RSNA 2011 

Abstract Archives of the RSNA, 2011


SSE02-06

Clinical Application of Shear Wave Elastography (SWE) in the Diagnosis of Benign and Malignant Breast Diseases  

Scientific Formal (Paper) Presentations

Presented on November 28, 2011
Presented as part of SSE02: Breast Imaging (Ultrasound: Automated Systems, and Other)

Participants

Jung Min Chang MD, Presenter: Nothing to Disclose
Woo Kyung Moon, Abstract Co-Author: Nothing to Disclose
Nariya Cho MD, Abstract Co-Author: Nothing to Disclose
Ann Yi MD, Abstract Co-Author: Nothing to Disclose
Hye Ryoung Koo MD, Abstract Co-Author: Nothing to Disclose
Seung Ja Kim, Abstract Co-Author: Nothing to Disclose

PURPOSE

To evaluate the diagnostic performance of shear wave elastography (SWE) for the differentiation of breast masses compared with conventional ultrasound (US).

METHOD AND MATERIALS

Conventional US and SWE were performed by three experienced radiologists for 158 consecutive women who had been scheduled for US-guided core biopsy or surgical excision in 182 breast masses (89 malignancies and 93 benign; mean size, 1.76 cm). For each lesion, quantitative elasticity was measured in terms of the Young’s modulus (in kilopascals, kPa) with SWE, and BI-RADS final categories were assessed with conventional US. Sensitivity, specificity, and the area under the curve (Az) by receiver operating characteristic (ROC) curve analysis were obtained for SWE and conventional US to evaluate diagnostic performance. 

RESULTS

The mean elasticity values were significantly higher in malignant masses (153.3 kPa ± 58.1) than in benign masses (46.1 kPa ± 42.9), (P <0.0001). The average mean elasticity values of invasive ductal (157.5 ± 57.07) or invasive lobular (169.5 ± 61.06) carcinomas were higher than those of ductal carcinoma in situ (117.8 kPa ± 54.72). The average mean value was 49.58 ± 43.51 for fibroadenoma, 35.3 ± 31.2 for fibrocystic changes, 69.5 ± 63.2 for intraductal papilloma and 149.5 ± 132.4 for adenosis or stromal fibrosis. The optimal cut-off value, yielding the maximal sum of sensitivity and specificity, was 80.17 kPa, and the sensitivity and specificity of SWE were 88.8% (79 of 89) and 84.9% (79 of 93). The area under the ROC curve (Az value) was 0.898 for conventional US and 0.932 for SWE (P = 0.250). When category 4 lesions with elasticity values higher than 80.17kPa, and category 5 lesions regardless of elasticity findings considered as test positive, the sensitivity and specificity were 95.5% (85 of 89) and 88.2% (82 of 93), showing higher value than those of individual conventional US and SWE. 

CONCLUSION

There were significant differences in the elasticity values of benign and malignant masses as well as invasive and intraductal cancers with SWE. Adding SWE data to conventional US could increase diagnostic performance for the differentiation of variable breast masses. 

CLINICAL RELEVANCE/APPLICATION

Knowing quantitative values of various breast lesions in a larger population will potentially increase our level of confidence regarding the final assessment of various breast lesions. 

Cite This Abstract

Chang, J, Moon, W, Cho, N, Yi, A, Koo, H, Kim, S, Clinical Application of Shear Wave Elastography (SWE) in the Diagnosis of Benign and Malignant Breast Diseases  .  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11007211.html