DIAGNOSTIC ACCURACY OF SHEAR-WAVE ELASTOGRAPHY AS DECISION MAKING MODALITY IN THE EVALUATION OF SUSPICIOUS BREAST LESIONS
Abstract
Abstract:
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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References
Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A. Global cancer statistics. 2012. CA CancerJ Clin. 2015;65:(2):87- 108. doi: 10.3322/caac.21262.
Raza S, Sajun S, Selhorst C. Breast cancer in Pakistan: identifying local beliefs and knowledge. J Am Coll Radio. 2012;9:571-77.
Chang JY, Moon JH, Koh SH, Park SY, Lee KS. Clinical Application of ShearWave Elastography in Breast Masses. Iran J Radio. 2017; 14(1):e39585. doi: 10.5812/iranjradiol.39585.
Olgun DC, Korkmazer B, Kılıç F, Dikici AS, Velidedeoğlu M, Aydoğan F, et al. Use of shear wave elastography to differentiate benign and malignant breast lesions. Diagn Interv Radiol. 2014; 20(3): 239–44. DOI: [10.5152/dir.2014.13306]
Guo X, Liu Y, Li W. Diagnostic accuracy of shear wave elastography for prediction of breast malignancy in patients with pathological nipple discharge. BMJ Open. 2016;6:e008848. doi:10.1136/bmjopen-2015-008848
Kim YS, Park JG, Kim BS, Lee CH, Ryu DW. Diagnostic value of elastography using acoustic radiation force impulse imaging and strain ratio for breast tumors. J Breast Cancer. 2014;17:76–82.
Ng WL, Rahmat K, Fadzli F, Rozalli FI, Mohd-Shah MN, Chandran PA, et al. Shearwave Elastography Increases Diagnostic Accuracy in Characterization of Breast Lesions. Medicine. 2016;95(12):e3146. doi: 10.1097/MD.0000000000003146
Liu B, Zheng Y, Huang G, Lin M, Shan Q, Lu Y, et al. Breast Lesions: Quantitative Diagnosis Using Ultrasound Shear Wave Elastography—A Systematic Review and Meta-Analysis. Ultrasound in Med. & Biol. 2016; 42(4): 835-47.
Li G, Li D-W, Fang Y-X, Song Y-J, Deng Z-J, Gao J, et al. Performance of Shear Wave Elastography for Differentiation of Benign and Malignant Solid Breast Masses. PLoS ONE. 2013; 8(10): e76322. https://doi.org/10.1371/journal.pone.0076322
Youk JH, Gweon HM, Son EJ. Shear-wave elastography in breast ultrasonography: the state of the art. Ultrasonography. 2017; 36(4): 300-9. URL: https://doi.org/10.14366/usg.17024
Hanif M, Zaidi P, Kamal S, Hameed S. Institution-based cancer incidence in a local population in Pakistan: nine year data analysis. Asian Pac J Cancer Prev. 2009;10(2):227-30.
Evans A, Whelehan P, Thomson K, Brauer K, Jordan L, Purdie C, et al. Differentiating benign from malignant solid breast masses: value of shear wave elastography according to lesion stiffness combined with grey scale ultrasound according to BI-RADS classification. Br J Cancer. 2012;107(2):224–9.
Evans A, Whelehan P, Thomson K, McLean D, Brauer K, Purdie C, et al. Quantitative shear wave ultrasound elastography: initial experience in solid breast masses. Breast Cancer Res. 2010;12:R104
Giannotti E, Vinnicombe S, Thomson K, McLean D, Purdie C, Jorden L, et al. shear wave elastography and gray scale assessment of palpable probably benign masses: is biopsy always required?. Br J Radiol. 2016; 89: 20150865. URL: https://doi.org/10.1259/bjr.20150865
Imtiaz S. Breast elastography: A new paradigm in diagnostic breast imaging. Appl Radiolo. 2018; 47(3): 14-9.
Itoh A, Ueno E, Tohno E, et al. Breast disease: clinical application of US elastography for diagnosis. Radiology. 2006;239(2):341–350.
Ianculescu V, Ciolovan LM, Dunant A, Vielh P, Mazouni C, Delaloge S et al. Added value of Virtual Touch IQ shear wave elastography in the ultrasound assessment of breast lesion. Eur J Radiol. 2014;83(5): 773-7.
Barr RG, Zhang Z. Shear-Wave Elastography of the Breast: Value of a Quality Measure and Comparison with Strain Elastography. Radiology. 2014; 275(1). URL: https://doi.org/10.1148/radiol.14132404
Tsai WC, Lin CK, Wei HK, Yu BL, Hung CF, Cheng SH, et al. Sonographic elas-tography improves the sensitivity and specificity of axilla sampling in breast cancer: a prospective study. Ultrasound Med Biol. 2013;39(6):941-949.
Yao M, Wu J, Zou L, Xu G, Xie J, Wu R, Xu H. Diagnostic value of Virtual Touch tissue quantification for breast lesions with different size. Biomed Res Int. 2014;2014:142504.
Elkharbotly A, Farouk HM. Ultrasound elastog¬raphy improves differentiation between benign and malignant breast lumps using B-mode ultrasound and color Doppler. Egyptian Journal of Radiology and Nuclear Medicine. 2015. 46;(4):1231–9.
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