scholarly journals Efficacy of contrast-enhanced ultrasonography and shear-wave elastography in conjunction with BI-RADS classification for diagnosis of small breast nodules

2020 ◽  
Author(s):  
Yan Shen ◽  
Jie He ◽  
Miao Liu ◽  
Jiaojiao Hu ◽  
Yonglin Wan ◽  
...  
Keyword(s):  
Shear Wave ◽  
Breast Imaging ◽  
Imaging Techniques ◽  
Shear Wave Elastography ◽  
Roc Curves ◽  
Imaging Data ◽  
Diagnostic Efficacy ◽  
Predictive Values ◽  
Small Breast ◽  
Contrast Enhanced

Abstract Background: Identification of malignancy in small breast nodules can be difficult using conventional methods, especially in patients with dense breast tissue. Advanced imaging techniques, including contrast-enhanced ultrasound (CEUS) and shear-wave elastography (SWE), could be used in conjunction with the Breast Imaging Reporting and Data System (BI-RADS) classification to characterize these nodules more effectively. This retrospective study aimed to evaluate the use of CEUS and SWE for the differentiation of benign from malignant small (≤ 2 cm) breast nodules.Methods: We reviewed the medical records and imaging data of 302 patients who underwent evaluation for 305 small breast nodules from November 2015 to December 2019. The BI-RADS classification values of the nodules and the results of CEUS and SWE were retrospectively analyzed; the diagnostic efficacy of these techniques was evaluated by comparison of the pathology results. Receiver operating characteristic (ROC) curves were analyzed based on the CEUS patterns and shear-wave velocity values of the nodules. The sensitivity, specificity, positive and negative predictive values, accuracies of BI-RADS, CEUS, SWE, and a combination of all three methods for identifying benign and malignant small breast nodules were investigated.Results: CEUS was effective at diagnosing malignant nodules when at least two out of nine suspicious features were present. ROC analysis revealed that the best cut-off value for SWE was at 3.7 m/s. For the diagnosis of benign breast nodules, the BI-RADS classification was reduced by one level when both, CEUS and SWE were used, and remained unchanged when either one, CEUS or SWE was used; the highest and lowest levels were of category 5 and 3, respectively. Furthermore, when using the combined method, 75.8% (91/120) of small breast nodules with a BI-RADS category 4A classification avoided the need for coarse needle biopsies.Conclusions: CEUS and SWE can be used as auxiliary methods for clarifying BI-RADS classification of the breast nodules, and a combination of these techniques may provide more diagnostic efficacy for identifying malignancy in small breast nodules.Trial registration: Retrospectively registered.

scholarly journals Efficacy of contrast-enhanced ultrasonography and shear-wave elastography in conjunction with BI-RADS classification for diagnosis of small breast nodules

2020 ◽  
Author(s):  
Yan Shen ◽  
Jie He ◽  
Miao Liu ◽  
Jiaojiao Hu ◽  
Yonglin Wan ◽  
...  
Keyword(s):  
Shear Wave ◽  
Breast Imaging ◽  
Shear Wave Elastography ◽  
Receiver Operating Curve ◽  
Diagnostic Efficacy ◽  
Predictive Values ◽  
Small Breast ◽  
Contrast Enhanced ◽  
Receiver Operating

