J Korean Soc Radiol.  2020 Jan;81(1):157-165. 10.3348/jksr.2020.81.1.157.

Application of Point Shearwave Elastography to Breast Ultrasonography: Initial Experience Using “S-Shearwave” in Differential Diagnosis

• Lee MH
• Kim EK
• Lee EJ
• Kim HY
• Yoon JH

• KMID: 2469189
• DOI: http://doi.org/10.3348/jksr.2020.81.1.157

Abstract

PURPOSE
To evaluate the optimal measurement location, cut-off value, and diagnostic performance of S-Shearwave in differential diagnosis of breast masses seen on ultrasonography (US).
MATERIALS AND METHODS
During the study period, 225 breast masses in 197 women were included. S-Shearwave measurements were made by applying a square region-of-interest automatically generated by the US machine. Shearwave elasticity was measured three times at four different locations of the mass, and the highest shearwave elasticity was used for calculating the optimal cut-off value. Diagnostic performance was evaluated by using the area under the receiving operator characteristic curve (AUC).
RESULTS
Of the 225 breast masses, 156 (69.3%) were benign and 69 (30.7%) were malignant. Mean S-Shearwave values were significantly higher for malignant masses (108.0 ± 70.0 kPa vs. 43.4 ± 38.3 kPa; p < 0.001). No significant differences were seen among AUC values at different measurement locations. With a cut-off value of 41.9 kPa, S-Shearwave showed 85.7% sensitivity, 63.9% specificity, 70.7% accuracy, and positive and negative predictive values of 51.7% and 90.8%, respectively. The AUCs for US and S-Shearwave did not show significant differences (p = 0.179).
CONCLUSION
S-Shearwave shows comparable diagnostic performance to that of grayscale US that can be applied for differential diagnosis of breast masses seen on US.

MeSH Terms

Area Under Curve
Breast*
Diagnosis, Differential*
Elasticity
Elasticity Imaging Techniques*
Female
Humans
Sensitivity and Specificity
Ultrasonography
Ultrasonography, Mammary*

Figure

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  Fig. 1. Example of application of S-Shearwave to breast ultrasonography examination. A. A square ROI is set at the center of the breast mass for shearwave elasticity measurement. B. An ROI is set at the normal breast parenchyma adjacent to the breast mass, with the ROI set at the same depth as that of the breast mass.

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  Fig. 2. After generating the S-Shearwave, shearwave elasticity is measured three times at four different locations of the mass by applying square regions-of-interest – interior (mass center), superior border, right lateral border, and left lateral border of the mass.

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