Shearwave Elastography Increases Diagnostic Accuracy in Characterization of Breast Lesions

Ng, Wei Lin; Rahmat, Kartini; Fadzli, Farhana; Rozalli, Faizatul Izza; Mohd-Shah, M.N.; Chandran, Patricia Ann; Westerhout, Caroline Judy; Vijayananthan, Anushya; Aziz, Yang Faridah Abdul

doi:10.1097/md.0000000000003146

Cited by 40 publications

(26 citation statements)

References 20 publications

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“…In clinical practice when a lesion is considered potentially malignant, further evaluation (MRI and/or biopsy) is usually considered mandatory. Hybrid techniques combining visual inspection and quantitative methods such as SWE may provide additional conidence that a lesion is benign, and more invasive measures such as biopsy can be avoided as has been reported in breast radiology (8,(17)(18)(19). SWE could be useful in avoiding unnecessary interventions, medical costs, and distress for patients.…”

Section: Discussionmentioning

confidence: 99%

Shear-Wave Elastography of Benign versus Malignant Musculoskeletal Soft-Tissue Masses: Comparison with Conventional US and MRI

Tavare¹,

Alfuraih²,

Hensor³

et al. 2019

Radiology

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To examine if shear-wave elastography (SWE) improves the accuracy of diagnosing soft-tissue masses as benign or malignant compared with US alone or in combination with MRI. Materials and Methods: Two hundred six consecutive adult participants (mean age, 57.7 years; range, 18-91 years), including 89 men (median age, 56.0 years; range, 21-91 years) and 117 women (median age, 59.1 years; range, 18-88 years), who were referred for biopsy of a soft-tissue mass were prospectively recruited from December 2015 through March 2017. Participants underwent B-mode US, MRI, and SWE prior to biopsy. hree musculoskeletal radiologists independently reviewed US images alone, followed by US and MRI images together, and classiied lesions as benign, probably benign, probably malignant, or malignant. For SWE, the area under the receiver operating characteristic (ROC) curve (AUC) was calculated for transverse shear-wave velocity (SWV). Multivariable logistic regression was used to investigate the association between SWE and malignancy alongside individual demographic and imaging variables. Results: At histologic examination, 79 of 206 (38%) participants had malignant lesions. SWV showed good diagnostic accuracy for lesions classiied as benign or probably benign by US alone (AUC = 0.87 [95% conidence interval {CI}: 0.79, 0.95]). SWV did not provide substantive diagnostic information for lesions classiied as probably malignant or malignant, whether the classiication was made with or without MRI. However, multivariable modeling indicated that diagnostic accuracy may vary by lesion position (interaction P = .

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Section: Discussionmentioning

confidence: 99%

Shear-Wave Elastography of Benign versus Malignant Musculoskeletal Soft-Tissue Masses: Comparison with Conventional US and MRI

Tavare¹,

Alfuraih²,

Hensor³

et al. 2019

Radiology

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“…Ng et al . determined the cut-off value of Emax to be 56 kPa 24 . “Blue” or “soft” cancers are occasionally found on shear wave elastography 10 .…”

Section: Discussionmentioning

confidence: 99%

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

Kim

et al. 2018

Sci Rep

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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.

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“…The findings are a mixture of features as noted in different previous MRI studies. [ 21 , 30 , 40 – 43 ]…”

Section: Discussionmentioning

confidence: 99%

Radiopathological characteristics and outcomes of phyllodes tumor of the breast in Malaysian women

et al. 2018

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Phyllodes tumor or cystosarcoma phyllodes is a rare fibroepithelial neoplasm which arises from the periductal stroma of the breast. They are classified as benign, borderline, and malignant based on the histologic features. However, all phyllodes tumor (PT) subtypes are regarded as having malignant potential and correct diagnosis is important for surgical management and optimal care. This study is a retrospective review of 76 women diagnosed as PT with highlights on the imaging characteristics, pathology, and surgical treatment over a 7-year period in a tertiary medical center of urban population in Malaysia. There were 45 benign, 16 borderline, and 15 malignant PT. The median age for benign PT was 43, borderline 48.5, and malignant 42 years. The Malay ethnic group constitute 52.6% of cases, with 27.6% and 18.4% in Chinese and Indian ethnic groups, respectively. On mammograms, most benign (64.3%) and 33.3% of malignant PT showed high-density lesions. Calcifications were only seen in 2 benign PT. On ultrasound, 86% of benign PT was well-circumscribed whilst 50.0% of malignant PT had irregular outline. Cystic spaces were seen in 40.0% of malignant and 9.5% of benign PT. 80% of malignant PT lesions were heterogenous. Malignant PT demonstrates tumor heterogeneity, cystic spaces, and posterior acoustic enhancement on ultrasound. Half of malignant PT showed regular borders on ultrasound and appear well circumscribed on mammogram. A total of 46 patients had wide local excision or excision biopsy whilst 30 underwent mastectomy as primary treatment. The majority of the borderline and malignant PTs in our study (75.0% and 85.7% respectively) and only 5 out of the 43 (11.6%) benign PT underwent mastectomy. There were 2 tumor recurrence in the benign PT group and 1 case in the borderline and malignant group respectively.

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Shearwave Elastography Increases Diagnostic Accuracy in Characterization of Breast Lesions

Cited by 40 publications

References 20 publications

Shear-Wave Elastography of Benign versus Malignant Musculoskeletal Soft-Tissue Masses: Comparison with Conventional US and MRI

Shear-Wave Elastography of Benign versus Malignant Musculoskeletal Soft-Tissue Masses: Comparison with Conventional US and MRI

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

Radiopathological characteristics and outcomes of phyllodes tumor of the breast in Malaysian women

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