Abstract Background Identification of malignancy in small breast nodules can be difficult using conventional methods, especially in patients with dense breast tissue. Advanced imaging techniques, including contrast-enhanced ultrasound (CEUS) and shear-wave elastography (SWE), may work in conjunction with Breast Imaging Reporting and Data System (BI-RADS) classification to more effectively characterize these nodules. This study aimed to evaluate the use of CEUS and SWE for differentiation of benign from malignant small (≤ 2 cm) breast nodules. Methods This retrospective study reviewed the medical records and imaging data of 302 patients who underwent evaluation for 305 small breast nodules from November 2015 to December 2019. BI-RADS classification of nodules and results from CEUS and SWE studies were retrospectively analyzed, and the diagnostic efficacy of these techniques were evaluated by comparison to pathology results. Receiver operating characteristic curves were analyzed based on CEUS patterns and shear wave velocity values of nodules. The sensitivities, specificities, positive and negative predictive values, and accuracies of BI-RADS, CEUS, SWE, and a combination of all methods for identifying benign versus malignant small breast nodules were investigated. Results CEUS was effective at diagnosing malignant nodules when at least two out of nine suspicious features were present. Receiver operating curve analysis revealed that the best cut-off value for SWE was 3.7 m/s. The BI-RADS classification of nodules was reduced by one level when both CEUS and SWE diagnosed benign BNs and was unchanged when only CEUS or SWE diagnosed benign BN, with the highest level being category 5 and the lowest level being category 3. Furthermore, when using the combined method, 75.8% (91/120) of small breast nodules with a BI-RADS category 4A classification avoided the need for coarse needle biopsies. Conclusion CEUS and SWE can be used as auxiliary methods for clarifying BI-RADS classification of BNs, and a combination of these techniques may provide more diagnostic efficacy for identifying malignancy in small breast nodules.

scholarly journals Efficacy of contrast-enhanced ultrasonography and shear-wave elastography in conjunction with BI-RADS classification for diagnosis of small breast nodules

2020 ◽  
Author(s):  
Yan Shen ◽  
Jie He ◽  
Miao Liu ◽  
Jiaojiao Hu ◽  
Yonglin Wan ◽  
...  
Keyword(s):  
Shear Wave ◽  
Breast Imaging ◽  
Shear Wave Elastography ◽  
Receiver Operating Curve ◽  
Diagnostic Efficacy ◽  
Predictive Values ◽  
Small Breast ◽  
Contrast Enhanced ◽  
Receiver Operating

Abstract Background: Identification of malignancy in small breast nodules can be difficult using conventional methods, especially in patients with dense breast tissue. Advanced imaging techniques, including contrast-enhanced ultrasound (CEUS) and shear-wave elastography (SWE), could be used in conjunction with Breast Imaging Reporting and Data System (BI-RADS) classification to characterize these nodules more effectively. This study aimed to evaluate the use of CEUS and SWE for the differentiation of benign from malignant small (≤ 2 cm) breast nodules.Methods: This retrospective study reviewed the medical records and imaging data of 302 patients who underwent evaluation for 305 small breast nodules from November 2015 to December 2019. BI-RADS classification of nodules and the results of CEUS and SWE were retrospectively analyzed; the diagnostic efficacy of these techniques was evaluated by comparison with pathology results. Receiver operating characteristic curves were analyzed based on the CEUS patterns and shear-wave velocity values of nodules. The sensitivities, specificities, positive and negative predictive values, and accuracies of BI-RADS, CEUS, SWE, and a combination of all three methods for identifying benign versus malignant small breast nodules were investigated.Results: CEUS was effective at diagnosing malignant nodules when at least two out of nine suspicious features were present. Receiver operating curve analysis revealed that the best cut-off value for SWE was 3.7 m/s. For the diagnosis of benign breast nodules, the BI-RADS classification was reduced by one level when both CEUS and SWE were used, and was unchanged when either CEUS or SWE alone were used; the highest and lowest levels were category 5 and 3, respectively. Furthermore, when using the combined method, 75.8% (91/120) of small breast nodules with a BI-RADS category 4A classification avoided the need for coarse needle biopsies.Conclusion: Both CEUS and SWE can be used as auxiliary methods for clarifying BI-RADS classification of breast nodules, and a combination of these techniques may provide more diagnostic efficacy for identifying malignancy in small breast nodules.

scholarly journals Efficacy of contrast-enhanced ultrasonography and shear-wave elastography in conjunction with BI-RADS classification for diagnosis of small breast nodules

2020 ◽  
Author(s):  
Yan Shen ◽  
Jie He ◽  
Miao Liu ◽  
Jiaojiao Hu ◽  
Yonglin Wan ◽  
...  
Keyword(s):  
Shear Wave ◽  
Shear Wave Elastography ◽  
Receiver Operating Curve ◽  
Maximum Diameter ◽  
Diagnostic Efficacy ◽  
Predictive Values ◽  
Small Breast ◽  
Contrast Enhanced ◽  
Receiver Operating

