Value of Shear Wave Elastography in Discriminating Category IV Breast Lesions According to Breast Imaging-Reporting and Data System

Kadhim, Mohammed Abd; Abed, Noor Yousif

doi:10.33091/amj.2021.174526

	Value of Shear Wave Elastography in Discriminating Category IV Breast Lesions According to Breast Imaging-Reporting and Data System
Al- Anbar Medical Journal
Article 5, Volume 18, Issue 1, 2022, Pages 21-26 PDF (776.48 K)
Document Type: Original articles
DOI: 10.33091/amj.2021.174526
Authors
Mohammed Abd Kadhim; Noor Yousif Abed^*
Department of Diagnostic Radiology, Baghdad Medical City, Baghdad, Iraq.
Abstract
Background: Breast cancer is the second cause of cancer death in women. Shear wave elastography (SWE) is an ultrasound (US) procedure that can improves the sensitivity and the specificity in the diagnosis of breast lesions. Objective: To evaluate the value of SWE to discriminate benign from malignant Breast Imaging-Reporting and Data System (BI-RADS) IV breast lesions. Materials and Methods: A cross sectional analytic study was done in the Radiology Department, Oncology Teaching Hospital, Baghdad Medical City, Baghdad, Iraq. The study period was one year (February 2020 to January 2021). The study included 42 female patients with suspicious breast lesions in the group BI-RAD 4 by mammography and US. Shear wave elastography was done for all patients. The final diagnosis of all breast lesions were done by fine needle aspiration cytology or true cut biopsy or excisional biopsy. Results: The final histological diagnosis showed that 23 (54.8%) of study patients were with benign breast lesions. There was a statistically significant association between the quality of SWE and histopathological diagnosis as the proportion of malignant breast lesions was significantly higher among the patients with score 5 (homogenous dark blue) images (85.7%, P= 0.004). Subjectts with malignant lesions had a significantly higher mean of E-mean SWV than those with benign lesions (133.8 versus 75.47 kPa, P = 0.001). The best cut point of E-mean SWV was 83 kPa (E-mean SWV > 83 kPa is predictive for malignant lesion of breast) with 89.5% sensitivity, 60.9% specificity, and 73.8% accuracy. Conclusion: SWE have a significant diagnostic value in differentiation of BI-RADS IV breast lesions into benign and malignant in both qualitative and quantitative patterns. The best cut off value in SWE is 83 KPa for E-mean.
Keywords
Shear Wave Elastography; BI-RADS IV; Breast lesions

