Update on Breast Cancer Detection Using Comb-Push Ultrasound Shear Elastography

Abstract

In this work, tissue stiffness estimates are used to differentiate between benign and malignant breast masses in a group of pre-biopsy patients. The rationale is that breast masses are often stiffer than healthy tissue; furthermore, malignant masses are stiffer than benign masses. The comb-push ultrasound shear elastography (CUSE) method is used to noninvasively assess a tissue's mechanical properties. CUSE utilizes a sequence of simultaneous multiple laterally spaced acoustic radiation force (ARF) excitations and detection to reconstruct the region of interest (ROI) shear wave speed map, from which a tissue stiffness property can be quantified. In this study, the tissue stiffnesses of 73 breast masses were interrogated. The mean shear wave speeds for benign masses (3.42 ± 1.32 m/s) were lower than malignant breast masses (6.04 ± 1.25 m/s). These speed values correspond to higher stiffness in malignant breast masses (114.9 ± 40.6 kPa) than benign masses (39.4 ± 28.1 kPa and p <; 0.001), when tissue elasticity is quantified by Young's modulus. A Young's modulus >83 kPa is established as a cut-off value for differentiating between malignant and benign suspicious breast masses, with a receiver operating characteristic curve (ROC) of 89.19% sensitivity, 88.69% specificity, and 0.911 for the area under the curve (AUC).

Conflict of interest statement

Disclosure of Conflict of Interest: Mayo Clinic and some of the authors have a potential financial interest related to a device or technology referenced in this paper.

Figures

Figure 1

(a) Unfocused and (b) focused acoustic radiation force beams

Figure 2

CUSE phantom experiment. (a) FCUSE excitation in the FOV. (b) RL shear wave propagation and (c) the corresponding speed map. (d) LR shear wave propagation and (e) its corresponding speed map. (f) Final shear wave speed map.

Figure 3

US B-mode image and CUSE shear wave speed map for (a, b) benign intramammary lymph node, (c, d) benign fibroadenoma, (e, f) malignant mass with grade II IDC, and (g, h) malignant mass with grade I IDC.