellappa Vijayakumar ◽

K.M. Abdulbasith ◽

...

Keyword(s):

Shear Wave ◽

Shear Wave Elastography ◽

Breast Masses ◽

Diagnostic Role ◽

Malignant Breast

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Shear-Wave Elastography Variability Analysis and Relation with Kidney Allograft Dysfunction: A Single-Center Study

Diagnostics ◽

10.3390/diagnostics10010041 ◽

2020 ◽

Vol 10 (1) ◽

pp. 41

Author(s):

Sorana D. Bolboacă ◽

Florin Ioan Elec ◽

Alina Daciana Elec ◽

Adriana Milena Muntean ◽

Mihai Adrian Socaciu ◽

...

Keyword(s):

Shear Wave ◽

Shear Wave Elastography ◽

Interquartile Range ◽

P Value ◽

Single Center ◽

Tissue Stiffness ◽

Kidney Allograft ◽

Stable Function ◽

Allograft Dysfunction ◽

Allograft Function

Shear-wave elastography (SWE) showed the absence or presence of significant differences among stable kidney allograft function and allograft dysfunction. We evaluated the variability of kidney allograft stiffness in relation to allograft dysfunction, respectively, in terms of a correlation of stiffness with patients’ characteristics. A single-center prospective study on patients who had undergone renal transplantation was conducted between October 2017 and November 2018. Patients were clinically classified as having a stable allograft function or allograft dysfunction. SWE examinations performed by the same radiologist with a LOGIQ E9 were evaluated. Ten measurements were done for Young’s modulus (kPa) at the level of allograft cortex and another ten at the level of medulla. Eighty-three SWE examinations from 63 patients, 69 stable allografts, and 14 allografts with dysfunction were included in the analysis. The intra-examinations stiffness showed high variability, with the quantile covariation coefficient ranging from 2.21% to 45.04%. The inter-examinations stiffness showed heterogeneity (from 28.66% to 42.38%). The kidney allograft cortex stiffness showed significantly higher values in cases with dysfunction (median = 28.70 kPa, interquartile range (IQR) = (25.68–31.98) kPa) as compared to those with stable function (median = 20.99 kPa, interquartile range = (16.08–27.68) kPa; p-value = 0.0142). Allograft tissue stiffness (both cortex and medulla) was significantly negatively correlated with body mass index (−0.44, p-value < 0.0001 for allograft cortex and −0.42, p-value = 0.0001 for allograft medulla), and positively correlated with Proteinuria/Creatinuria ratio (0.33, p-value = 0.0021 for allograft cortex and 0.28, p-value = 0.0105 for allograft medulla) but remained statistically significant only in cases with stable function. The cortical tissue stiffness proved significantly higher values for patients with allograft dysfunction as compared to patients with stable function, but to evolve as an additional tool for the evaluation of patients with a kidney transplant and to change the clinical practice, more extensive studies are needed.

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