Abstract Background: Identification of malignancy in small breast nodules can be difficult using conventional methods, especially in patients with dense breast tissue. Advanced imaging techniques, including contrast-enhanced ultrasound (CEUS) and shear-wave elastography (SWE), could be used in conjunction with Breast Imaging Reporting and Data System (BI-RADS) classification to characterize these nodules more effectively. This study aimed to evaluate the use of CEUS and SWE for the differentiation of benign and malignant small breast nodules (maximum diameter ≤ 2 cm).Methods: This retrospective study reviewed the imaging data of 302 patients who underwent evaluation for 305 small breast nodules from November 2015 to December 2019. BI-RADS classification of nodules and the results of CEUS and SWE were retrospectively analyzed; the diagnostic efficacy of these techniques was evaluated by comparison with pathology results. Receiver operating characteristic curves were analyzed based on the CEUS patterns and shear-wave velocity values of nodules. The sensitivities, specificities, positive and negative predictive values, and accuracies of BI-RADS, CEUS, SWE, and a combination of all three methods for identifying benign versus malignant small breast nodules were investigated.Results: CEUS was effective in diagnosing malignant nodules when at least two of the nine suspicious features were present. Receiver operating curve analysis revealed that the best cut-off value for SWE was 3.7 m/s. For the diagnosis of benign breast nodules, the BI-RADS classification was reduced by one level when both CEUS and SWE data were used, and was unchanged when CEUS or SWE alone was used; the highest and lowest levels were category 5 and 3, respectively. Furthermore, when using the combined method, 75.8% (91/120) of small breast nodules with a BI-RADS category 4A did not need coarse needle biopsies.Conclusion: Both CEUS and SWE can be used as auxiliary methods for clarifying BI-RADS classification of breast nodules, and a combination of these techniques may provide improved diagnostic efficacy for identifying malignancy in small breast nodules.

SWE combined with ACR TI-RADS categories for malignancy risk stratification of thyroid nodules with indeterminate FNA cytology

2020 ◽  
Vol 76 (3) ◽  
pp. 381-390 ◽  
Author(s):  
Wei-Bing Zhang ◽  
Jing-Jing Li ◽  
Xiang-Yong Chen ◽  
Bei-Li He ◽  
Rong-Hua Shen ◽  
...  
Keyword(s):  
Risk Stratification ◽  
Shear Wave ◽  
Gold Standard ◽  
Thyroid Nodules ◽  
Shear Wave Elastography ◽  
Roc Curves ◽  
Diagnostic Sensitivity ◽  
Diagnostic Efficacy ◽  
Malignancy Risk ◽  
Sensitivity Specificity

OBJECTIVES: To compare the diagnostic efficacy of shear wave elastography (SWE) comnined with ACR TI-RADS categories for malignancy risk stratification of thyroid nodules with interminate FNA cytology. METHODS: The clinical data, sonographic features, ACR TI-RADS grading and shear wave elastography images of 193 patients of surgical pathologically proven thyroid nodules with interminate FNA cytology were retrospectively analyzed. The diagnostic efficacy of ACR TI-RADS categories, the maximum Young’s modulus (Emax) of SWE and the combination of the two were calculated respectively. RESULTS: The ROC curves were drawn using surgical pathology results as the gold standard. The ROC curves indicated that the cut-off value of ACR TI-RADS and Emax of SWE was TR5 and 41.2 kPa respectively, and the area under the ROC curve (AUC) was 0.864 (95% CI: 0.879–0.934) and 0.858 (95% CI: 0.796–0.920) respectively. The diagnostic sensitivity, specificity and accuracy of ACR TI-RADS was 81.4% (127/156), 84.8% (31/37), and 81.9% (158/193), respectively. That of SWE Emax was 80.8% (126/156), 78.4% (29/37), and 80.3% (155/193), respectively. After SWE combined with ACR TI-RADS, the sensitivity, specificity and accuracy was 94.2% (147/156), 75.7% (28/37), and 90.7% (175/193), respectively. CONCLUSIONS: ACR TI-RADS classification system and shear wave elastography had high diagnostic efficacy for thyroid nodules with interminate FNA cytology. The combination of the two could improve diagnostic sensitivity and accuracy, and could help to differentiate benign and malignant thyroid nodules with interminate FNA cytology.