References
[1] R. A. da Costa Vieira, G. Biller, G. Uemura, C. A. Ruiz, and M. P. Curado, “Breast cancer screening in developing countries,” Clinics, vol. 72, pp. 244–253, 2017. [2] R. L. Siegel and K. D. Miller, “Cancer Statistics , 2020,” vol. 70, no. 1, pp. 7–30, 2020. [3] W. H. Organization, “Strategy for cancer prevention and control in the Eastern Mediterranean Region 2009-2013,” 2010. [4] W. H. Organization, “International agency for research on cancer,” 2019. [5] B. O. Anderson and E. Cazap, “Breast health global initiative (BHGI) outline for program development in Latin America,” Salud Publica Mex., vol. 51, pp. s309–s315, 2009. [6] O. Sarica and F. Uluc, “Additional diagnostic value of MRI in patients with suspicious breast lesions based on ultrasound,” Br. J. Radiol., vol. 87, no. 1041, p. 20140009, 2014. [7] S. E. Lee, J. E. Moon, Y. H. Rho, E.-K. Kim, and J. H. Yoon, “Which supplementary imaging modality should be used for breast ultrasonography? Comparison of the diagnostic performance of elastography and computer-aided diagnosis,” Ultrasonography, vol. 36, no. 2, p. 153, 2017. [8] S. Hari et al., “Breast mass characterization using shear wave elastography and ultrasound,” Diagn. Interv. Imaging, vol. 99, no. 11, pp. 699–707, 2018. [9] U. R. Acharya et al., “Shear wave elastography for characterization of breast lesions: Shearlet transform and local binary pattern histogram techniques,” Comput. Biol. Med., vol. 91, pp. 13–20, 2017. [10] S. J. Kim, K. H. Ko, H. K. Jung, and H. Kim, “Shear wave elastography: is it a valuable additive method to conventional ultrasound for the diagnosis of small (≤ 2 cm) breast cancer?,” Medicine (Baltimore)., vol. 94, no. 42, 2015. [11] X. Lin et al., “Confirmed value of shear wave elastography for ultrasound characterization of breast masses using a conservative approach in Chinese women: a large-size prospective multicenter trial,” Cancer Manag. Res., vol. 10, p. 4447, 2018. [12] F. Zhang et al., “Sub-classification of BI-RADS by MRI dynamic enhanced vascular imaging and diffusion weighted imaging,” Int. J. Clin. Exp. Med., vol. 10, no. 7, pp. 10324–10332, 2017. [13] J. Han et al., “Reducing unnecessary biopsy of breast lesions: Preliminary results with combination of strain and shear-wave elastography,” Ultrasound Med. Biol., vol. 45, no. 9, pp. 2317–2327, 2019. [14] R. G. Barr et al., “WFUMB guidelines and recommendations for clinical use of ultrasound elastography: Part 2: breast,” Ultrasound Med. Biol., vol. 41, no. 5, pp. 1148–1160, 2015. [15] G. A. Elmoneam, R. M. Almolla, A. F. Ahmed, and M. A. Al Ekrashy, “Supersonic shear waves quantitative elastography and kinetic magnetic resonance dynamic curve in discriminating BI-RADS 4 breast masses: a comparative study,” Egypt. J. Radiol. Nucl. Med., vol. 47, no. 4, pp. 1773–1782, 2016. [16] W.-W. Ren, X.-L. Li, D. Wang, B.-J. Liu, C.-K. Zhao, and H.-X. Xu, “Evaluation of shear wave elastography for differential diagnosis of breast lesions: A new qualitative analysis versus conventional quantitative analysis,” Clin. Hemorheol. Microcirc., vol. 69, no. 3, pp. 425–436, 2018. [17] M. Farghadani, R. Barikbin, M. H. Rezaei, A. Hekmatnia, M. Aalinezhad, and H. Zare, “Differentiating solid breast masses: comparison of the diagnostic efficacy of shear wave elastography and magnetic resonance imaging,” Diagnosis, 2020. [18] B. E. Lee, J. Chung, E.-S. Cha, J. E. Lee, and J. H. Kim, “Role of shear-wave elastography (SWE) in complex cystic and solid breast lesions in comparison with conventional ultrasound,” Eur. J. Radiol., vol. 84, no. 7, pp. 1236–1241, 2015. [19] F. M. Awad, “Role of supersonic shear wave imaging quantitative elastography (SSI) in differentiating benign and malignant solid breast masses,” Egypt. J. Radiol. Nucl. Med., vol. 44, no. 3, pp. 681–685, 2013. [20] B. S. Garra, “Imaging and estimation of tissue elasticity by ultrasound,” Ultrasound Q., vol. 23, no. 4, pp. 255–268, 2007. [21] S. Y. Park, J. S. Choi, B.-K. Han, E. Y. Ko, and E. S. Ko, “Shear wave elastography in the diagnosis of breast non-mass lesions: factors associated with false negative and false positive results,” Eur. Radiol., vol. 27, no. 9, pp. 3788–3798, 2017. [22] J. H. Youk, H. M. Gweon, and E. J. Son, “Shear-wave elastography in breast ultrasonography: the state of the art,” Ultrasonography, vol. 36, no. 4, p. 300, 2017. [23] J. S. Choi, B.-K. Han, E. Y. Ko, E. S. Ko, J. H. Shin, and G. R. Kim, “Additional diagnostic value of shear-wave elastography and color Doppler US for evaluation of breast non-mass lesions detected at B-mode US,” Eur. Radiol., vol. 26, no. 10, pp. 3542–3549, 2016. [24] W. A. Berg et al., “Shear-wave elastography improves the specificity of breast US: the BE1 multinational study of 939 masses,” Radiology, vol. 262, no. 2, pp. 435–449, 2012.
Statistics Article View: 1,460 PDF Download: 494