Application of 3D and 2D quantitative shear wave elastography (SWE) to differentiate between benign and malignant breast masses

Abstract

As breast cancer tissues are stiffer than normal tissues, shear wave elastography (SWE) can locally quantify tissue stiffness and provide histological information. Moreover, tissue stiffness can be observed on three-dimensional (3D) colour-coded elasticity maps. Our objective was to evaluate the diagnostic performances of quantitative features in differentiating breast masses by two-dimensional (2D) and 3D SWE. Two hundred ten consecutive women with 210 breast masses were examined with B-mode ultrasound (US) and SWE. Quantitative features of 3D and 2D SWE were assessed, including elastic modulus standard deviation (ESDE) measured on SWE mode images and ESDU measured on B-mode images, as well as maximum elasticity (Emax). Adding quantitative features to B-mode US improved the diagnostic performance (p < 0.05) and reduced false-positive biopsies (p < 0.0001). The area under the receiver operating characteristic curve (AUC) of 3D SWE was similar to that of 2D SWE for ESDE (p = 0.026) and ESDU (p = 0.159) but inferior to that of 2D SWE for Emax (p = 0.002). Compared with ESDU, ESDE showed a higher AUC on 2D (p = 0.0038) and 3D SWE (p = 0.0057). Our study indicates that quantitative features of 3D and 2D SWE can significantly improve the diagnostic performance of B-mode US, especially 3D SWE ESDE, which shows considerable clinical value.

Three‐Dimensional Shear Wave Elastography for Differentiating Benign From Malignant Thyroid Nodules

“…Maximum elasticity max on 3D SWE was significantly higher than that on 2D SWE, which is concordant with the finding in previous literature on the breast. 14,15 One possible reason is that 3D SWE provides a more comprehensive evaluation of the nodule than 2D SWE and thus has a higher chance of finding the stiffest region within the nodule. For example, the stiffest region may be detected in the coronal plane of 3D SWE, which is hard to obtain with 2D SWE.…”

“…Bhatia et al reported that when E_SD was used as a surrogate indicator of heterogeneity, malignant thyroid nodules showed significantly higher heterogeneity than benign nodules. Tian et al found that E_SD showed better diagnostic accuracy compared with E_max on 3D SWE for differentiating malignant from benign breast lesions. Therefore, for 3D SWE, E_SD, rather than E_max or E_mean, should be applied for differentiation between malignant and benign thyroid nodules.…”

“…Three‐dimensional SWE has shown promise for breast tumor diagnosis and is valuable for treatment monitoring of breast lesions under chemotherapy . On the other hand, to our best knowledge, all previous SWE studies on the thyroid were performed with 2D SWE, and no studies have been conducted to investigate the diagnostic performance of 3D SWE for thyroid nodules.…”

“…Three-dimensional SWE has shown promise for breast tumor diagnosis and is valuable for treatment monitoring of breast lesions under chemotherapy. [14][15][16] On the other hand, to our best knowledge, all previous SWE studies on the thyroid were performed with 2D SWE, 1,3,17,18 and no studies have been conducted to investigate the diagnostic performance of 3D SWE for thyroid nodules. To answer the question of whether 3D SWE is helpful in clinical practice, this prospective study was performed with the aim of evaluating the diagnostic performance of 3D SWE in predicting thyroid nodule malignancy.…”

Accuracy of real-time shear wave elastography in staging hepatic fibrosis: a meta-analysis

“…Putting a region of interest (ROI) in the area being investigated provides quantitative information about tissue elasticity in kilopascals or meter per second [11]. At present, SWE technology has been widely and successfully used in diagnosis of various diseases such as diseases in gland, vessel wall and superficial organ [12,13]. It is also used to detection of portal hypertension in cirrhosis which can use to reflect the liver stiffness with comparable or better success rate and accuracy as compared with TE [14] and can be used to diagnose patients with or without clinical significant portal hypertension [15].…”