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.

Can shear wave elastography be utilized as an additional tool for the assessment of non-mass breast lesions?

Ultrasound ◽  
2021 ◽  
pp. 1742271X2199872
Author(s):  
Sepideh Sefidbakht ◽  
Sara Haseli ◽  
Neda Khalili ◽  
Vahid Bazojoo ◽  
Pedram Keshavarz ◽  
...  
Keyword(s):  
High Risk ◽  
Diagnostic Accuracy ◽  
Shear Wave ◽  
Breast Imaging ◽  
Shear Wave Elastography ◽  
Breast Lesions ◽  
Benign Lesions ◽  
Conventional Ultrasound ◽  
Malignant Lesions ◽  
Mass Lesions

Introduction We aimed to describe shear wave elastography parameters of non-mass lesions of the breast and to assess the measures of diagnostic accuracy of shear wave elastography in the differentiation of non-mass lesions compared with conventional ultrasound, using histopathologic results as the reference standard. Methods This retrospective study included breast ultrasound-detected non-mass lesions with a confirmed pathologic diagnosis during a two-year study period. B-mode ultrasound and shear wave elastography were performed for all lesions before biopsy. Ultrasound features, shear wave elastography parameters (mean elasticity and maximum stiffness color), as well as Breast Imaging-Reporting and Data System categories were recorded for each lesion. Measures of diagnostic accuracy of ultrasound and ultrasound + shear wave elastography were also assessed. Results From a total of 567 breast lesions requiring core-needle biopsy, 49 (8.6%) were considered as non-mass lesions. Based on histopathologic reports, 32 patients (65.3%) had non-high-risk benign lesions, five (10.2%) had high-risk benign lesions, five (10.2%) had ductal carcinoma in situ, and seven (14.3%) had invasive carcinoma. There was no significant difference in patients’ age and palpability between benign and malignant lesions ( p = 0.16 and p = 0.12, respectively). Mean elasticity values and Breast Imaging-Reporting and Data System categories were significantly higher among malignant lesions compared with benign non-mass lesions (both p < 0.001). Furthermore, the addition of shear wave elastography to grayscale ultrasound increased the specificity, positive predictive value, and diagnostic accuracy. Conclusion The complementary use of shear wave elastography with conventional ultrasound might help in the differentiation of non-mass breast lesions and has the potential to decrease the frequency of unnecessary biopsies performed for benign non-mass lesions.

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

Diagnostics ◽  
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.

scholarly journals Use of shear wave elastography to differentiate benign and malignant breast lesions

2014 ◽  
Vol 20 (3) ◽  
pp. 239-244 ◽  
Author(s):  
Deniz Cebi Olgun ◽  
Bora Korkmazer ◽  
Fahrettin Kilic ◽  
Atilla Suleyman Dikici ◽  
Mehmet Velidedeoglu ◽  
...  
Keyword(s):  
Shear Wave ◽  
Shear Wave Elastography ◽  
Breast Lesions ◽  
Malignant Breast

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 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 Section Discrepancy and Diagnostic Performance of Breast Lesions in Two-dimensional Ultrasound by Dynamic Videos versus Static Images

2021 ◽  
Author(s):  
Dinghong Yang ◽  
Xiaoyun Xiao ◽  
Haohu Wang ◽  
Huan Wu ◽  
Wei Qin ◽  
...  
Keyword(s):  
Breast Imaging ◽  
Diagnostic Performance ◽  
Architectural Distortion ◽  
Breast Lesions ◽  
Two Dimensional ◽  
Benign Lesions ◽  
Static Image ◽  
Malignant Breast ◽  
Static Images ◽  
Malignant Lesions

