Aiman Ashraf, Saba Sohail, Rehana Shaikh, Mukhtiar Memon



Objective: To determine the diagnostic accuracy of shear- wave Elastography in determining breast malignancy in suspicious breast lesions needing further radiologic evaluation, keeping histopathology as gold standard.

Methods: This cross-sectional study was conducted in Radiology department, Dr Ruth K.M Pfau Civil Hospital, Karachi from March 2016 to January 2017. This study included 170 patients referred for Shear-wave Elastography (SWE) with suspected malignant breast lesions considered BIRADS-0 or IV on mammography or ultrasound. Elastography was performed after taking detailed history, breast examination, mammography and gray scale ultrasound. Elastography findings were recorded and compared with the histopathology. The primary performance outcomes of shear-wave elastography were determined in terms of sensitivity, specificity, accuracy, positive and negative predictive values against the histopathology. Post stratification chi square test was applied taking p-value ≤ 0.05 as significant.

Results: The mean age of the patients was 44.03±9.31 years. Mean size of lump was 2.50±2.29 cm with mean duration of 6.48±3.29 months. Out of the 170 patients, 108 (63.5%) patients were diagnosed as malignant by shear-wave elastography while 109 (64.1%) patients by histopathology. The sensitivity of Shear-wave Elastography was 88.1% with specificity of 80.3%, positive predictive value of 88.8%, negative predictive value of 79.03% and an overall accuracy of 85.29%.

Conclusion: SWE is a useful adjunct to mammography and conventional gray scale ultrasound to identify breast malignancy with good accuracy in suspicious breast lesion.

Keywords: Diagnostic Accuracy, Shear-Wave Elastography, Breast Malignancy, Breast Lesions, Histopathology

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