Diagnostic features of quantitative comb-push shear elastography for breast lesion differentiationReport as inadecuate




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Background

Lesion stiffness measured by shear wave elastography has shown to effectively separate benign from malignant breast masses. The aim of this study was to evaluate different aspects of Comb-push Ultrasound Shear Elastography CUSE performance in differentiating breast masses.

Methods

With written signed informed consent, this HIPAA- compliant, IRB approved prospective study included patients from April 2014 through August 2016 with breast masses identified on conventional imaging. Data from 223 patients 19–85 years, mean 59.93±14.96 years with 227 suspicious breast masses identifiable by ultrasound mean size 1.83±2.45cm were analyzed. CUSE was performed on all patients. Three regions of interest ROI, 3 mm in diameter each, were selected inside the lesion on the B-mode ultrasound which also appeared in the corresponding shear wave map. Lesion elasticity values were measured in terms of the Young’s modulus. In correlation to pathology results, statistical analyses were performed.

Results

Pathology revealed 108 lesions as malignant and 115 lesions as benign. Additionally, 4 lesions BI-RADS 2 and 3 were considered benign and were not biopsied. Average lesion stiffness measured by CUSE resulted in 84.26% sensitivity 91 of 108, 89.92% specificity 107 of 119, 85.6% positive predictive value, 89% negative predictive value and 0.91 area under the curve P<0.0001. Stiffness maps showed spatial continuity such that maximum and average elasticity did not have significantly different results P > 0.21.

Conclusion

CUSE was able to distinguish between benign and malignant breast masses with high sensitivity and specificity. Continuity of stiffness maps allowed for choosing multiple quantification ROIs which covered large areas of lesions and resulted in similar diagnostic performance based on average and maximum elasticity. The overall results of this study, highlights the clinical value of CUSE in differentiation of breast masses based on their stiffness.



Author: Mahdi Bayat, Max Denis, Adriana Gregory, Mohammad Mehrmohammadi, Viksit Kumar, Duane Meixner, Robert T. Fazzio, Mostafa Fatemi, A

Source: http://plos.srce.hr/



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