Accuracy of tumor size measurement: comparison of B-mode ultrasound, strain elastography, and 2D and 3D shear wave elastography with histopathological lesion size

Abstract

Background Predicting the exact extent of a breast tumor is of great importance for oncologic treatment strategies. Different types of elastography can be used as new tools for measuring lesion size. Purpose To provide evidence regarding the accuracy of tumor size measurement of strain elastography (SE), two-dimensional (2D) and three-dimensional (3D) shear wave elastography (SWE), and conventional B-image ultrasound. Material and Methods In this prospective study, the diameter of 105 malignant breast lesions was measured by SE, 2D and 3D SWE, and B-mode ultrasound. The histopathological lesion size was compared to all imaging-based measuring methods. Results The mean lesion size of all breast carcinomas was 1.54 cm. B-mode ultrasound underestimates breast cancer size in 65.7 % of all cases in this study ( P < 0.0001). Mean lesion size was more accurately determined by SE, 2D and 3D SWE compared to B-mode ultrasound. Absolute differences between measured and actual lesion are smaller for B-mode ultrasound (0.26 cm) than for SE (0.41 cm) and 2D and 3D SWE (0.41 cm and 0.44 cm, respectively). Conclusion B-mode ultrasound allows more accurate lesion size measurement than SE and 2D or 3D SWE but has a significantly higher risk of underestimating tumor size which could lead to incomplete margins during surgery. 3D SWE was not superior to 2D SWE or SE but by trend more precise in predicting the size of invasive lobular carcinoma.

Preoperative imaging accuracy in size determination of prostate cancer in men undergoing radical prostatectomy for clinically localised disease

“…Farrokh et al [ 1 ] recently reported data that proves that USWE is much more precise for measuring cancer size. Another study by Farrokh et al [ 41 ] confirmed that USWE can predict the lesion size precisely compared to other modalities.…”

“…Prostate cancer size assessment with preoperative imaging is crucial for the staging of disease [ 1 ]. Size of the primary tumour is also a major prognostic indicator and is one of the three parameters used in the American Joint Committee on Cancer/Union for International Cancer Control (AJCC/UICC) cancer staging; although T does not represent the precise size of the tumour, this does indicate the location and extent of the tumour in the prostate gland.…”

Highlights of the development in ultrasound during the last 70 years: A historical review

“…In some studies, a correlation between breast tumor stiffness and receptor status, histological grade, and Ki-67 expression has been reported, suggesting that tumor evaluation using elastography could in future venture beyond determining whether tumors are malignant or benign (205). To this end, 3D elastography has recently become clinically available, facilitating whole tumor evaluation, which could also pave the way for more accurate tumor classifications (206).…”

Elastography in Breast Imaging

“…Die 3D-SWE wurde auch für die Beurteilung der Tumorgröße bei Brustkrebs in einer aktuellen Studie verwendet [26]. Im Vergleich zur 2D-SWE, Strain-Elastografie und zum B-Mode Ultraschall war die konventionelle B-Mode Bildgebung überlegen, obwohl 3D-SWE in der Untergruppe mit invasiv-duktalem Karzinom genauer war als 2D-SWE und SE.…”

“…3D SWE has also been used for tumor size assessment in breast cancer in a recent study [26]. When compared to 2D SWE, strain elastography and B-mode ultrasound, conventional B-mode imaging was superior, although 3D SWE was more accurate than 2D SWE and SE for the subgroup of invasive ductal carcinoma.…”