Future of breast elastography

Barr, Richard G.

doi:10.14366/usg.18053

Cited by 65 publications

(57 citation statements)

References 35 publications

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“…Further clinical studies should therefore be carried out to determine the appropriate cutoff value for screening breast cancer by considering the related factors that can have an effect on diagnostic accuracy. In addition, radiologists need to evaluate the most appropriate cutoff for their institution, and it should be regularly monitored and adjusted [49].…”

Section: B)mentioning

confidence: 99%

“…Choi et al [39] used the highest quantitative cutoff levels (E mean cutoff: 123.9 kPa, E max cutoff: 145.9 kPa) among the selected articles; hence, they reported higher false-negative rates, in the range of 8.0%-9.4%, than other studies. Furthermore, radiologists need to decide whether to perform biopsy based on the fact that relatively low elasticity values are seen in SWE for soft malignant lesions (ductal carcinoma in situ, lobular carcinoma, mucinous carcinoma, and lymphomas) [3,7,9,36,49], small lesions, deep lesions, and lesions in women with higher breast thickness [27,50], while certain benign lesions, such as fat necrosis and mastitis, have relatively high elasticity values [49].…”

Section: B)mentioning

confidence: 99%

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Combination of shear-wave elastography with ultrasonography for detection of breast cancer and reduction of unnecessary biopsies: a systematic review and meta-analysis

Park

Kang

2021

Ultrasonography

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This study was undertaken to compare the diagnostic performance and biopsy reduction rate of combined shear-wave elastography (SWE) and B-mode ultrasonography (US) versus B-mode US alone for breast lesions and to determine the most discriminatory parameter in SWE. Methods: A systematic review and meta-analysis were conducted. The resources for the study were obtained from MEDLINE, Embase, Cochrane Library, and KoreaMed on August 17, 2018. The quality of the articles was evaluated using the Scottish Intercollegiate Guidelines Network (SIGN) tool. Results: Twenty-five articles with 5,147 breast lesions were selected. The meta-analysis showed pooled sensitivities of 0.94 and 0.97 (P=0.083), pooled specificities of 0.85 and 0.61 (P=0.009), and area under the receiver operating characteristic curve (AUC) of 0.96 and 0.96 (P=0.095) for combined SWE and B-mode US versus B-mode US alone. When SWE was combined with B-mode US, the Breast Imaging Reporting and Data System category changed from 4 to 3 in 71.3% of the tests, decreasing the frequency of unnecessary biopsies by 41.1%. All four parameters of SWE (the color grade of lesion stiffness, maximum elasticity, mean elasticity, and color grade of lesion stiffness/homogeneity of the lesion) improved the specificity when they were added to B-mode US. The AUC for each SWE parameter was 0.99, 0.96, 0.96, and 0.93, respectively. Conclusion: Adding SWE to B-mode US not only provides additional diagnostic information for differentiating between benign and malignant breast lesions, but also decreases the likelihood of unnecessary biopsies.

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Section: B)mentioning

confidence: 99%

Section: B)mentioning

confidence: 99%

Combination of shear-wave elastography with ultrasonography for detection of breast cancer and reduction of unnecessary biopsies: a systematic review and meta-analysis

Park

Kang

2021

Ultrasonography

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“…These techniques suggest a promising scenario, but the recent expansion of elastography among all device designers and manufacturers has led to a dizzying increase in the number of tests whose results call for consistency improvements [197]. Despite this, it has been exhibited that both linear and nonlinear elastography, possibly together, promise better sensitivity and specificity with which to characterize benign and malignant mammary lesions [198].…”

Section: Breastmentioning

confidence: 99%

Why Are Viscosity and Nonlinearity Bound to Make an Impact in Clinical Elastographic Diagnosis?

Rus

Faris

Torres

et al. 2020

Sensors

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The adoption of multiscale approaches by the biomechanical community has caused a major improvement in quality in the mechanical characterization of soft tissues. The recent developments in elastography techniques are enabling in vivo and non-invasive quantification of tissues’ mechanical properties. Elastic changes in a tissue are associated with a broad spectrum of pathologies, which stems from the tissue microstructure, histology and biochemistry. This knowledge is combined with research evidence to provide a powerful diagnostic range of highly prevalent pathologies, from birth and labor disorders (prematurity, induction failures, etc.), to solid tumors (e.g., prostate, cervix, breast, melanoma) and liver fibrosis, just to name a few. This review aims to elucidate the potential of viscous and nonlinear elastic parameters as conceivable diagnostic mechanical biomarkers. First, by providing an insight into the classic role of soft tissue microstructure in linear elasticity; secondly, by understanding how viscosity and nonlinearity could enhance the current diagnosis in elastography; and finally, by compounding preliminary investigations of those elastography parameters within different technologies. In conclusion, evidence of the diagnostic capability of elastic parameters beyond linear stiffness is gaining momentum as a result of the technological and imaging developments in the field of biomechanics.

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“…Breast elastography has been used to evaluate breast lesions by tissue elasticity with high sensitivity and specificity [ 7 ]. Shear wave elastography (SWE) is a quantitative technique that can calculate tissue elasticity by measuring the velocity of shear waves propagating in the tissue [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

What shear wave elastography parameter best differentiates breast cancer and predicts its histologic aggressiveness?

et al. 2021

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This study aimed to identify useful shear wave elastography (SWE) parameters for differentiating breast cancer and predicting associated immunohistochemical factors and subtypes. Methods: From November 2018 to February 2019, a total of 211 breast lesions from 190 patients who underwent conventional breast ultrasonography and SWE were included. The Breast Imaging, Reporting and Data System categories and qualitative and quantitative SWE parameters for each lesion were obtained. Pathologic results including immunohistochemical factors were evaluated. The diagnostic performance of each parameter and its correlation with histological characteristics, immunohistochemical factors, and subtypes of breast cancer were analyzed using analysis of variance, the independent t test, the Fisher exact test, logistic regression analysis, and the DeLong method. Results: Among 211 breast lesions, 82 were malignant, and 129 were benign. Of the SWE parameters, Emax showed the highest area under the curve (AUC) for differentiating malignant from benign lesions (AUC, 0.891; cut-off>50.85). Poor tumor differentiation and progesterone receptor-negativity were correlated with higher SDmean and Emax (P<0.05). Ki-67-positive breast cancer showed higher SDmean and a heterogeneous color distribution (P<0.05). Ki-67 and cytokeratin 5/6-positive breast cancers showed higher Emax/Efat ratios (P<0.05). Luminal B, human epidermal growth factor receptor 2-enriched, and triple-negative (non-basal) subtypes showed somewhat higher SDmean values than the luminal A and triple-negative (basal) subtypes (P=0.028). Conclusion: Emax is a reliable parameter for differentiating malignancies from benign breast lesions. In addition, high stiffness and SDmean values in tumors measured on SWE could be used to predict poorly differentiated, progesterone receptor-negative, or Ki-67-positive breast cancer.

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Future of breast elastography

Cited by 65 publications

References 35 publications

Combination of shear-wave elastography with ultrasonography for detection of breast cancer and reduction of unnecessary biopsies: a systematic review and meta-analysis

Combination of shear-wave elastography with ultrasonography for detection of breast cancer and reduction of unnecessary biopsies: a systematic review and meta-analysis

Why Are Viscosity and Nonlinearity Bound to Make an Impact in Clinical Elastographic Diagnosis?

What shear wave elastography parameter best differentiates breast cancer and predicts its histologic aggressiveness?

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