Diagnostic Value of Real-Time Shear Wave Elastography in Diagnosing Thyroid Cancer

2018 ◽  
Vol 68 (12) ◽  
pp. 2818-2822
Author(s):  
Maria Cristina Oprea ◽  
Mihaela Vlad ◽  
Ioana Golu ◽  
Ioan Sporea ◽  
Lazar Fulger
Keyword(s):  
Shear Wave ◽  
Predictive Value ◽  
Thyroid Nodules ◽  
Imaging Techniques ◽  
Area Under The Curve ◽  
Thyroid Volume ◽  
Shear Wave Elastography ◽  
Maximum Diameter ◽  
Diagnostic Tools ◽  
Tissue Elasticity

Thyroid nodules are a common pathology found in 50 to 60% of otherwise healthy people. Diagnostic imaging techniques are help discriminating between benign and malignant nodules, while fine needle aspiration is still a gold standard. Shear wave elastography, a recent imaging technique, holds the promise to become reliable diagnostic tools and is currently used in combination with ultrasound. We here report data obtained in a series of 52 thyroid nodules analysed by means of elastography, as well as conventional and Doppler ultrasound. We found no differences in age, nodule and thyroid volume, length, width, thickness and maximum diameter between benign and malignant lesions. Several sonographic patterns are considered to be predictive of malignancy, out of which we only found the intranodular blood flow to be statistically significant. By the means of shear wave elastography we have first assessed tissue elasticities, which are shown in a range of colours, depending on tissue elasticity/stiffness. Then, we have measured and recorded four parameters automatically displayed by the system, namely SWE-mean, SWE-max, SWE-SD and SWE-ratio. Data analysis showed all these quantitative parameters had good sensitivity, specificity, positive predictive value, negative predictive value and area under the curve, as calculated by the ROC curve. As with these parameters, the cut-off points were lower than in literature, still able to indicate reliable diagnoses, which were confirmed by histopathological exam. Our conclusion is that shear wave elastography has great potential for reliably and accurately diagnosing thyroid malignancies.

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

2014 ◽  
Vol 69 (12) ◽  
pp. 1259-1263 ◽  
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

scholarly journals Use of Contrast-Enhanced Ultrasonography and Shear-Wave Elastography in the Diagnosis of Granulomatous Colitis in a French Bulldog

2021 ◽  
Vol 8 (7) ◽  
pp. 133
Author(s):  
Alessia Cordella ◽  
Emmelie Stock ◽  
Isabel Van de Maele ◽  
Annelies Willems ◽  
Jimmy Saunders
Keyword(s):  
Shear Wave ◽  
Histological Examination ◽  
Shear Wave Elastography ◽  
Granulomatous Colitis ◽  
Colonic Wall ◽  
Contrast Enhanced ◽  
Contrast Enhanced Ultrasonography ◽  
French Bulldog

An 11-month-old male intact French Bulldog was referred for chronic intermittent diarrhea lasting three months. Ultrasonographic (US) examination revealed severe thickening of the wall of the colon and caecum; contrast-enhanced US (CEUS) and elastography showed increased, heterogeneous vascularization and non-uniform stiffness of the colonic wall. The mucosa was thickened, fragile, and ulcerated as revealed by endoscopy, and histological examination confirmed the suspicion of granulomatous colitis.

