scholarly journals The value of peri-lesional tissue stiffness and stiff rim sign in the differential diagnosis between benign and malignant breast lesions

2019 ◽  
Author(s):  
wen-tao Kong ◽  
yin Wang ◽  
wei-jun Zhou ◽  
yi-dang Zhang ◽  
xiao-ming Zhuang ◽  
...  
Keyword(s):  
Shear Wave ◽  
Diagnostic Performance ◽  
Breast Lesion ◽  
Elasticity Modulus ◽  
Shear Wave Elastography ◽  
Surrounding Tissue ◽  
Pathological Examination ◽  
Breast Lesions ◽  
Tissue Stiffness ◽  
Malignant Lesions

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.

scholarly journals The role of tissue elasticity in the differential diagnosis of benign and malignant breast lesions using shear wave elastography

BMC Cancer ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Hui Yang ◽  
Yongyuan Xu ◽  
Yanan Zhao ◽  
Jing Yin ◽  
Zhiyi Chen ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Shear Wave ◽  
Logistic Regression Analysis ◽  
Diagnostic Performance ◽  
Shear Wave Elastography ◽  
Surrounding Tissue ◽  
Breast Lesions ◽  
Tissue Elasticity ◽  
Malignant Breast

Abstract Background Elastography is a promising way to evaluate tissue differences regarding stiffness, and the stiffness of the malignant breast lesions increased at the lesion margin. However, there is a lack of data on the value of the shear wave elastography (SWE) parameters of the surrounding tissue (shell) of different diameter on the diagnosis of benign and malignant breast lesions. Therefore, the purpose of our study was to evaluate the diagnostic performance of shell elasticity in the diagnosis of benign and malignant breast lesions using SWE. Methods Between September 2016 and June 2017, women with breast lesions underwent both conventional ultrasound (US) and SWE. Elastic values of the lesions peripheral tissue were determined according to the shell size, which was automatically drawn along the edge of the lesion using the following software guidelines: (1): 1 mm; (2): 2 mm; and (3): 3 mm. Quantitative elastographic features of the inner lesions and shell, including the elasticity mean (Emean), elasticity maximum (Emax), and elasticity minimum (Emin), were calculated using an online-available software. The receiver operating characteristic curves (ROCs) of the elastographic features was analyzed to assess the diagnostic performance, and the area under curve (AUC) of each elastographic feature was obtained. Logistic regression analysis was used to predict significant factors of malignancy, permitting the design of predictive models. Results This prospective study included 63 breast lesions of 63 women. Of the 63 lesions, 33 were malignant and 30 were benign. The diagnostic performance of Emax-3shell was the highest (AUC = 0.76) with a sensitivity of 60.6% and a specificity of 83.3%. According to stepwise logistic regression analysis, the Emax-3shell and the Emin-3shell were significant predictors of malignancy (p < 0.05). The AUC of the predictive equation was 0.86. Conclusions SWE features, particularly the combination of Emax-3shell and Emin-3shell can improve the diagnosis of breast lesions.

scholarly journals Can continuous scans in orthogonal planes improve diagnostic performance of shear wave elastography for breast lesions?

2015 ◽  
Vol 23 (s2) ◽  
pp. S293-S300
Author(s):  
Pan Yang ◽  
Yulan Peng ◽  
Haina Zhao ◽  
Honghao Luo ◽  
Ya Jin ◽  
...  
Keyword(s):  
Shear Wave ◽  
Diagnostic Performance ◽  
Shear Wave Elastography ◽  
Breast Lesions

scholarly journals Usefulness of Elastography for the Evaluation of Subcentimeter Solid Breast Nodules

2021 ◽  
Vol 11 (4) ◽  
pp. 1409
Author(s):  
Florentina Guzmán-Aroca ◽  
Yésica Martínez-Paredes ◽  
Juan de Dios Berná-Serna ◽  
Ana Azahara García-Ortega ◽  
Juan de Dios Berná-Mestre ◽  
...  
Keyword(s):  
Shear Wave ◽  
Correct Diagnosis ◽  
Shear Wave Elastography ◽  
Accurate Diagnosis ◽  
Breast Lesions ◽  
Diagnostic Strategy ◽  
Benign Lesions ◽  
Ultrasound Study ◽  
Malignant Breast ◽  
Malignant Lesions

