Comparison of strain and shear wave elastography for qualitative and quantitative assessment of breast masses in the same population

Abstract

We investigated addition of strain and shear wave elastography to conventional ultrasonography for the qualitative and quantitative assessment of breast masses; cut-off points were determined for strain ratio, elasticity ratio, and visual score for differentiating between benign and malignant masses. In all, 108 masses from 94 patients were evaluated with strain and shear wave elastography and scored for suspicion of malignancy, visual score, strain ratio, and elasticity ratio. The diagnostic performance between ultrasonography alone and ultrasonography combined with either type of elastography was compared; cut-off points were determined for strain ratio, elasticity ratio, and visual score. Of the 108 masses, 44 were malignant and 64 were benign. The areas under the curves were significantly higher for strain and shear wave elastography-supplemented ultrasonography (0.839 and 0.826, respectively; P = 0.656) than for ultrasonography alone (0.764; P = 0.018 and 0.035, respectively). The diagnostic performances of strain and elasticity ratios were similar when differentiating benign from malignant masses. Cut-off values for strain ratio, elasticity ratio, and visual scores for strain and shear wave elastography were 2.93, 4, 3, and 2, respectively. Both forms of elastography similarly improved the diagnostic performance of conventional ultrasonography in the qualitative and quantitative assessment of breast masses.

A review of various modalities in breast imaging: technical aspects and clinical outcomes

“…The sensitivity and specificity of sonoelastography are 88.5% and 92.7%, respectively [29]. The distinction between benign and malignant tissues in sonoelastography is important and is still subject of discussion [28]. In general, the sonoelastography technique is performed in two ways: stress elastography (SE) and shear wave elastography (SWE) [30].…”

“…In general, the sonoelastography technique is performed in two ways: stress elastography (SE) and shear wave elastography (SWE) [30]. Studies have shown that there is no significant difference between SE and SWE ultrasonography, and both have similar sensitivity and specificity when compared with conventional sonography [28].…”

“…If the compression or propagation force is too large, it causes elastogram noise, and if compression is not sufficient, no elastogram is obtained. The sonoelastography technique does not require complex software but is highly dependent on user performance [28,30].…”

“…The patients must remain static during the acquisition of information. Color scales are considered for the lesions observed [28] ( Figs. 11 and 12).…”

First Evaluation of Zygomaticus Major Muscle Elastic Properties Using a US Elastography Technique

“…SWE produces elastographic color maps capable of providing quantitative elasticity measurements in a user-defined region of interest (ROI) at different sites, such as superficial or deep soft tissues. Importantly, in contrast to strain elastography, SWE does not require any operator compression or a mechanical source for the stress generation and, hence, is a more reproducible technique [15]. SWE has been applied to head and neck tissues and, more specifically, to evaluate the elastic properties of the masseter muscle [16,17], cervical muscles [18,19], salivary glands [20] and thyroid [21,22].…”