Clinical Utility of Shear Wave Elastography Patterns for Differentiating between Benign and Malignant Breast Lesions

다국어 초록 (Multilingual Abstract)

Purpose: This retrospective study evaluated the utility of shear wave elastography (SWE), Tozaki’s visual pattern classification, and conventional Breast Imaging Reporting and Data System (BI-RADS) classification for differentiating between benign and malignant lesions. Methods: Between May 2015 and July 2016, 388 patients underwent SWE and B-mode ultrasonography. The BI-RADS system was used to exclude cases with category 1–2 lesions or unbiopsied category 3 lesions. A total of 100 patients with 100 solid breast masses underwent tissue sampling (ultrasonography-guided core biopsy or vacuum-assisted biopsy) or surgical excision. The quantitative elasticity was measured for each lesion, and the imaging and histological findings were compared. Results: The mean age of the patients was 51 years (range, 18–79 years). Histological examination identified 50 malignant lesions and 50 benign lesions. According to the BI-RADS classification, 20 lesions were classified as category 3, 56 as category 4, and 24 as category 5. Based on the Tozaki classification, 39 lesions were classified as pattern 1, seven as pattern 2, 23 as pattern 3, and 31 as pattern 4. If patterns 1 and 2 were assumed to be benign, and patterns 3 and 4 were assumed to be malignant, the combination of BI-RADS and SWE provided a sensitivity of 100% (50/50), a specificity of 92.0% (46/50), a positive predictive value of 92.5% (50/54), and a negative predictive value of 100% (50/50). Conclusion: The combination of SWE and BI-RADS was useful for evaluating breast lesions, improved the specificity of ultrasonography and may help facilitate appropriate treatment planning.

참고문헌 (Reference)

1 Bercoff J, "The role of viscosity in the impulse diffraction field of elastic waves induced by the acoustic radiation force" 51 : 1523-1536, 2004

2 Bercoff J, "Supersonic shear imaging: a new technique for soft tissue elasticity mapping" 51 : 396-409, 2004

3 Berg WA, "Shear-wave elastography improves the specificity of breast US: the BE1 multinational study of 939 masses" 262 : 435-449, 2012

4 Cosgrove DO, "Shear wave elastography for breast masses is highly reproducible" 22 : 1023-1032, 2012

5 Alhabshi SM, "Semi-quantitative and qualitative assessment of breast ultrasound elastography in differentiating between malignant and benign lesions" 39 : 568-578, 2013

6 Tanter M, "Quantitative assessment of breast lesion viscoelasticity: initial clinical results using supersonic shear imaging" 34 : 1373-1386, 2008

7 Tozaki M, "Pattern classification of ShearWaveTM Elastography images for differential diagnosis between benign and malignant solid breast masses" 52 : 1069-1075, 2011

8 Lee S, "Clinical application of a color map pattern on shear-wave elastography for invasive breast cancer" 25 : 44-48, 2016

9 Athanasiou A, "Breast lesions: quantitative elastography with supersonic shear imaging: preliminary results" 256 : 297-303, 2010

10 Zhou J, "Breast lesions: evaluation with shear wave elastography, with special emphasis on the “stiff rim” sign" 272 : 63-72, 2014

11 Sickles E, "ACR BI-RADS® Atlas: Breast Imaging Reporting and Data System"