The accurate diagnosis of subcentimeter lesions is controversial, and therefore a standardized diagnosis algorithm is needed. The objective of the present work was to study the value of the elastography patterns obtained through the use of the shear wave elastography (SWE) technique with respect to histopathology for the evaluation of nodular breast lesions ≤1 cm. A retrospective study was conducted which included 65 sub-centimeter lesions from 57 patients with an average age of 45.6 ± 11.9. For all the cases, a B-mode ultrasound study, shear wave elastography, and a posterior anatomopathological study were conducted. The lesions had a diameter greater than 7.5 ± 1.7 mm (range: 4–9 mm). Through elastography, the distribution of the patterns was: cyst artifact (n = 13), pattern 1 (n = 4), pattern 2 (n = 31), pattern 3 (n = 13), and pattern 4 (n = 4). Of the 65 lesions, 15 were cysts, 46 were solid benign lesions, and 3 were malignant lesions. The sensitivity of the elastography was 75%, with a specificity of 98.46% and a correct diagnosis in 96.92% of the cases (n = 63). The results from this study show the usefulness of SWE for the evaluation of sub-centimeter breast lesions. In addition, this diagnostic strategy helps with the differential diagnosis between benign and malignant lesions and contributes to the early detection of malignant breast lesions.

A qualitative and quantitative assessment of simultaneous strain, shear wave, and point shear wave elastography to distinguish malignant and benign breast lesions

2020 ◽  
pp. 028418512096142
Author(s):  
Yasemin Altıntas ◽  
Mehmet Bayrak ◽  
Ömer Alabaz ◽  
Medih Celiktas
Keyword(s):  
Shear Wave ◽  
Diagnostic Performance ◽  
Area Under The Curve ◽  
Shear Wave Elastography ◽  
Strain Ratio ◽  
Breast Lesions ◽  
Breast Masses ◽  
Malignant Breast ◽  
The Mean ◽  
Us Elastography

Background Ultrasound (US) elastography has become a routine instrument in ultrasonographic diagnosis that measures the consistency and stiffness of tissues. Purpose To distinguish benign and malignant breast masses using a single US system by comparing the diagnostic parameters of three kinds of breast elastography simultaneously added to B-mode ultrasonography. Material and Methods A total of 163 breast lesions in 159 consecutive women who underwent US-guided core needle biopsy were included in this prospective study. Before the biopsy, the lesions were examined with B-mode ultrasonography and strain (SE), shear wave (SWE), and point shear wave (STQ) elastography. The strain ratio was computed and the Tsukuba score determined. The mean elasticity values using SWE and STQ were computed and converted to Young’s modulus E (kPa). Results All SE, SWE, and STQ parameters showed similar diagnostic performance. The SE score, SE ratio, SWEmean, SWEmax, STQmean, and STQmax yielded higher specificity than B-mode US alone to differentiate benign and malignant masses. The sensitivity of B-mode US, SWE, and STQ was slightly higher than that of the SE score and SE ratio. The SE score, SE ratio, SWEmean, SWEmax, STQmean, and STQmax had significantly higher positive predictive value and diagnostic accuracy than B-mode US alone. The area under the curve for each of these elastography methods in differentiating benign and malignant breast lesions was 0.93, 0.93, 0.98, 0.97, 0.98, and 0.96, respectively; P<0.001 for all measurements. Conclusion SE (ratio and score), SWE, and STQ had higher diagnostic performance individually than B-mode US alone in distinguishing between malignant and benign breast masses.

Shear Wave Elastography (SWE): An Analysis of Breast Lesion Characterization in 83 Breast Lesions

2015 ◽  
Vol 41 (10) ◽  
pp. 2594-2604 ◽  
Author(s):  
Alice Feldmann ◽  
Carole Langlois ◽  
Marion Dewailly ◽  
Elise Fréart Martinez ◽  
Loic Boulanger ◽  
...  
Keyword(s):  
Shear Wave ◽  
Breast Lesion ◽  
Shear Wave Elastography ◽  
Breast Lesions ◽  
Lesion Characterization

scholarly journals Qualitative and quantitative strain and shear wave elastography paradigm in differentiation of breast lesions

2022 ◽  
Vol 53 (1) ◽  
Author(s):  
Roaa M. A. Shehata ◽  
Mostafa A. M. El-Sharkawy ◽  
Omar M. Mahmoud ◽  
Hosam M. Kamel
Keyword(s):  
Shear Wave ◽  
Diagnostic Performance ◽  
Strain Ratio ◽  
Breast Lesions ◽  
Breast Masses ◽  
Significant Difference ◽  
Malignant Breast ◽  
Malignant Lesions ◽  
The Mean ◽  
Sensitivity Specificity

