Value of shear wave arrival time contour display in shear wave elastography for breast masses diagnosis

Bang-Guo Zhou, Dan Wang, Wei-Wei Ren, Xiao-Long Li, Ya-Ping He, Bo-Ji Liu, Qiao Wang, Shi-Gao Chen, Azra Alizad, Hui-Xiong Xu, Bang-Guo Zhou, Dan Wang, Wei-Wei Ren, Xiao-Long Li, Ya-Ping He, Bo-Ji Liu, Qiao Wang, Shi-Gao Chen, Azra Alizad, Hui-Xiong Xu

Abstract

To evaluate the diagnostic performance of shear wave arrival time contour (SWATC) display for the diagnosis of breast lesions and to identify factors associated with the quality of shear wave propagation (QSWP) in breast lesions. This study included 277 pathologically confirmed breast lesions. Conventional B-mode ultrasound characteristics and shear wave elastography parameters were computed. Using the SWATC display, the QSWP of each lesion was assigned to a two-point scale: score 1 (low quality) and score 2 (high quality). Binary logistic regression analysis was performed to identify factors associated with QSWP. The area under the receiver operating characteristic curve (AUROC) for QSWP to differentiate benign from malignant lesions was 0.913, with a sensitivity of 91.9%, a specificity of 90.7%, a positive predictive value (PPV) of 74.0%, and a negative predictive value (NPV) of 97.5%. Compared with using the standard deviation of shear wave speed (SWSSD) alone, SWSSD combined with QSWP increased the sensitivity from 75.8% to 93.5%, but decreased the specificity from 95.8% to 89.3% (P < 0.05). SWSSD was identified to be the strongest factor associated with the QSWP, followed by tumor malignancy and the depth of the lesion. In conclusion, SWATC display may be useful for characterization of breast lesions.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
Images of a 31-year-old woman with fibroadenoma. (A) The lesion is shown on B-mode ultrasound. (B) The lesion is shown on color Doppler ultrasound (C) shear wave arrival time contour of the lesion shows regularly parallel lines on the shear wave propagation mode. (D) The mean and standard deviation of the lesion on elasticity mode are 17.8 kPa and 7.7 kPa, respectively. (E) The mean and standard deviation of the lesion on shear wave speed mode are 2.39 m/s and 0.51 m/s, respectively. (F) Pathological examination confirms the diagnosis of fibroadenoma (Hematoxylin-eosin stain; × 100).
Figure 2
Figure 2
Images of a 57-year-old woman with invasive ductal carcinoma. (A) The lesion is shown on B-mode ultrasound. (B) The lesion is shown on color Doppler ultrasound (C) shear wave arrival time contour of the lesion shows distorted and unparalleled lines on the shear wave propagation mode. (D) The mean and standard deviation of the lesion on elasticity mode are 38.1 kPa and 37.8 kPa, respectively. (E) The mean and standard deviation of the lesion on shear wave speed mode are 3.13 m/s and 2.04 m/s, respectively. (F) Pathological examination confirms the diagnosis of invasive ductal carcinoma (Hematoxylin-eosin stain; × 200).
Figure 3
Figure 3
Image explanation for the discrepancy of quality scores for determination. Score1 (low quality) was assigned when the contour lines are distorted and unparalleled; score 2 (high quality) was assigned to lesions with parallel lines.

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