Background: Benign or malignant breast lesions with typical ultrasonic characteristics could be easily and correctly diagnosed with two-dimensional ultrasound (2D US). However, diagnosis of atypical lesions remains a challenge. Most atypical lesions have different ultrasonographic features with probe direction variation. Thus, the interpretation of ultrasonographic features based on static images empirically collected by sonographers might be inaccurate. We aimed to investigate the section discrepancy and diagnostic performance of breast lesions in 2D US by dynamic videos versus static images.Methods: Static images and dynamic videos based on two perpendicular planes of 468 breast lesions were collected and evaluated. The Breast Imaging and Reporting Data System (BI-RADS&#x00AE;) US lexicon was used. Category 3 was used as the cut-off point, and section discrepancy was defined as two perpendicular planes showing different BI-RADS categories (3 versus 4A, 4B, 4C, and 5).Results: This retrospective study included 315 benign and 153 malignant lesions. There were 53 and 50 lesions with section discrepancy during static and dynamic observations, respectively. The proportion of benign lesions with section discrepancy was significantly higher than that of malignant lesions (P &#x003C; 0.05) either in dynamic or static observation, and the contingency coefficient was 0.2 between section discrepancy and histopathology. Duct changes were more clearly depicted in dynamic videos than in static images (P &#x003C; 0.05) both in malignant and benign lesions. Calcification and architectural distortion were more sensitively detected by dynamic videos than with static images (P &#x003C; 0.05) in malignant lesions. The interpretation of &#x201C;margin&#x201D; significantly differed in benign lesions between static images and dynamic videos (P &#x003C; 0.05). The areas under the curve of static image-horizontal, static image-sagittal, dynamic video-horizontal, and dynamic video-sagittal were 0.807, 0.820, 0.837, and 0.846, respectively. The specificities of dynamic videos were higher than those of static images (P &#x003C; 0.05).Conclusion: Breast lesions have section discrepancy in 2D US. Observations based on dynamic videos could more accurately reflect lesion features and increase the specificity of US in the differentiation of atypical breast lesions.

scholarly journals Immunohistochemical Expression of p63 in Benign and Malignant Breast Lesions

2021 ◽  
Author(s):  
Abhishek Saini ◽  
Swaran Kaur Saluja ◽  
MK Garg ◽  
Deepti Agarwal ◽  
Amrita Kulhria ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Myoepithelial Cells ◽  
Normal Breast ◽  
High Morbidity ◽  
Breast Lesions ◽  
Benign Lesions ◽  
Medical College ◽  
Malignant Breast ◽  
Malignant Lesions

Introduction: Breast carcinoma demands attention as it causes high morbidity and mortality. It is important to recognise benign lesions to distinguish them from in situ and invasive breast cancer and to assess a patient’s risk of developing breast cancer, so that the most appropriate treatment modality for each case can be established. The p63 has been characterised as a reliable marker of myoepithelial cells of lactiferous duct. It is exclusively expressed in myoepithelial cells of normal breast tissue. Hence, p63 can be of great help in the differential diagnosis involving benign lesions. Also, p63 may aid in distinguishing benign from malignant lesions. Aim: To study the Immunohistochemistry (IHC) expression of p63 in benign and malignant breast lesions. Materials and Methods: The prospective study was conducted on 76 breast specimens for a period of one year, from 1st December 2018 to 30th November 2019 in the Department of Pathology, Bhagat Phool Singh, Government Medical College for Women, Khanpur Kalan, Sonepat, Haryana, India. IHC assessment for p63 nuclear protein was performed. The intensity of p63 expression was evaluated as continuous positive, discontinuous positive and negative. The extent was scored on the basis of percentage of positive cells and assigned a score of negative (0%), 1 (<25%), 2 (26-90%) and 3 (91-100%). Results: Out of 76 cases, 38 cases were diagnosed as benign and 38 cases as malignant. IHC staining with p63 showed nuclear positivity in all benign lesions. Among malignant lesions, four were positive and 34 were negative. Conclusion: According to the above results, p63 is a very useful IHC marker in diagnosing difficult cases, cases of carcinoma in situ, borderline cases and cases with inconclusive histomorphological diagnosis.

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.

Sign in / Sign up

Export Citation Format

Share Document