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KMID : 1147320170040020048
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Journal of Surgical Ultrasound
2017 Volume.4 No. 2 p.48 ~ p.54
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Diagnostic Usefulness of Shear-wave Elastography for an Evaluation of BI-RADS Category 4a Breast Lesions Detected by US
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Kim Yang-Soo
Park Won-Seo
Min Sun-Young
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Abstract
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Purpose: This study evaluated the diagnostic usefulness of shear wave elastography (SWE) for the differentiation of a Breast Imaging Reporting and Data System (BI-RADS) category 4a lesion.
Methods: Between September 2015 and June 2017, 61 category 4a lesions were evaluated. Conventional ultrasonography, SWE, and core needle biopsy were performed. The B-mode features and assessments were recorded. SWE evaluation (mean, maximum, lesion-to-fat elasticity ratio) was performed. The lesions were classified according to the pathology (benign vs. malignant, non-proliferative vs. proliferative without atypia vs. malignant), and the B-mode features and SWE findings of the classified lesions were analyzed. The receiver operating characteristics (ROC) curves for the SWE findings were analyzed to evaluate the diagnostic utility. The optimal cut-off values for the SWE findings, sensitivity, specificity, positive predictive value, and negative predictive value were calculated.
Results: Six out of 61 (9.8%) lesions were malignant, and the remaining 55 lesions were benign. In the benign lesions, 45.8% were non-proliferative lesions and 44.2% were proliferative without atypia lesions. In the B-mode features, the benign lesions and malignant lesions showed significant difference in the margin status. The elasticity of SWE were E max (66.55 kPa vs. 100.65 kPa), E mean (52.98 kPa vs. 80.91 kPa), and SWE ratio (4.17 vs. 11.77); the SWE ratio showed significant differences. (P ＜ 0.01). The area under the ROC curve was 0.867, which was significant (P = .003), and the cut-off value was 6.15, which showed a sensitivity and specificity of 83.3% and 78.2%, respectively.
Conclusion: Shear-wave elastography is a helpful tool for distinguishing benign lesions from malignant lesions when applied to a BI-RADS category 4a lesions.
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KEYWORD
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Sonoelastography, Ultrasonography, Breast, Diagnosis
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