Abstract Background Breast cancer is the most common life-threatening cancer in women worldwide. A high number of women are going through biopsy procedures for characterization of breast masses every day and yet 75% of the pathological results prove these masses to be benign. Ultrasound (US) elastography is a non-invasive technique that measures tissue stiffness. It is convenient for differentiating benign from malignant breast tumors. Our study aims to evaluate the role of qualitative ultrasound elastography scoring (ES), quantitative mass strain ratio (SR), and shear wave elasticity ratio (SWER) in differentiation between benign and malignant breast lesions. Results Among 51 female patients with 77 histopathologically proved breast lesions, 57 breast masses were malignant and 20 were benign. All patients were examined by B-mode ultrasound then strain and shear wave elastographic examinations using ultrasound machine (Logiq E9, GE Medical Systems) with 8.5–12 MHz high-frequency probes. Our study showed that ES best cut-off point > 3 with sensitivity, specificity, PPV, NPP, accuracy was 94.7%, 85%, 94.7%, 85%, 90.9%, respectively, and AUC = 0.926 at P < 0.001, mass SR the best cut-off point > 4.6 with sensitivity, specificity, PPV, NPP, accuracy was 96.5%, 80%, 93.2%, 88.9%, 92.2%, respectively, and AUC = 0.860 at P < 0.001, SWER the best cut-off value > 4.9 with sensitivity, specificity, PPV, NPP and accuracy was 91.2%, 80%, 92.9%, 76.2%, 93.5%, respectively, and AUC = 0.890 at P < 0.001. The mean mass strain ratio for malignant lesions is 10.1 ± 3.7 SD and for solid benign lesions 4.7 ± 4.3 SD (p value 0.001). The mean shear wave elasticity ratio for malignant lesions is 10.6 ± 5.4 SD and for benign (solid and cystic) lesions 3.6 ± 4.2 SD. Using ROC curve and Youden index, the difference in diagnostic performance between ES, SR and SWER was not significant in differentiation between benign and malignant breast lesions and also was non-significant difference when comparing them with conventional US alone. Conclusion ES, SR, and SWER have a high diagnostic performance in differentiating malignant from benign breast lesions with no statistically significant difference between them.

scholarly journals Diagnostic performance of shear wave elastography in discriminating malignant and benign breast lesions

2020 ◽  
Vol 23 (4) ◽  
pp. 575-583
Author(s):  
Karina Pesce ◽  
Fernando Binder ◽  
María José Chico ◽  
María Paz Swiecicki ◽  
Diana Herbas Galindo ◽  
...  
Keyword(s):  
Shear Wave ◽  
Diagnostic Performance ◽  
Shear Wave Elastography ◽  
Breast Lesions ◽  
Benign Breast Lesions

scholarly journals Impact of region of interest (ROI) size on the diagnostic performance of shear wave elastography in differentiating solid breast lesions

2017 ◽  
Vol 59 (6) ◽  
pp. 657-663 ◽  
Author(s):  
Jin Hee Moon ◽  
Ji-Young Hwang ◽  
Jeong Seon Park ◽  
Sung Hye Koh ◽  
Sun-Young Park
Keyword(s):  
Shear Wave ◽  
Sensitivity And Specificity ◽  
Diagnostic Performance ◽  
Characteristic Curve ◽  
Region Of Interest ◽  
Shear Wave Elastography ◽  
Breast Lesions ◽  
Malignant Breast ◽  
Solid Lesions ◽  
The Impact

Background Shear wave elastography (SWE) using a region of interest (ROI) can demonstrate the quantitative elasticity of breast lesions. Purpose To prospectively evaluate the impact of two different ROI sizes on the diagnostic performance of SWE for differentiating benign and malignant breast lesions. Material and Methods A total of 154 breast lesions were included. Two types of ROIs were investigated: one involving an approximately 2-mm diameter, small round ROIs placed over the stiffest area of the lesion, as determined by SWE (ROI-S); and another ROI drawn along the margin of the lesion using a touch pen or track ball to encompass the entire lesion (ROI-M). Maximum elasticity (Emax), mean elasticity (Emean), minimum elasticity (Emin), and standard deviation (SD) were measured for the two ROIs. The area under the receiver operating characteristic curve (AUC) as well as the sensitivity and specificity of each elasticity value were determined. Results The AUCs for ROI-S were higher than those for ROI-M when differentiating benign and malignant breast solid lesions. The Emax, Emean, Emin, and SD of the elasticity values for ROI-S were 0.865, 0.857, 0.816, and 0.849, respectively, and for ROI-M were 0.820, 0.780, 0.724, and 0.837, respectively. However, only Emax ( P = 0.0024) and Emean ( P = 0.0015) showed statistically significant differences. For ROI-S, the sensitivity and specificity of Emax were 78.8% and 84.3%, respectively, and those for Emean were 80.8% and 81.4%, respectively. Conclusion Using ROI-S with Emax and Emean has better diagnostic performance than ROI-M for differentiating between benign and malignant breast lesions.

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