Contrast-enhanced spectral mammography in patients with MRI contraindications

2017 ◽  
Vol 59 (7) ◽  
pp. 798-805 ◽  
Author(s):  
Vivien Richter ◽  
Valerie Hatterman ◽  
Heike Preibsch ◽  
Sonja D Bahrs ◽  
Markus Hahn ◽  
...  
Keyword(s):  
Problem Solving ◽  
Diagnostic Accuracy ◽  
Breast Imaging ◽  
Diagnostic Yield ◽  
Therapy Response ◽  
Lesion Size ◽  
Size Estimation ◽  
Imaging Data ◽  
Technical Problems ◽  
Contrast Enhanced

Background Contrast-enhanced spectral mammography (CESM) is a novel breast imaging technique providing comparable diagnostic accuracy to breast magnetic resonance imaging (MRI). Purpose To show that CESM in patients with MRI contraindications is feasible, accurate, and useful as a problem-solving tool, and to highlight its limitations. Material and Methods A total of 118 patients with MRI contraindications were examined by CESM. Histology was obtained in 94 lesions and used as gold standard for diagnostic accuracy calculations. Imaging data were reviewed retrospectively for feasibility, accuracy, and technical problems. The diagnostic yield of CESM as a problem-solving tool and for therapy response evaluation was reviewed separately. Results CESM was more accurate than mammography (MG) for lesion categorization (r = 0.731, P < 0.0001 vs. r = 0.279, P = 0.006) and for lesion size estimation (r = 0.738 vs. r = 0.689, P < 0.0001). Negative predictive value of CESM was significantly higher than of MG (85.71% vs. 30.77%, P < 0.0001). When used for problem-solving, CESM changed patient management in 2/8 (25%) cases. Superposition artifacts and timing problems affected diagnostic utility in 3/118 (2.5%) patients. Conclusion CESM is a feasible and accurate alternative for patients with MRI contraindications, but it is necessary to be aware of the method’s technical limitations.

scholarly journals Liver ultrasound elastography for the evaluation of periportal fibrosis in schistosomiasis mansoni: A cross-sectional study

2018 ◽  
Author(s):  
Joelma Carvalho Santos ◽  
Andrea Dória Batista ◽  
Carla Maria Mola Vasconcelos ◽  
Roberto Souza Lemos ◽  
Valter Romão de Souza ◽  
...  
Keyword(s):  
Shear Wave ◽  
Shear Wave Elastography ◽  
Cross Sectional Study ◽  
Cutoff Point ◽  
Sectional Study ◽  
Cross Sectional ◽  
Predictive Values ◽  
Cutoff Value ◽  
Periportal Fibrosis ◽  
Schistosomiasis Mansoni

AbstractBackgroundARFI elastrography has been used as a noninvasive method to assess the severity of liver fibrosis in viral hepatitis, although with few studies in schistosomiasis mansoni. We aimed to evaluate the performance of point shear wave elastography (pSWE) for predicting significant periportal fibrosis (PPF) in schistosomotic patients and to determine its best cutoff point.Methodology/Principal findingsThis cross-sectional study included 358 adult schistosomotic patients subjected to US and pSWE on the right lobe. Two hundred two patients (62.0%) were women, with a median age of 54 (ranging 18-92) years. The pSWE measurements were compared to the US patterns of PPF, as gold standard, according to the Niamey classification. The performance of pSWE was calculated as the area under the ROC curve (AUC). Patients were further classified into two groups: 86 patients with mild PPF and 272 patients with significant PPF. The median pSWE of the significant fibrosis group was higher (1.40 m/s) than that of mild fibrosis group (1.14 m/s, p<0.001). AUC was 0.719 with ≤1.11 m/s as the best cutoff value for excluding significant PPF. Sensitivity and negative predictive values were 80.5% and 40.5%, respectively. Whereas, for confirming significant PPF, the best cutoff value was >1.39 m/s, with specificity of 86.1% and positive predictive value of 92.0%.Conclusions/SignificancepSWE was able to differentiate significant from mild PPF, with better performance to predict significant PPF.Author summaryIn the developing world, over 207 million people are infected with parasitic Schistosoma worms. Among the species of Schistosoma that infect humans Schistosoma mansoni is one of the most common causes of illness. Here, we investigated the performance of point shear wave elastography (pSWE) for predicting significant periportal fibrosis (PPF) in schistosomotic patients and to determine its best cutoff point. We examined 358 people from northeast of Brazil for Schistosoma infections. The present study showed that pSWE was able to differentiate significant from mild PPF, with better performance to predict significant PPF.

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