Can shear wave elastography be utilized as an additional tool for the assessment of non-mass breast lesions?

Sefidbakht, Sepideh; Haseli, Sara; Khalili, Neda; Bazojoo, Vahid; Keshavarz, Pedram; Zeinali-Rafsanjani, Banafsheh

doi:10.1177/1742271x21998721

Cited by 8 publications

(8 citation statements)

References 26 publications

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“…We found that malignant breast lesions had higher stiffness than benign breast lesions. Similar results have been reported in other studies (23,24). Among the malignant breast lesions, invasive ductal carcinomas (11/18) were the most common pathological type in our study.…”

Section: Discussionsupporting

confidence: 93%

Differential diagnosis of B-mode ultrasound Breast Imaging Reporting and Data System category 3–4a lesions in conjunction with shear-wave elastography using conservative and aggressive approaches

Zhi¹,

Miao²,

You³

et al. 2022

Quant Imaging Med Surg

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Background: The high false-positive rates of US Breast Imaging Reporting and Data System (BI-RADS) category 3-4a breast lesions leads to excessive biopsies of many benign lesions, and our aim was to investigate the diagnostic performance achieved by adding a maximum elasticity (Emax) of shear-wave elastography (SWE) to ultrasound (US) to evaluate US BI-RADS category 3-4a breast lesions using conservative and aggressive approaches. We explored the capacity of using this method to avoid unnecessary biopsies without increasing the probability of missing breast cancers.Methods: A total of 123 breast lesions of 120 patients classified as BI-RADS category 3 or 4a were enrolled from January 2019 to December 2019. The US features were evaluated according to the US BI-RADS lexicon. The maximum diameter measured on the US was defined as the size of the lesion. The Emax was assessed by SWE, and the average Emax of breast lesions on two images were calculated and recorded as the final maximum Young's modulus. The diagnostic performance of the combined B-mode US and SWE approach for BI-RADS category 3-4a breast lesions was tested using a conservative approach and an aggressive approach. In the conservative approach, the lesions were downgraded with Emax of 30 kPa or less and upgraded with Emax of 160 kPa or more. In the aggressive approach, the lesions were downgraded with Emax of 80 kPa or less and upgraded with Emax of 160 kPa or more. Pathologic results were defined as the reference standard.Results: Among all 123 breast lesions, there were 60 lesions classified as BI-RADS category 3 and 63 lesions classified as BI-RADS category 4a. Compared to the B-mode US, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, and area under the receiver operating characteristic (ROC) curve (AUC) of the combined B-mode US and SWE with a conservative approach

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Section: Discussionsupporting

confidence: 93%

Differential diagnosis of B-mode ultrasound Breast Imaging Reporting and Data System category 3–4a lesions in conjunction with shear-wave elastography using conservative and aggressive approaches

Zhi¹,

Miao²,

You³

et al. 2022

Quant Imaging Med Surg

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“…Another concern was selection bias. In our meta-analysis, the total malignancy rate was 51%, but studies [10,23] have shown that NMLs have only about a 2% risk of malignancy, which is important. The main reason for this is clinical management.…”

Section: Discussionmentioning

confidence: 65%

“…However, Aslan et al's study [18] did not use a clear measurement index or cut-off value. Five studies [7,[20][21][22][23] did not mention whether patients were enrolled consecutively.…”

Section: Study Characteristicsmentioning

confidence: 99%

Diagnostic performance of elastography for breast non-mass lesions: A systematic review and meta-analysis

Shen

Gao

et al. 2021

European Journal of Radiology

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This systematic review and meta-analysis aimed to evaluate the diagnostic performance of ultrasound elastography in the differentiation of benign and malignant breast non-mass lesions (NMLs). Methods: PubMed, Cochrane Library, and Embase databases were searched for eligible studies up to end of June 2021. The diagnostic performance of elastography for NMLs was investigated using pooled sensitivity and specificity, likelihood ratio, diagnostic odds ratio (DOR), post-test probability, and the area under hierarchical summary receiver operating characteristic curve (HSROC). Results: Eleven studies involving 812 NMLs (malignant 414) were included. The pooled sensitivity, specificity, DOR, positive likelihood ratio, and negative likelihood of elastography for the differentiation of benign and malignant breast NMLs were 79% (95 %CI: 71-85), 86% (95 %CI: 79-91), ), and 0.24 (95 %CI: 0.17-0.34), respectively. No significant publication bias existed. The area under the HSROC curve was 90% (95 %CI: 87-92). Fagan plots demonstrated good clinical utility. However, substantial heterogeneity existed. Country, measurement index, and number of lesions served as potential sources of heterogeneity. Conclusions:The results of this study suggest that elastography has high diagnostic accuracy in differentiating between malignant and benign NMLs. Elastography can be a feasible and non-invasive tool for breast NMLs.

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“…Dağılıma baktığımızda ise Park ve ark. artırarak, gereksiz biyopsi sayısını azaltabildiği bildirilmiştir [10,19,26]. Hong ve ark.…”

Section: Benign Ve Malign Lezyonlarda Histolojik Korelasyonunclassified

Non-mass Findings on Breast Ultrasonography and Differential Diagnosis

Örgüç,

Açar

2023

trs

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Kitle dışı bulguların sonografik bulgularının tanınması Kitle dışı ultrasonografi (US) bulgularının mamografi ve manyetik rezonans görüntüleme bulguları ile korelasyonu US'de kitle bulgusu oluşturan benign ve malign lezyonların saptanması Örgüç Ş, Açar ÇR. Non-mass Findings on USG and Differential Diagnosis. Trd Sem 2023;11(3):297-311. ÖZKitle dışı bulgu (KDB); çevresindeki meme dokusunda farklı eko yapısına sahip, ancak kitle şekli oluşturmayan bir alandır. Son yıllarda ultrason teknolojindeki gelişmeler nedeniyle ultrasonografi (US) bakıda KDB'ye daha sık rastlanmaktadır. Kontrastlı mamografi ve meme manyetik rezonans görüntülemede saptanan KDB'lerin biyopsi rehberliği için ikincil US bakısı da meme radyologlarının günlük US pratiğinde KDB ile karşılaşma sıklığını artırmaktadır. Güncel Meme Görüntüleme, Raporlama ve Data Sistemi ultrason veri sözlüğünde karşılığı bulunmaması nedeniyle KDB'nin ultrason bulgularının tanımlanması ve sınıflanmasında da literatürde de farklı yaklaşımlar bulunmaktadır. Sınıflama en sık ekojenite ve dağılım ile yapılmaktadır. Eşlikçi bulgular; tübüler ve duktal yapılar, arka gölgelenme, yapısal distorsiyon ve kalsifikasyonlardır. Literatürde kitle dışı lezyonların %46-90'ı benign, %10-54'ü malign olarak rapor edilmektedir.

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Can shear wave elastography be utilized as an additional tool for the assessment of non-mass breast lesions?

Cited by 8 publications

References 26 publications

Differential diagnosis of B-mode ultrasound Breast Imaging Reporting and Data System category 3–4a lesions in conjunction with shear-wave elastography using conservative and aggressive approaches

Differential diagnosis of B-mode ultrasound Breast Imaging Reporting and Data System category 3–4a lesions in conjunction with shear-wave elastography using conservative and aggressive approaches

Diagnostic performance of elastography for breast non-mass lesions: A systematic review and meta-analysis

Non-mass Findings on Breast Ultrasonography and Differential Diagnosis

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